| 1 | The Health & Families Council recommends the following: |
| 2 |
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| 3 | Council/Committee Substitute |
| 4 | Remove the entire bill and insert: |
| 5 | A bill to be entitled |
| 6 | An act relating to programs of the Department of Children |
| 7 | and Family Services; amending s. 383.0115, F.S.; deleting |
| 8 | a provision that repeals the Commission on Marriage and |
| 9 | Family Support Initiatives; directing the Department of |
| 10 | Children and Family Services to advise the Legislature |
| 11 | when the commission ceases to be essential; amending s. |
| 12 | 397.451, F.S.; requiring service provider personnel who |
| 13 | request an exemption from disqualification to submit the |
| 14 | request within a certain time after notification of the |
| 15 | disqualification; requiring a service provider to comply |
| 16 | with the provisions of s. 435.06, F.S.; deleting a |
| 17 | provision requiring immediate dismissal of service |
| 18 | provider personnel upon disapproval of a request for an |
| 19 | exemption; prohibiting the department from issuing a |
| 20 | regular license to a service provider that fails to |
| 21 | provide proof that background screening information has |
| 22 | been submitted; repealing s. 3, ch. 2003-279, Laws of |
| 23 | Florida; abrogating the repeal of s. 20.19(2)(c) and |
| 24 | (4)(b)6. and 8., F.S., relating to the appointment of |
| 25 | certain mental health and substance abuse positions and |
| 26 | the establishment of program offices for mental health and |
| 27 | substance abuse; amending s. 394.455, F.S.; revising and |
| 28 | providing definitions; amending s. 394.463, F.S.; |
| 29 | providing that a marriage and family therapist may execute |
| 30 | a certificate for involuntary examination; amending s. |
| 31 | 394.4655, F.S.; providing that a mental health counselor |
| 32 | or a marriage and family therapist may deem a services |
| 33 | treatment plan clinically appropriate for an involuntary |
| 34 | outpatient placement; amending s. 394.467, F.S.; requiring |
| 35 | that documentation of any evaluation performed by a mental |
| 36 | health counselor or a marriage and family therapist be |
| 37 | provided when a patient is ordered for involuntary |
| 38 | inpatient placement; providing effective dates. |
| 39 |
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| 40 | Be It Enacted by the Legislature of the State of Florida: |
| 41 |
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| 42 | Section 1. Subsection (6) of section 383.0115, Florida |
| 43 | Statutes, is amended to read: |
| 44 | 383.0115 The Commission on Marriage and Family Support |
| 45 | Initiatives.-- |
| 46 | (6) Pursuant to the requirements in s. 20.052(2), the |
| 47 | department shall advise the Legislature when the commission |
| 48 | ceases to be essential to the furtherance of a public purpose. |
| 49 | This section is repealed on June 30, 2008, unless reviewed and |
| 50 | saved from repeal through reenactment by the Legislature. |
| 51 | Section 2. Paragraph (f) of subsection (1) of section |
| 52 | 397.451, Florida Statutes, is amended, and paragraph (g) is |
| 53 | added to that subsection, to read: |
| 54 | 397.451 Background checks of service provider personnel.-- |
| 55 | (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND |
| 56 | EXCEPTIONS.-- |
| 57 | (f) Service provider personnel who request an exemption |
| 58 | from disqualification must submit the request within 30 days |
| 59 | after being notified of the a pending disqualification. Upon |
| 60 | notification of the disqualification, the service provider shall |
| 61 | comply with the requirements regarding exclusion from employment |
| 62 | under s. 435.06. The employment of service provider personnel |
| 63 | shall not be adversely affected pending disposition of the |
| 64 | request for an exemption. Disapproval of a request for an |
| 65 | exemption shall result in the immediate dismissal of the service |
| 66 | provider personnel from employment with the provider. |
| 67 | (g) The department may not issue a regular license to any |
| 68 | service provider that fails to provide proof that background |
| 69 | screening information has been submitted in accordance with |
| 70 | chapter 435. |
| 71 | Section 3. Section 3 of chapter 2003-279, Laws of Florida, |
| 72 | is repealed. |
| 73 | Section 4. Effective July 1, 2006, subsection (31) of |
| 74 | section 394.455, Florida Statutes, is amended, and subsections |
| 75 | (34) and (35) are added to that section, to read: |
| 76 | 394.455 Definitions.--As used in this part, unless the |
| 77 | context clearly requires otherwise, the term: |
| 78 | (31) "Service provider" means any public or private |
| 79 | receiving facility, an entity under contract with the Department |
| 80 | of Children and Family Services to provide mental health |
| 81 | services, a clinical psychologist, a clinical social worker, a |
| 82 | mental health counselor, a marriage and family therapist, a |
| 83 | physician, a psychiatric nurse as defined in subsection (23), or |
| 84 | a community mental health center or clinic as defined in this |
| 85 | part. |
| 86 | (34) "Marriage and family therapist" means a person |
| 87 | licensed as a marriage and family therapist under chapter 491. |
| 88 | (35) "Mental health counselor" means a person licensed as |
| 89 | a mental health counselor under chapter 491. |
| 90 | Section 5. Effective July 1, 2006, paragraph (a) of |
| 91 | subsection (2) of section 394.463, Florida Statutes, is amended |
| 92 | to read: |
| 93 | 394.463 Involuntary examination.-- |
| 94 | (2) INVOLUNTARY EXAMINATION.-- |
| 95 | (a) An involuntary examination may be initiated by any one |
| 96 | of the following means: |
| 97 | 1. A court may enter an ex parte order stating that a |
| 98 | person appears to meet the criteria for involuntary examination, |
| 99 | giving the findings on which that conclusion is based. The ex |
| 100 | parte order for involuntary examination must be based on sworn |
| 101 | testimony, written or oral. If other less restrictive means are |
| 102 | not available, such as voluntary appearance for outpatient |
| 103 | evaluation, a law enforcement officer, or other designated agent |
| 104 | of the court, shall take the person into custody and deliver him |
| 105 | or her to the nearest receiving facility for involuntary |
| 106 | examination. The order of the court shall be made a part of the |
| 107 | patient's clinical record. No fee shall be charged for the |
| 108 | filing of an order under this subsection. Any receiving facility |
| 109 | accepting the patient based on this order must send a copy of |
| 110 | the order to the Agency for Health Care Administration on the |
| 111 | next working day. The order shall be valid only until executed |
| 112 | or, if not executed, for the period specified in the order |
| 113 | itself. If no time limit is specified in the order, the order |
| 114 | shall be valid for 7 days after the date that the order was |
| 115 | signed. |
| 116 | 2. A law enforcement officer shall take a person who |
| 117 | appears to meet the criteria for involuntary examination into |
| 118 | custody and deliver the person or have him or her delivered to |
| 119 | the nearest receiving facility for examination. The officer |
| 120 | shall execute a written report detailing the circumstances under |
| 121 | which the person was taken into custody, and the report shall be |
| 122 | made a part of the patient's clinical record. Any receiving |
| 123 | facility accepting the patient based on this report must send a |
| 124 | copy of the report to the Agency for Health Care Administration |
| 125 | on the next working day. |
| 126 | 3. A physician, clinical psychologist, psychiatric nurse, |
| 127 | mental health counselor, marriage and family therapist, or |
| 128 | clinical social worker may execute a certificate stating that he |
| 129 | or she has examined a person within the preceding 48 hours and |
| 130 | finds that the person appears to meet the criteria for |
| 131 | involuntary examination and stating the observations upon which |
| 132 | that conclusion is based. If other less restrictive means are |
| 133 | not available, such as voluntary appearance for outpatient |
| 134 | evaluation, a law enforcement officer shall take the person |
| 135 | named in the certificate into custody and deliver him or her to |
| 136 | the nearest receiving facility for involuntary examination. The |
| 137 | law enforcement officer shall execute a written report detailing |
| 138 | the circumstances under which the person was taken into custody. |
| 139 | The report and certificate shall be made a part of the patient's |
| 140 | clinical record. Any receiving facility accepting the patient |
| 141 | based on this certificate must send a copy of the certificate to |
| 142 | the Agency for Health Care Administration on the next working |
| 143 | day. |
| 144 | Section 6. Effective July 1, 2006, paragraphs (a) and (c) |
| 145 | of subsection (2) of section 394.4655, Florida Statutes, are |
| 146 | amended to read: |
| 147 | 394.4655 Involuntary outpatient placement.-- |
| 148 | (2) INVOLUNTARY OUTPATIENT PLACEMENT.-- |
| 149 | (a)1. A patient may be retained by a receiving facility |
| 150 | upon the recommendation of the administrator of a receiving |
| 151 | facility where the patient has been examined and after adherence |
| 152 | to the notice of hearing procedures provided in s. 394.4599. The |
| 153 | recommendation must be supported by the opinion of a |
| 154 | psychiatrist and the second opinion of a clinical psychologist |
| 155 | or another psychiatrist, both of whom have personally examined |
| 156 | the patient within the preceding 72 hours, that the criteria for |
| 157 | involuntary outpatient placement are met. However, in a county |
| 158 | having a population of fewer than 50,000, if the administrator |
| 159 | certifies that no psychiatrist or clinical psychologist is |
| 160 | available to provide the second opinion, the second opinion may |
| 161 | be provided by a licensed physician who has postgraduate |
| 162 | training and experience in diagnosis and treatment of mental and |
| 163 | nervous disorders or by a psychiatric nurse as defined in this |
| 164 | chapter. Such a recommendation must be entered on an involuntary |
| 165 | outpatient placement certificate, which certificate must |
| 166 | authorize the receiving facility to retain the patient pending |
| 167 | completion of a hearing. The certificate shall be made a part of |
| 168 | the patient's clinical record. |
| 169 | 2. If the patient has been stabilized and no longer meets |
| 170 | the criteria for involuntary examination pursuant to s. |
| 171 | 394.463(1), the patient must be released from the receiving |
| 172 | facility while awaiting the hearing for involuntary outpatient |
| 173 | placement. Prior to filing a petition for involuntary outpatient |
| 174 | treatment, the administrator of a receiving facility or a |
| 175 | designated department representative shall identify the service |
| 176 | provider that will have primary responsibility for service |
| 177 | provision under an order for involuntary outpatient placement, |
| 178 | unless the person is otherwise participating in outpatient |
| 179 | psychiatric treatment and is not in need of public financing for |
| 180 | that treatment, in which case the individual, if eligible, may |
| 181 | be ordered to involuntary treatment pursuant to the existing |
| 182 | psychiatric treatment relationship. |
| 183 | 3. The service provider shall prepare a written proposed |
| 184 | treatment plan in consultation with the patient or the patient's |
| 185 | guardian advocate, if appointed, for the court's consideration |
| 186 | for inclusion in the involuntary outpatient placement order. The |
| 187 | service provider shall also provide a copy of the proposed |
| 188 | treatment plan to the patient and the administrator of the |
| 189 | receiving facility. The treatment plan must specify the nature |
| 190 | and extent of the patient's mental illness. The treatment plan |
| 191 | must address the reduction of symptoms that necessitate |
| 192 | involuntary outpatient placement and include measurable goals |
| 193 | and objectives for the services and treatment that are provided |
| 194 | to treat the person's mental illness and to assist the person in |
| 195 | living and functioning in the community or to attempt to prevent |
| 196 | a relapse or deterioration. Service providers may select and |
| 197 | provide supervision to other individuals to implement specific |
| 198 | aspects of the treatment plan. The services in the treatment |
| 199 | plan must be deemed to be clinically appropriate by a physician, |
| 200 | clinical psychologist, psychiatric nurse, mental health |
| 201 | counselor, marriage and family therapist, or clinical social |
| 202 | worker, as defined in this chapter, who consults with, or is |
| 203 | employed or contracted by, the service provider. The service |
| 204 | provider must certify to the court in the proposed treatment |
| 205 | plan whether sufficient services for improvement and |
| 206 | stabilization are currently available and whether the service |
| 207 | provider agrees to provide those services. If the service |
| 208 | provider certifies that the services in the proposed treatment |
| 209 | plan are not available, the petitioner may not file the |
| 210 | petition. |
| 211 | (c)1. The administrator of the treatment facility shall |
| 212 | provide a copy of the involuntary outpatient placement |
| 213 | certificate and a copy of the state mental health discharge form |
| 214 | to a department representative in the county where the patient |
| 215 | will be residing. For persons who are leaving a state mental |
| 216 | health treatment facility, the petition for involuntary |
| 217 | outpatient placement must be filed in the county where the |
| 218 | patient will be residing. |
| 219 | 2. The service provider that will have primary |
| 220 | responsibility for service provision shall be identified by the |
| 221 | designated department representative prior to the order for |
| 222 | involuntary outpatient placement and must, prior to filing a |
| 223 | petition for involuntary outpatient placement, certify to the |
| 224 | court whether the services recommended in the patient's |
| 225 | discharge plan are available in the local community and whether |
| 226 | the service provider agrees to provide those services. The |
| 227 | service provider must develop with the patient, or the patient's |
| 228 | guardian advocate, if appointed, a treatment or service plan |
| 229 | that addresses the needs identified in the discharge plan. The |
| 230 | plan must be deemed to be clinically appropriate by a physician, |
| 231 | clinical psychologist, psychiatric nurse, mental health |
| 232 | counselor, marriage and family therapist, or clinical social |
| 233 | worker, as defined in this chapter, who consults with, or is |
| 234 | employed or contracted by, the service provider. |
| 235 | 3. If the service provider certifies that the services in |
| 236 | the proposed treatment or service plan are not available, the |
| 237 | petitioner may not file the petition. |
| 238 | Section 7. Effective July 1, 2006, paragraph (e) of |
| 239 | subsection (6) of section 394.467, Florida Statutes, is amended |
| 240 | to read: |
| 241 | 394.467 Involuntary inpatient placement.-- |
| 242 | (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.-- |
| 243 | (e) The administrator of the receiving facility shall |
| 244 | provide a copy of the court order and adequate documentation of |
| 245 | a patient's mental illness to the administrator of a treatment |
| 246 | facility whenever a patient is ordered for involuntary inpatient |
| 247 | placement, whether by civil or criminal court. The Such |
| 248 | documentation shall include any advance directives made by the |
| 249 | patient, a psychiatric evaluation of the patient, and any |
| 250 | evaluations of the patient performed by a clinical psychologist, |
| 251 | a mental health counselor, a marriage and family therapist, or a |
| 252 | clinical social worker. The administrator of a treatment |
| 253 | facility may refuse admission to any patient directed to its |
| 254 | facilities on an involuntary basis, whether by civil or criminal |
| 255 | court order, who is not accompanied at the same time by adequate |
| 256 | orders and documentation. |
| 257 | Section 8. Except as otherwise expressly provided in this |
| 258 | act, this act shall take effect upon becoming a law. |