Florida Senate - 2009 SB 2194
By Senator Garcia
40-01633A-09 20092194__
1 A bill to be entitled
2 An act relating to mental health; revising part I of
3 ch. 394, F,S., relating to the Florida Mental Health
4 Act, to substitute the term “individual” for the terms
5 “person,” “patient,” or “client”; amending s. 394.453,
6 F.S.; conforming terms; amending s. 394.455, F.S.;
7 redefining terms, defining new terms, and deleting
8 terms; amending s. 394.457, F.S.; conforming terms;
9 amending s. 394.4572, F.S.; conforming terms; deleting
10 certain background screening requirements and
11 exemptions for certain mental health professionals;
12 amending s. 394.4573, F.S.; conforming terms; deleting
13 a report requirement relating to the implementation of
14 staffing standards in state treatment facilities;
15 amending ss. 394.4574 and 394.458, F.S.; conforming
16 terms; amending s. 394.459, F.S.; conforming terms;
17 requiring physical examinations and psychiatric
18 evaluations to be documented in the clinical record;
19 requiring facilities to provide procedures for
20 reporting events that place individuals receiving
21 services at risk of harm; requiring facilities to
22 provide information and assist individuals with
23 advance directives; amending ss. 394.4593 and
24 394.4595, F.S.; conforming terms; amending s.
25 394.4597, F.S.; conforming terms; specifying the
26 rights, authority, and responsibilities of a
27 representative; amending s. 394.4598, F.S.; conforming
28 terms; requiring a guardian advocate to make every
29 effort to make the decision the individual would have
30 made; amending s. 394.4599, F.S.; conforming terms;
31 repealing s. 394.460, F.S., relating to the rights of
32 professionals; amending s. 394.461, F.S.; conforming
33 terms; specifying that only governmental facilities
34 may serve as receiving and treatment facilities;
35 creating s. 394.4611, F.S.; providing for integrated
36 adult mental health crisis stabilization unit and
37 addictions receiving facility services; authorizing
38 licensure by the Agency for Health Care
39 Administration; specifying who may receive services;
40 requiring the Department of Children and Family
41 Services to adopt rules; amending s. 394.4615, F.S.;
42 conforming terms; amending s. 394.462, F.S.;
43 conforming terms; providing that a law enforcement
44 officer acting in good faith may not be held liable
45 for false imprisonment; amending s. 394.4625, F.S.;
46 conforming terms; requiring a minor’s assent to
47 voluntary admission; requiring an individual who has
48 been voluntarily admitted and charged with a crime to
49 be returned to the custody of a law enforcement agency
50 after discharge; amending s. 394.463, F.S.; conforming
51 terms; requiring an ex parte order for involuntary
52 examination to be based on specific facts and have
53 occurred within the last 14 days; specifying
54 requirements for certificates for involuntary
55 examination executed by examining professionals;
56 providing notification requirements to guardians of
57 minors who are involuntarily examined; revising the
58 procedures for holding a person for involuntary
59 examination and for emergency situations; amending s.
60 394.4655, F.S.; conforming terms; amending s. 394.467,
61 F.S.; conforming terms; requiring a facility to send a
62 copy of the petition for involuntary inpatient
63 placement to the Agency for Health Care
64 Administration; requiring an attorney representing an
65 individual in involuntary placement to represent the
66 individual’s expressed desires; requiring the state
67 attorney to participate in all hearings on involuntary
68 placement; prohibiting continuance requests from
69 parties other than the individual; requiring the court
70 to also conduct a hearing on capacity to consent to
71 treatment; providing for the appointment of a guardian
72 advocate if an individual is found incompetent;
73 requiring the court to allow certain testimony at
74 hearings on involuntary placement; requiring the
75 Division of Administrative Hearings to inform an
76 individual of his or her right to an independent
77 expert examination; amending ss. 394.46715 and
78 394.4672, F.S.; conforming terms; repealing s.
79 394.4674, F.S., relating to a plan and report on the
80 deinstitutionalization of patients in treatment
81 facilities; amending s. 394.4685, F.S.; conforming
82 terms; authorizing a public facility to request the
83 transfer of an individual to a private facility;
84 amending s. 394.469, F.S.; conforming terms; requiring
85 a discharged individual who is charged with a crime to
86 be returned to the custody of a law enforcement
87 agency; amending ss. 394.473, 394.475, 394.4785,
88 394.4786, 394.47865, 394.4787, 394.4788, and 394.4789,
89 F.S.; conforming terms; amending ss. 39.407, 394.495,
90 394.496, 394.9085, 419.001, and 744.704, F.S.;
91 conforming cross-references; providing an effective
92 date.
93
94 Be It Enacted by the Legislature of the State of Florida:
95
96 Section 1. Section 394.453, Florida Statutes, is amended to
97 read:
98 394.453 Legislative intent.—It is the intent of the
99 Legislature to authorize and direct the Department of Children
100 and Family Services to evaluate, research, plan, and recommend
101 to the Governor and the Legislature programs designed to reduce
102 the occurrence, severity, duration, and disabling aspects of
103 mental, emotional, and behavioral disorders. It is the intent of
104 the Legislature that treatment programs for such disorders shall
105 include, but not be limited to, comprehensive health, social,
106 educational, and rehabilitative services for individuals to
107 persons requiring intensive short-term and continued treatment
108 in order to encourage them to assume responsibility for their
109 treatment and recovery. It is intended that such individuals
110 persons be provided with emergency service and temporary
111 detention for evaluation if when required; that they be admitted
112 to treatment facilities on a voluntary basis if when extended or
113 continuing care is needed and unavailable in the community; that
114 involuntary placement be provided only if when expert evaluation
115 determines that it is necessary; that any involuntary treatment
116 or examination be accomplished in a setting that which is
117 clinically appropriate and most likely to facilitate the
118 individual’s person's return to the community as soon as
119 possible; and that individual dignity and human rights be
120 guaranteed to all individuals persons who are admitted to mental
121 health facilities or who are being held under s. 394.463. It is
122 the further intent of the Legislature that the least restrictive
123 means of intervention be employed based on the individual’s
124 individual needs of each person, within the scope of available
125 services. It is the policy of this state that the use of
126 restraint and seclusion on clients is justified only as an
127 emergency safety measure to be used in response to imminent
128 danger to the individual client or others. It is, therefore, the
129 intent of the Legislature to achieve an ongoing reduction in the
130 use of restraint and seclusion in programs and facilities
131 serving individuals who have persons with mental illness.
132 Section 2. Section 394.455, Florida Statutes, is amended to
133 read:
134 394.455 Definitions.—As used in this part, unless the
135 context clearly requires otherwise, the term:
136 (1) “Administrator” means the chief administrative officer
137 of a receiving or treatment facility or his or her designee.
138 (2) “Advance directive” has the same meaning as in s.
139 765.101.
140 (3)(2) “Clinical psychologist” means a psychologist as
141 defined in s. 490.003 490.003(7) with 3 years of postdoctoral
142 experience in the practice of clinical psychology, inclusive of
143 the experience required for licensure, or a psychologist
144 employed by a facility operated by the United States Department
145 of Veterans Affairs or the United States Department of Defense
146 that qualifies as a receiving or treatment facility under this
147 part.
148 (4)(3) “Clinical record” means all parts of the record
149 required to be maintained and includes all medical records,
150 progress notes, charts, and admission and discharge data, and
151 all other information recorded by a facility staff which
152 pertains to an individual’s the patient's hospitalization or
153 treatment.
154 (5)(4) “Clinical social worker” has the same meaning as
155 provided in s. 491.003 means a person licensed as a clinical
156 social worker under chapter 491.
157 (6)(5) “Community facility” means a any community service
158 provider contracting with the department to furnish substance
159 abuse or mental health services under part IV of this chapter.
160 (7)(6) “Community mental health center or clinic” means a
161 publicly funded, not-for-profit center that which contracts with
162 the department for the provision of inpatient, outpatient, day
163 treatment, or emergency services.
164 (8)(7) “Court,” unless otherwise specified, means the
165 circuit court.
166 (9)(8) “Department” means the Department of Children and
167 Family Services.
168 (10)(9) “Express and informed consent” means consent
169 voluntarily given in writing, by a competent individual person,
170 after sufficient explanation and disclosure of the subject
171 matter involved to enable the individual person to make a
172 knowing and willful decision without any element of force,
173 fraud, deceit, duress, or other form of constraint or coercion.
174 (11)(10) “Facility” means a any hospital, community
175 facility, public or private facility, or receiving or treatment
176 facility providing for the evaluation, diagnosis, care,
177 treatment, training, or hospitalization of individuals persons
178 who appear to have a mental illness or who have been diagnosed
179 as having a mental illness. The term “Facility” does not include
180 a any program or entity licensed under pursuant to chapter 400
181 or chapter 429.
182 (12) ”Government facility” means a facility owned,
183 operated, directly supported, or administered by the Department
184 of Corrections or the United States Department of Veterans
185 Affairs.
186 (13)(11) “Guardian” means the natural guardian of a minor,
187 or a person appointed by a court to act on behalf of a ward's
188 person if the ward is a minor or has been adjudicated
189 incapacitated.
190 (14)(12) “Guardian advocate” means a person appointed by a
191 court to make decisions regarding mental health treatment on
192 behalf of an individual a patient who has been found incompetent
193 to consent to treatment pursuant to this part. The guardian
194 advocate may be granted specific additional powers by written
195 order of the court, as provided in this part.
196 (15)(13) “Hospital” means a hospital facility as defined in
197 s. 395.002 and licensed under chapter 395 and part II of chapter
198 408.
199 (16)(14) “Incapacitated” means that an individual a person
200 has been adjudicated incapacitated pursuant to part V of chapter
201 744 and a guardian of the person has been appointed.
202 (17)(15) “Incompetent to consent to treatment” means that
203 an individual's a person's judgment is so affected by his or her
204 mental illness that he or she the person lacks the capacity to
205 make a well-reasoned, willful, and knowing decision concerning
206 his or her medical or mental health treatment.
207 (18) “Involuntary examination” means an examination
208 performed under s. 394.463 to determine if an individual
209 qualifies for involuntary inpatient treatment under s. 394.467
210 or involuntary outpatient treatment under s. 394.4655.
211 (19) “Involuntary placement” means involuntary outpatient
212 treatment pursuant to s. 394.4655 or involuntary inpatient
213 treatment pursuant to s. 394.467.
214 (20)(16) “Law enforcement officer” has the same meaning as
215 provided means a law enforcement officer as defined in s.
216 943.10.
217 (21) “Marriage and family therapist” has the same meaning
218 as provided in s. 491.003.
219 (22) “Mental health counselor” has the same meaning as
220 provided in s. 491.003.
221 (23)(17) “Mental health overlay program” means a mobile
222 service that which provides an independent examination for
223 voluntary admission admissions and a range of supplemental
224 onsite services to an individual who has persons with a mental
225 illness in a residential setting such as a nursing home,
226 assisted living facility, adult family-care home, or a
227 nonresidential setting such as an adult day care center.
228 Independent examinations provided pursuant to this part through
229 a mental health overlay program must only be provided only under
230 contract with the department for this service or be attached to
231 a public receiving facility that is also a community mental
232 health center.
233 (24)(18) “Mental illness” means an impairment of the mental
234 or emotional processes that exercise conscious control of one's
235 actions or of the ability to perceive or understand reality,
236 which impairment substantially interferes with the a person's
237 ability to meet the ordinary demands of living, regardless of
238 etiology. For the purposes of this part, the term does not
239 include a retardation or developmental disability as defined in
240 chapter 393, intoxication, brain injury, dementia, or conditions
241 manifested only by antisocial behavior or substance abuse
242 impairment.
243 (25)(19) “Mobile crisis response service” means a
244 nonresidential crisis service attached to a public receiving
245 facility and available 24 hours a day, 7 days a week, through
246 which provides immediate intensive assessments and
247 interventions, including screening for admission into a
248 receiving facility, take place for the purpose of identifying
249 appropriate treatment services.
250 (20) “Patient” means any person who is held or accepted for
251 mental health treatment.
252 (26)(21) “Physician” means a medical practitioner licensed
253 under chapter 458 or chapter 459 who has experience in the
254 diagnosis and treatment of mental and nervous disorders or a
255 physician employed by a facility operated by the United States
256 Department of Veterans Affairs or the United States Department
257 of Defense which qualifies as a receiving or treatment facility
258 under this part.
259 (27) “Physician assistant” means a person licensed as a
260 physician assistant under chapter 458 or chapter 459.
261 (28)(22) “Private facility” means any hospital or facility
262 operated by a for-profit or not-for-profit corporation or
263 association that provides mental health services and is not a
264 public facility.
265 (29)(23) “Psychiatric nurse” means an advanced a registered
266 nurse practitioner licensed under part I of chapter 464 who has
267 a national advanced practice certification from an approved
268 nursing specialty board and a collaborative practice agreement
269 with a psychiatrist on file with the Board of Nursing master's
270 degree or a doctorate in psychiatric nursing and 2 years of
271 post-master's clinical experience under the supervision of a
272 physician.
273 (30)(24) “Psychiatrist” means a medical practitioner
274 licensed under chapter 458 or chapter 459 who has primarily
275 diagnosed and treated mental and nervous disorders for a period
276 of not less than 3 years, inclusive of psychiatric residency.
277 (31)(25) “Public facility” means any facility that has
278 contracted with the department to provide mental health services
279 to all individuals persons, regardless of their ability to pay,
280 and is receiving state funds for such purpose.
281 (32)(26) “Receiving facility” means any public or private
282 facility expressly designated by the department to receive and
283 hold individuals involuntarily involuntary patients under
284 emergency conditions or for psychiatric evaluation and to
285 provide short-term treatment. The term does not include a county
286 jail.
287 (33)(27) “Representative” means a person selected pursuant
288 to s. 394.4597(2) to receive notice of proceedings during the
289 time a patient is held in or admitted to a receiving or
290 treatment facility.
291 (34)(28)(a) “Restraint” means a physical device, method, or
292 drug used to control behavior.
293 (a) A physical restraint is any manual method or physical
294 or mechanical device, material, or equipment attached or
295 adjacent to an the individual's body so that he or she cannot
296 easily remove the restraint and which restricts freedom of
297 movement or normal access to one's body.
298 (b) A drug used as a restraint is a medication used to
299 control an individual’s the person's behavior or to restrict his
300 or her freedom of movement and is not part of the standard
301 treatment regimen for an individual having of a person with a
302 diagnosed mental illness who is a client of the department.
303 Physically holding an individual a person during a procedure to
304 forcibly administer psychotropic medication is a physical
305 restraint.
306 (c) Restraint does not include physical devices, such as
307 orthopedically prescribed appliances, surgical dressings and
308 bandages, supportive body bands, or other physical holding when
309 necessary for routine physical examinations and tests; or for
310 purposes of orthopedic, surgical, or other similar medical
311 treatment; when used to provide support for the achievement of
312 functional body position or proper balance; or when used to
313 protect an individual a person from falling out of bed.
314 (35)(29) “Seclusion” means the physical segregation of a
315 person in any fashion or involuntary isolation of an individual
316 a person in a room or area from which the individual person is
317 prevented from leaving. The prevention may be by physical
318 barrier or by a staff member who is acting in a manner, or who
319 is physically situated, so as to prevent the individual person
320 from leaving the room or area. For purposes of this chapter, the
321 term does not mean isolation due to a person's medical condition
322 or symptoms.
323 (36)(30) “Secretary” means the Secretary of Children and
324 Family Services.
325 (37) “Service provider” means a public or private receiving
326 facility, an entity under contract with the department to
327 provide mental health services, a community mental health center
328 or clinic, a clinical psychologist, a clinical social worker, a
329 marriage and family therapist, a mental health counselor, a
330 physician, or a psychiatric nurse.
331 (38)(31) “Transfer evaluation” means the process, as
332 approved by the appropriate district office of the department,
333 during which an individual whereby a person who is being
334 considered for placement in a state treatment facility is first
335 evaluated for appropriateness of admission to a state treatment
336 the facility by a community-based public receiving facility or
337 by a community mental health center or clinic if the public
338 receiving facility is not a community mental health center or
339 clinic.
340 (39)(32) “Treatment facility” means a any state-owned,
341 state-operated, or state-supported hospital, or a community
342 mental health center, or clinic, designated by the department
343 for extended treatment and hospitalization of individuals who
344 have a mental illness, beyond that provided for by a receiving
345 facility or a, of persons who have a mental illness, including
346 facilities of the United States Government, and any private
347 facility designated by the department when rendering such
348 services to a person pursuant to the provisions of this part.
349 Patients treated in facilities of the United States Government
350 shall be solely those whose care is the responsibility of the
351 United States Department of Veterans Affairs.
352 (33) “Service provider” means any public or private
353 receiving facility, an entity under contract with the department
354 of Children and Family Services to provide mental health
355 services, a clinical psychologist, a clinical social worker, a
356 marriage and family therapist, a mental health counselor, a
357 physician, a psychiatric nurse as defined in subsection (23), or
358 a community mental health center or clinic as defined in this
359 part.
360 (34) “Involuntary examination” means an examination
361 performed under s. 394.463 to determine if an individual
362 qualifies for involuntary inpatient treatment under s.
363 394.467(1) or involuntary outpatient treatment under s.
364 394.4655(1).
365 (35) “Involuntary placement” means either involuntary
366 outpatient treatment pursuant to s. 394.4655 or involuntary
367 inpatient treatment pursuant to s. 394.467.
368 (36) “Marriage and family therapist” means a person
369 licensed as a marriage and family therapist under chapter 491.
370 (37) “Mental health counselor” means a person licensed as a
371 mental health counselor under chapter 491.
372 Section 3. Section 394.457, Florida Statutes, is amended to
373 read:
374 394.457 Operation and administration.—
375 (1) ADMINISTRATION.—The Department of Children and Family
376 Services is designated the “Mental Health Authority” of Florida.
377 The department and the Agency for Health Care Administration
378 shall exercise executive and administrative supervision over all
379 mental health facilities, programs, and services.
380 (2) RESPONSIBILITIES OF THE DEPARTMENT.—The department is
381 responsible for:
382 (a) The planning, evaluation, and implementation of a
383 complete and comprehensive statewide program of mental health,
384 including community services, receiving and treatment
385 facilities, child services, research, and training as authorized
386 and approved by the Legislature, based on the annual program
387 budget of the department. The department is also responsible for
388 the coordination of efforts with other departments and divisions
389 of the state government, county and municipal governments, and
390 private agencies concerned with and providing mental health
391 services. It is responsible for establishing standards,
392 providing technical assistance, and supervising exercising
393 supervision of mental health programs of, and the treatment of
394 individuals patients at, community facilities, other facilities
395 serving individuals for persons who have a mental illness, and
396 any agency or facility providing services under to patients
397 pursuant to this part.
398 (b) The publication and distribution of an information
399 handbook to facilitate the understanding of this part, the
400 policies and procedures involved in the implementation of this
401 part, and the responsibilities of the various service providers
402 of services under this part. The department It shall stimulate
403 research by public and private agencies, institutions of higher
404 learning, and hospitals in the interest of the elimination and
405 amelioration of mental illness.
406 (3) POWER TO CONTRACT.—The department may contract to
407 provide, and be provided with, services and facilities in order
408 to carry out its responsibilities under this part with respect
409 to the following agencies: public and private hospitals;
410 receiving and treatment facilities; clinics; laboratories;
411 departments, divisions, and other units of state government; the
412 state colleges and universities; the community colleges; private
413 colleges and universities; counties, municipalities, and any
414 other political subdivisions governmental unit, including
415 facilities of the United States Government; and any other public
416 or private entity that which provides or needs facilities or
417 services. Baker Act funds for community inpatient, crisis
418 stabilization, short-term residential treatment, and screening
419 services under this part must be allocated to each county
420 pursuant to the department's funding allocation methodology.
421 Notwithstanding the provisions of s. 287.057(5)(f), contracts
422 for community-based Baker Act services for inpatient, crisis
423 stabilization, short-term residential treatment, and screening
424 provided under this part, other than those with other units of
425 government, to be provided for the department must be awarded
426 using competitive solicitation if sealed bids when the county
427 commission of the county receiving the services makes a request
428 to the department's circuit district office by January 15 of the
429 contracting year. The office may district shall not enter into a
430 competitively bid contract under this provision if such action
431 will result in increases of state or local expenditures for
432 Baker Act services within the circuit district. Contracts for
433 these Baker Act services using competitive solicitation are
434 sealed bids will be effective for 3 years. The department shall
435 adopt rules establishing minimum standards for such contracted
436 services and facilities and shall make periodic audits and
437 inspections to assure that the contracted services are provided
438 and meet the standards of the department.
439 (4) APPLICATION FOR AND ACCEPTANCE OF GIFTS AND GRANTS.—The
440 department may apply for and accept any funds, grants, gifts, or
441 services made available to it by any agency or department of the
442 Federal Government or any other public or private agency or
443 person individual in aid of mental health programs. All such
444 moneys must shall be deposited in the State Treasury and shall
445 be disbursed as provided by law.
446 (5) RULES.—The department shall adopt rules:
447 (a) The department shall adopt rules Establishing forms and
448 procedures relating to the rights and privileges of individuals
449 patients seeking mental health treatment from facilities under
450 this part.
451 (b) The department shall adopt rules Necessary for the
452 implementation and administration of the provisions of this
453 part., and A program subject to the provisions of this part may
454 shall not be permitted to operate unless rules designed to
455 ensure the protection of the health, safety, and welfare of the
456 individuals patients treated under through such program have
457 been adopted. Such rules adopted under this subsection must
458 include provisions governing the use of restraint and seclusion
459 which are consistent with recognized best practices and
460 professional judgment; prohibit inherently dangerous restraint
461 or seclusion procedures; establish limitations on the use and
462 duration of restraint and seclusion; establish measures to
463 ensure the safety of program participants and staff during an
464 incident of restraint or seclusion; establish procedures for
465 staff to follow before, during, and after incidents of restraint
466 or seclusion; establish professional qualifications of and
467 training for staff who may order or be engaged in the use of
468 restraint or seclusion; and establish mandatory reporting, data
469 collection, and data dissemination procedures and requirements.
470 Such rules adopted under this subsection must require that each
471 instance of the use of restraint or seclusion be documented in
472 the clinical record of the individual who has been restrained or
473 secluded patient.
474 (c) The department shall adopt rules Establishing minimum
475 standards for services provided by a mental health overlay
476 program or a mobile crisis response service.
477 (6) PERSONNEL.—
478 (a) The department shall, by rule, establish minimum
479 standards of education and experience for professional and
480 technical personnel employed in mental health programs,
481 including members of a mobile crisis response service.
482 (b) The department shall design and distribute appropriate
483 materials for the orientation and training of persons actively
484 engaged in implementing the provisions of this part relating to
485 the involuntary examination and placement of individuals persons
486 who are believed to have a mental illness.
487 (7) PAYMENT FOR CARE OF PATIENTS.—Fees and fee collections
488 for individuals receiving treatment or services patients in
489 state-owned, state-operated, or state-supported treatment
490 facilities must shall be in accordance with according to s.
491 402.33.
492 Section 4. Section 394.4572, Florida Statutes, is amended
493 to read:
494 394.4572 Screening of mental health personnel.—
495 (1)(a) The department and the Agency for Health Care
496 Administration shall require employment screening for mental
497 health personnel using the standards for level 2 screening
498 standards provided in s. 435.04 set forth in chapter 435.
499 “Mental health personnel” includes all program directors,
500 professional clinicians, staff members, and volunteers working
501 in public or private mental health programs and facilities who
502 have direct contact with individuals held for examination or
503 admitted for mental health treatment unmarried patients under
504 the age of 18 years. For purposes of this chapter, employment
505 screening of mental health personnel shall also include, but is
506 not limited to, employment screening as provided under chapter
507 435.
508 (a)(b) Students in the health care professions who are
509 interning in a mental health facility licensed under chapter
510 395, where the primary purpose of the facility is not the
511 treatment of minors, are exempt from the fingerprinting and
512 screening requirements if, provided they are under direct
513 supervision in the actual physical presence of a licensed health
514 care professional.
515 (c) Mental health personnel working in a facility licensed
516 under chapter 395 who have less than 15 hours per week of direct
517 contact with patients or who are health care professionals
518 licensed by the Agency for Health Care Administration or a board
519 thereunder are exempt from the fingerprinting and screening
520 requirements, except for persons working in mental health
521 facilities where the primary purpose of the facility is the
522 treatment of minors.
523 (b)(d) A volunteer who assists on an intermittent basis for
524 less than 40 hours per month is exempt from the fingerprinting
525 and screening requirements if, provided the volunteer is under
526 direct and constant supervision by persons who meet the
527 screening requirements of this section paragraph (a).
528 (2) The department or the Agency for Health Care
529 Administration may grant exemptions from disqualification as
530 provided in s. 435.07 435.06.
531 (3) Prospective mental health personnel who have previously
532 been fingerprinted or screened pursuant to this chapter, chapter
533 393, chapter 397, chapter 402, or chapter 409, or teachers who
534 have been fingerprinted pursuant to chapter 1012, who have not
535 been unemployed for more than 90 days thereafter, and who under
536 the penalty of perjury attest to the completion of such
537 fingerprinting or screening and to compliance with the
538 provisions of this section and the standards for level 1
539 screening under contained in chapter 435, are shall not be
540 required to be refingerprinted or rescreened in order to comply
541 with the any screening requirements of this part.
542 Section 5. Section 394.4573, Florida Statutes, is amended
543 to read:
544 394.4573 Continuity of care management system; measures of
545 performance; reports.—
546 (1) For the purposes of this section:
547 (a) “Case management” means those activities aimed at
548 assessing the client needs, planning services, linking the
549 service system to a client, coordinating the various system
550 components, monitoring service delivery, and evaluating the
551 effect of service delivery for individuals eligible for publicly
552 funded mental health services.
553 (b) “Case manager” means a person an individual who works
554 with individuals who are eligible for publicly funded mental
555 health services clients, and their families and significant
556 others, to provide case management.
557 (c) “Client manager” means an employee of the department
558 who is assigned to specific provider agencies and geographic
559 areas to ensure that the full range of needed services is
560 available to individuals who are eligible for publicly funded
561 mental health services clients.
562 (d) “Continuity of care management system” means a system
563 that assures, within available resources, that individuals who
564 are eligible for publicly funded mental health services clients
565 have access to the full array of services within the mental
566 health services delivery system.
567 (2) The department shall is directed to implement a
568 continuity of care management system for the provision of mental
569 health care, through the provision of client and case
570 management, including individuals clients referred from state
571 treatment facilities to community mental health facilities. Such
572 system must shall include a statewide network of client managers
573 and case managers throughout the state designed to:
574 (a) Reduce the possibility of an individual’s a client's
575 admission or readmission to a state treatment facility.
576 (b) Provide for the creation or designation of an agency in
577 each county to provide single intake services for each
578 individual person seeking mental health services. Such agency
579 shall provide information and referral services necessary to
580 ensure that such individuals clients receive the most
581 appropriate and least restrictive form of care, based on the
582 individual’s individual needs of the person seeking treatment.
583 Such agency shall have a single telephone number, operating 24
584 hours per day, 7 days per week, if where practicable, at a
585 central location, where each individual receiving mental health
586 services has client will have a client central record.
587 (c) Advocate on behalf of the individual receiving mental
588 health services client to ensure that all appropriate services
589 are provided afforded to the client in a timely and dignified
590 manner.
591 (d) Require a that any public receiving facility initiating
592 an individual's a patient transfer to a licensed hospital for
593 acute care mental health services not accessible through the
594 public receiving facility to shall notify the hospital of the
595 such transfer and send all records relating to the emergency
596 psychiatric or medical condition.
597 (3) The department shall is directed to develop and include
598 performance measures in contracts with service providers
599 relating to measures of performance with regard to goals and
600 objectives as specified in the state plan. Such measures shall
601 use, To the extent practical, such measures must use existing
602 data collection methods and reports and may shall not require,
603 as a result of this subsection, additional reports on the part
604 of service providers. The department shall plan monitoring
605 visits of community mental health facilities with other state,
606 federal, and local governmental and private agencies charged
607 with monitoring such facilities.
608 (4) The department is directed to submit a report to the
609 Legislature, prior to April 1 of each year, outlining
610 departmental progress towards the implementation of the minimum
611 staffing patterns' standards in state mental health treatment
612 facilities. The report shall contain, by treatment facility,
613 information regarding goals and objectives and departmental
614 performance toward meeting each such goal and objective.
615 Section 6. Paragraph (a) of subsection (2) and subsection
616 (3) of section 394.4574, Florida Statutes, are amended to read:
617 394.4574 Department responsibilities for a mental health
618 resident who resides in an assisted living facility that holds a
619 limited mental health license.—
620 (2) The department shall must ensure that:
621 (a) A mental health resident has been assessed by a
622 psychiatrist, clinical psychologist, clinical social worker, or
623 psychiatric nurse, or an individual who is supervised by one of
624 these professionals, and determined to be appropriate to reside
625 in an assisted living facility. The documentation must be
626 provided to the administrator of the facility within 30 days
627 after the mental health resident has been admitted to the
628 facility. An evaluation completed upon discharge from a state
629 mental health treatment facility hospital meets the requirements
630 of this subsection related to appropriateness for placement as a
631 mental health resident if it was completed within 90 days before
632 prior to admission to the facility.
633 (3) The secretary of Children and Family Services, in
634 consultation with the Agency for Health Care Administration,
635 shall annually require each circuit district administrator to
636 develop, with community input, detailed plans that demonstrate
637 how the circuit district will ensure the provision of state
638 funded mental health and substance abuse treatment services to
639 residents of assisted living facilities that hold a limited
640 mental health license. These plans must be consistent with the
641 substance abuse and mental health circuit district plan
642 developed pursuant to s. 394.75 and must address case management
643 services; access to consumer-operated drop-in centers; access to
644 services during evenings, weekends, and holidays; supervision of
645 the clinical needs of the residents; and access to emergency
646 psychiatric care.
647 Section 7. Subsection (1) of section 394.458, Florida
648 Statutes, is amended to read:
649 394.458 Introduction or removal of certain articles
650 unlawful; penalty.—
651 (1)(a) Except as authorized by law or as specifically
652 authorized by the person in charge of a receiving or treatment
653 facility each hospital providing mental health services under
654 this part, it is unlawful to:
655 (a) Introduce into or upon the grounds of such facility
656 hospital, or to take or attempt to take or send from the
657 facility therefrom, any of the following articles, which are
658 hereby declared to be contraband for the purposes of this
659 section:
660 1. An Any intoxicating beverage or beverage that which
661 causes or may cause an intoxicating effect;
662 2. A Any controlled substance as defined in chapter 893; or
663 3. A firearm Any firearms or deadly weapon.
664 (b) It is unlawful to Transmit to, or attempt to transmit
665 to, or cause or attempt to cause to be transmitted to, or
666 received by, any individual receiving mental health services
667 from a receiving or treatment facility patient of any hospital
668 providing mental health services under this part any article or
669 thing declared by this section to be contraband, at any place
670 which is outside of the grounds of such facility hospital,
671 except as authorized by law or as specifically authorized by the
672 person in charge of such hospital.
673 Section 8. Section 394.459, Florida Statutes, is amended to
674 read:
675 394.459 Rights of individuals receiving treatment and
676 services patients.—
677 (1) RIGHT TO INDIVIDUAL DIGNITY.—It is the policy of this
678 state that the individual dignity of all individuals held for
679 examination or admitted for mental health treatment the patient
680 shall be respected at all times and upon all occasions,
681 including any occasion when the individual patient is taken into
682 custody, held, or transported. Procedures, facilities, vehicles,
683 and restraining devices used utilized for criminals or those
684 accused of a crime may shall not be used in connection with
685 individuals persons who have a mental illness, except for the
686 protection of that individual the patient or others. Individuals
687 Persons who have a mental illness but who are not charged with a
688 criminal offense may shall not be detained or incarcerated in
689 the jails of this state. An individual A person who is receiving
690 treatment for mental illness may shall not be deprived of any
691 constitutional rights. However, if such individual a person is
692 adjudicated incapacitated, his or her rights may be limited to
693 the same extent that the rights of any incapacitated person are
694 limited by law.
695 (2) RIGHT TO TREATMENT.—Each individual held for
696 examination or admitted for mental health treatment:
697 (a) May A person shall not be denied treatment for mental
698 illness and services may shall not be delayed at a receiving or
699 treatment facility because of inability to pay. However, every
700 reasonable effort to collect appropriate reimbursement for the
701 cost of providing mental health services from individuals to
702 persons able to pay for services, including insurance or third
703 party payers payments, shall be made by facilities providing
704 services under pursuant to this part.
705 (b) Shall be provided It is further the policy of the state
706 that the least restrictive appropriate available treatment, be
707 utilized based on the individual’s individual needs and best
708 interests of the patient, and consistent with the optimum
709 improvement of the individual’s patient's condition.
710 (c) Each person Who remains at a receiving or treatment
711 facility for more than 12 hours, shall be given a physical
712 examination by a health practitioner, authorized by law to give
713 such examinations, and an evaluation by a psychiatrist, within
714 24 hours after arrival at such facility. The physical
715 examination and psychiatric evaluation must be documented in the
716 clinical record.
717 (d) Every patient in a facility Shall be afforded the
718 opportunity to participate in activities designed to enhance
719 self-image and the beneficial effects of other treatments, as
720 determined by the facility.
721 (e) Not more than 5 days after admission to a facility,
722 each patient Shall have and receive an individualized treatment
723 plan in writing, which the individual patient has had an
724 opportunity to assist in preparing and to review prior to its
725 implementation, within 5 days after admission to a facility. The
726 plan must shall include a space for the individual’s patient's
727 comments.
728 (3) RIGHT TO EXPRESS AND INFORMED PATIENT CONSENT.—
729 (a)1. Each individual patient entering treatment shall be
730 asked to give express and informed consent for admission or
731 treatment.
732 1. If the individual patient has been adjudicated
733 incapacitated or found to be incompetent to consent to
734 treatment, express and informed consent must to treatment shall
735 be sought instead from his or her the patient's guardian or
736 guardian advocate. If the individual patient is a minor, express
737 and informed consent for admission or treatment must be obtained
738 shall also be requested from the patient's guardian. Express and
739 informed consent for admission or treatment of a patient under
740 18 years of age shall be required from the minor’s patient's
741 guardian, unless the minor is seeking outpatient crisis
742 intervention services under s. 394.4784. Express and informed
743 consent for admission or treatment given by a patient who is
744 under 18 years of age shall not be a condition of admission when
745 the patient's guardian gives express and informed consent for
746 the patient's admission pursuant to s. 394.463 or s. 394.467.
747 2. Before giving express and informed consent, the
748 following information shall be provided and explained in plain
749 language to the individual patient, or to his or her the
750 patient's guardian if the individual patient is 18 years of age
751 or older and has been adjudicated incapacitated, or to his or
752 her the patient's guardian advocate if the individual patient
753 has been found to be incompetent to consent to treatment, or to
754 both the individual patient and the guardian if the individual
755 patient is a minor: the reason for admission or treatment; the
756 proposed treatment; the purpose of the treatment to be provided;
757 the common risks, benefits, and side effects thereof; the
758 specific dosage range for the medication, when applicable;
759 alternative treatment modalities; the approximate length of
760 care; the potential effects of stopping treatment; how treatment
761 will be monitored; and that any consent given for treatment may
762 be revoked orally or in writing before or during the treatment
763 period by the individual receiving the treatment patient or by a
764 person who is legally authorized to make health care decisions
765 on the individual’s behalf of the patient.
766 (b) Before performing a medical procedure In the case of
767 medical procedures requiring the use of a general anesthetic or
768 electroconvulsive treatment, and prior to performing the
769 procedure, express and informed consent must shall be obtained
770 from the individual subject to the procedure patient if the
771 individual patient is legally competent, from the guardian of a
772 minor patient, from the guardian of an individual a patient who
773 has been adjudicated incapacitated, or from the individual’s
774 guardian advocate of the patient if the guardian advocate has
775 been given express court authority to consent to medical
776 procedures or electroconvulsive treatment as provided under s.
777 394.4598.
778 (c) If When the department is the legal guardian of a
779 patient, or is the custodian of an individual a patient whose
780 physician is unwilling to perform a medical procedure, including
781 an electroconvulsive treatment, based solely on the individual’s
782 patient's consent and whose guardian or guardian advocate is
783 unknown or unlocatable, the court shall hold a hearing to
784 determine the medical necessity of the medical procedure. The
785 individual subject to the procedure must patient shall be
786 physically present, unless his or her the patient's medical
787 condition precludes such presence, represented by counsel, and
788 provided the right and opportunity to be confronted with, and to
789 cross-examine, all witnesses alleging the medical necessity of
790 such procedure. In such proceedings, the burden of proof by
791 clear and convincing evidence is shall be on the party alleging
792 the medical necessity of the procedure.
793 (d) The administrator of a receiving or treatment facility
794 may, upon the recommendation of an individual’s the patient's
795 attending physician, authorize emergency medical treatment,
796 including a surgical procedure, if such treatment is deemed
797 lifesaving, or if the situation threatens serious bodily harm to
798 the individual patient, and the permission of the individual
799 patient or his or her the patient's guardian or guardian
800 advocate cannot be obtained.
801 (4) QUALITY OF TREATMENT.—
802 (a) Each individual held for examination or admitted for
803 mental health treatment, or receiving involuntary outpatient
804 treatment patient shall receive services, including, for a
805 patient placed under s. 394.4655, shall receive those services
806 that are included in the court order which are suited to his or
807 her needs, and which shall be administered skillfully, safely,
808 and humanely with full respect for the individual’s patient's
809 dignity and personal integrity. Each individual must patient
810 shall receive such medical, vocational, social, educational, and
811 rehabilitative services as his or her condition requires in
812 order to live successfully in the community. In order to achieve
813 this goal, the department shall is directed to coordinate its
814 mental health programs with all other programs of the department
815 and other state agencies.
816 (b) Facilities shall develop and maintain, in a form
817 accessible to and readily understandable by individuals held for
818 examination or admitted for mental health treatment, patients
819 and consistent with rules adopted by the department, the
820 following:
821 1. Criteria, procedures, and required staff training for
822 the any use of close or elevated levels of supervision;, of
823 restraint, seclusion, or isolation;, or of emergency treatment
824 orders;, and for the use of bodily control and physical
825 management techniques.
826 2. Procedures for documenting, monitoring, and requiring
827 clinical review of all uses of the procedures described in
828 subparagraph 1. and for documenting and requiring review of any
829 incidents resulting in injury to individuals receiving services
830 patients.
831 3. A system for investigating, tracking, managing, and
832 responding to complaints by individuals persons receiving
833 services or persons individuals acting on their behalf.
834 4. Procedures for reporting events that place individuals
835 receiving services at risk of harm. Such events must be reported
836 to the department in accordance with department operating
837 procedures after discovery and include, but are not limited to:
838 a. An individual whose life terminates due to a natural,
839 unnatural, expected, or unexpected cause while in the facility
840 or within 72 hours after release.
841 b. An injury sustained, or allegedly sustained, due to an
842 accident, act of abuse, neglect, or suicide attempt requiring
843 medical treatment by a licensed health care practitioner in an
844 acute care medical facility.
845 c. The unauthorized absence of an individual in the care of
846 a facility under this part.
847 d. An unusual occurrence or circumstance precipitated by
848 something uncommon, abnormal, or out of the ordinary, such as a
849 tornado, kidnapping, riot, or hostage situation that jeopardizes
850 the health, safety, or welfare of the individual.
851 e. An allegation of sexual battery upon the individual.
852 (c) A facility may not use seclusion or restraint for
853 punishment, to compensate for inadequate staffing, or for the
854 convenience of staff. Facilities shall ensure that all staff are
855 made aware of these restrictions on the use of seclusion and
856 restraint and shall make and maintain records that which
857 demonstrate that this information has been conveyed to each
858 individual staff member members.
859 (5) COMMUNICATION, ABUSE REPORTING, AND VISITS.—
860 (a) Each individual held for examination or admitted for
861 mental health treatment person receiving services in a facility
862 providing mental health services under this part has the right
863 to communicate freely and privately with persons outside the
864 facility unless it is determined that such communication is
865 likely to be harmful to the individual person or others. Each
866 facility shall make available as soon as reasonably possible to
867 persons receiving services a telephone that allows for free
868 local calls and access to a long-distance service available to
869 the individual as soon as reasonably possible. A facility is not
870 required to pay the costs of the individual’s a patient's long
871 distance calls. The telephone must shall be readily accessible
872 to the patient and shall be placed so that the individual
873 patient may use it to communicate privately and confidentially.
874 The facility may establish reasonable rules for the use of this
875 telephone which, provided that the rules do not interfere with
876 an individual’s a patient's access to a telephone to report
877 abuse pursuant to paragraph (e).
878 (b) Each individual patient admitted to a facility under
879 the provisions of this part shall be allowed to receive, send,
880 and mail sealed, unopened correspondence; and the individual’s
881 no patient's incoming or outgoing correspondence may not shall
882 be opened, delayed, held, or censored by the facility unless
883 there is reason to believe that it contains items or substances
884 that are which may be harmful to the individual patient or
885 others, in which case the administrator may direct reasonable
886 examination of such mail and may regulate the disposition of
887 such items or substances.
888 (c) Each facility shall allow must permit immediate access
889 to an individual held for examination or admitted for mental
890 health treatment any patient, subject to the patient's right to
891 deny or withdraw consent at any time, by the individual, or by
892 the individual's patient's family members, guardian, guardian
893 advocate, representative, Florida statewide or local advocacy
894 council, or attorney, unless such access would be detrimental to
895 the individual patient. If the a patient's right to communicate
896 or to receive visitors is restricted by the facility, written
897 notice of such restriction and the reasons for the restriction
898 shall be served on the individual and patient, the individual’s
899 patient's attorney, and the patient's guardian, guardian
900 advocate, or representative,; and such restriction, and the
901 reasons for the restriction, must shall be recorded in on the
902 patient's clinical record with the reasons therefor. The
903 restriction must of a patient's right to communicate or to
904 receive visitors shall be reviewed at least every 7 days. The
905 right to communicate or receive visitors may shall not be
906 restricted as a means of punishment. Nothing in This paragraph
907 does not shall be construed to limit the provisions of paragraph
908 (d).
909 (d) Each facility shall establish reasonable rules
910 governing visitors, visiting hours, and the use of telephones by
911 individuals held for examination or admitted for mental health
912 treatment patients in the least restrictive possible manner. An
913 individual has Patients shall have the right to contact and to
914 receive communication from their attorneys at any reasonable
915 time.
916 (e) Each individual held for examination or admitted for
917 patient receiving mental health treatment in any facility shall
918 have ready access to a telephone in order to report an alleged
919 abuse. The facility staff shall orally and in writing inform
920 each individual patient of the procedure for reporting abuse and
921 shall make every reasonable effort to present the information in
922 a language the individual patient understands. A written copy of
923 that procedure, including the telephone number of the central
924 abuse hotline and reporting forms, must shall be posted in plain
925 view.
926 (f) The department shall adopt rules providing a procedure
927 for reporting abuse. Facility staff shall be required, as a
928 condition of employment, must to become familiar with the
929 requirements and procedures for the reporting of abuse.
930 (6) CARE AND CUSTODY OF PERSONAL EFFECTS OF PATIENTS.—The
931 rights of an individual held for examination or admitted for
932 mental health treatment A patient's right to the possession of
933 his or her clothing and personal effects shall be respected. The
934 facility may take temporary custody of such effects if when
935 required for medical and safety reasons. The A patient's
936 clothing and personal effects shall be inventoried upon their
937 removal into temporary custody. Copies of this inventory shall
938 be given to the individual patient and to his or her the
939 patient's guardian, guardian advocate, or representative and
940 shall be recorded in the patient's clinical record. This
941 inventory may be amended upon the request of the individual
942 patient or his or her the patient's guardian, guardian advocate,
943 or representative. The inventory and any amendments to it must
944 be witnessed by two members of the facility staff and by the
945 individual patient, if he or she is able. All of the a patient's
946 clothing and personal effects held by the facility must shall be
947 returned to the individual patient immediately upon his or her
948 the discharge or transfer of the patient from the facility,
949 unless such return would be detrimental to the individual
950 patient. If personal effects are not returned to the patient,
951 the reason must be documented in the clinical record along with
952 the disposition of the clothing and personal effects, which may
953 be given instead to the individual’s patient's guardian,
954 guardian advocate, or representative. As soon as practicable
955 after an emergency transfer of a patient, the individual’s
956 patient's clothing and personal effects shall be transferred to
957 the individual’s patient's new location, together with a copy of
958 the inventory and any amendments, unless an alternate plan is
959 approved by the individual patient, if he or she is able, and by
960 his or her the patient's guardian, guardian advocate, or
961 representative.
962 (7) VOTING IN PUBLIC ELECTIONS.—An individual held for
963 examination or admitted for mental health treatment A patient
964 who is eligible to vote according to the laws of the state has
965 the right to vote in the primary and general elections. The
966 department shall establish rules to enable such individuals
967 patients to obtain voter registration forms, applications for
968 absentee ballots, and absentee ballots.
969 (8) HABEAS CORPUS.—
970 (a) At any time, and without notice, an individual a person
971 held for examination in a receiving or treatment facility, or a
972 relative, friend, guardian, guardian advocate, representative,
973 or attorney, or the department, on behalf of such individual
974 person, may petition for a writ of habeas corpus to question the
975 cause and legality of such detention and request that the court
976 order a return to the writ in accordance with chapter 79. Each
977 individual patient held in a facility shall receive a written
978 notice of the right to petition for a writ of habeas corpus.
979 (b) At any time, and without notice, an individual admitted
980 for mental health treatment a person who is a patient in a
981 receiving or treatment facility, or a relative, friend,
982 guardian, guardian advocate, representative, or attorney, or the
983 department, on behalf of such individual person, may file a
984 petition in the circuit court in the county where the individual
985 patient is being held alleging that he or she the patient is
986 being unjustly denied a right or privilege granted herein or
987 that a procedure authorized herein is being abused. Upon the
988 filing of such a petition, the court may shall have the
989 authority to conduct a judicial inquiry and to issue an any
990 order needed to correct an abuse of the provisions of this part.
991 (c) The administrator of any receiving or treatment
992 facility receiving a petition under this subsection shall file
993 the petition with the clerk of the court on the next court
994 working day.
995 (d) A No fee may not shall be charged for the filing of a
996 petition under this subsection.
997 (9) VIOLATIONS.—The department shall report to the Agency
998 for Health Care Administration any violation of the rights or
999 privileges of individuals patients, or of any procedures
1000 provided under this part, by any facility or professional
1001 licensed or regulated by the agency. The agency may is
1002 authorized to impose any sanction authorized for violation of
1003 this part, based solely on the investigation and findings of the
1004 department.
1005 (10) LIABILITY FOR VIOLATIONS.—Any person who violates or
1006 abuses the any rights or privileges of individuals held for
1007 examination or admitted for mental health treatment patients
1008 provided under by this part is liable for damages as determined
1009 by law. Any person who acts reasonably, in good faith, and
1010 without negligence in compliance with the provisions of this
1011 part is immune from civil or criminal liability for his or her
1012 actions in connection with the preparation or execution of
1013 petitions, applications, certificates, reports, or other
1014 documents initiating admission to a facility or the
1015 apprehension, detention, transportation, examination, admission,
1016 diagnosis, treatment, or discharge of an individual a patient to
1017 or from a facility. However, this section does not relieve any
1018 person from liability if such person commits negligence.
1019 (11) RIGHT TO PARTICIPATE IN TREATMENT AND DISCHARGE
1020 PLANNING.—An individual held for examination or admitted for
1021 mental health treatment The patient shall have the opportunity
1022 to participate in treatment and discharge planning and shall be
1023 notified in writing of his or her right, upon discharge from the
1024 facility, to seek treatment from the professional or agency of
1025 the individual’s patient's choice.
1026 (12) ADVANCE DIRECTIVES.—All receiving and treatment
1027 facilities and other service providers shall provide information
1028 concerning advance directives, and assist individuals who are
1029 competent and willing to complete mental health advance
1030 directives. Receiving and treatment facilities and service
1031 providers must honor the advance directive of an individual
1032 admitted to or served by the facility or provider.
1033 (13)(12) POSTING OF NOTICE OF RIGHTS OF PATIENTS.—Each
1034 facility shall post a notice, which lists and describes in
1035 listing and describing, in the language and terminology that the
1036 individual persons to whom the notice is addressed can
1037 understand, the rights provided in this section. This notice
1038 must shall include a statement that provisions of the federal
1039 Americans with Disabilities Act apply and the name and telephone
1040 number of a person to contact for further information. The This
1041 notice must shall be posted in a place readily accessible to
1042 patients and in a format easily seen by the individuals served
1043 patients. The This notice must shall include the telephone
1044 numbers of the Florida local advocacy council and Advocacy
1045 Center for Persons with Disabilities, Inc.
1046 Section 9. Subsections (1), (2), (3), and (4) of section
1047 394.4593, Florida Statutes, are amended to read:
1048 394.4593 Sexual misconduct prohibited; reporting required;
1049 penalties.—
1050 (1) As used in this section, the term:
1051 (a) “Employee” includes any paid staff member, volunteer,
1052 or intern of the department; any person under contract with the
1053 department; and any person providing care or support to an
1054 individual a client on behalf of the department or its service
1055 providers.
1056 (b) “Sexual activity” means:
1057 1. Fondling the genital area, groin, inner thighs,
1058 buttocks, or breasts of an individual a person.
1059 2. The oral, anal, or vaginal penetration by or union with
1060 the sexual organ of another or the anal or vaginal penetration
1061 of another by any other object.
1062 3. Intentionally touching in a lewd or lascivious manner
1063 the breasts, genitals, the genital area, or buttocks, or the
1064 clothing covering them, of an individual a person, or forcing or
1065 enticing an individual a person to touch the perpetrator.
1066 4. Intentionally masturbating in the presence of another
1067 person.
1068 5. Intentionally exposing the genitals in a lewd or
1069 lascivious manner in the presence of another individual person.
1070 6. Intentionally committing any other sexual act that does
1071 not involve actual physical or sexual contact with another
1072 individual the victim, including, but not limited to,
1073 sadomasochistic abuse, sexual bestiality, or the simulation of
1074 any act involving sexual activity in the presence of the
1075 individual a victim.
1076 (c) “Sexual misconduct” means any sexual activity between
1077 an employee and an individual held for examination or admitted
1078 for mental health treatment a patient, regardless of the consent
1079 of that individual the patient. The term does not include an act
1080 done for a bona fide medical purpose or an internal search
1081 conducted in the lawful performance of duty by an employee.
1082 (2) An employee who engages in sexual misconduct with an
1083 individual a patient who:
1084 (a) Is in the custody of the department; or
1085 (b) Resides in a receiving facility or a treatment
1086 facility, as those terms are defined in s. 394.455,
1087
1088 commits a felony of the second degree, punishable as provided in
1089 s. 775.082, s. 775.083, or s. 775.084. An employee may be found
1090 guilty of violating this subsection without having committed the
1091 crime of sexual battery.
1092 (3) The consent of an individual held for examination or
1093 admitted for treatment the patient to the sexual activity is not
1094 a defense to prosecution under this section.
1095 (4) This section does not apply to an employee who:
1096 (a) Is legally married to the individual patient; or
1097 (b) Has no reason to believe that the person with whom the
1098 employee engaged in sexual misconduct is an individual a patient
1099 receiving services as described in subsection (2).
1100 Section 10. Section 394.4595, Florida Statutes, is amended
1101 to read:
1102 394.4595 Florida statewide and local advocacy council
1103 councils; access to patients and records.—Any facility
1104 designated by the department as a receiving or treatment
1105 facility must allow access to any individual held for
1106 examination or admitted for mental health treatment patient and
1107 his or her the clinical and legal records of any patient
1108 admitted pursuant to the provisions of this act by members of
1109 the Florida statewide and local advocacy councils.
1110 Section 11. Section 394.4597, Florida Statutes, is amended
1111 to read:
1112 394.4597 Persons to be notified; appointment of a patient's
1113 representative.—
1114 (1) VOLUNTARY ADMISSION PATIENTS.—At the time an individual
1115 a patient is voluntarily admitted to a receiving or treatment
1116 facility, the identity and contact information of the a person
1117 to be notified in case of an emergency shall be entered in the
1118 patient's clinical record.
1119 (2) INVOLUNTARY ADMISSION PATIENTS.—
1120 (a) At the time an individual a patient is admitted to a
1121 facility for involuntary examination or placement, or when a
1122 petition for involuntary placement is filed, the names,
1123 addresses, and telephone numbers of the individual’s patient's
1124 guardian or guardian advocate, or representative if he or she
1125 the patient has no guardian or guardian advocate, and the
1126 patient's attorney shall be entered in the patient's clinical
1127 record.
1128 (a)(b) If the individual patient has no guardian or
1129 guardian advocate, he or she the patient shall be asked to
1130 designate a representative. If the individual patient is unable
1131 or unwilling to designate a representative, the facility shall
1132 select a representative.
1133 (b)(c) The individual patient shall be consulted with
1134 regard to the selection of a representative by the receiving or
1135 treatment facility and may shall have authority to request that
1136 the any such representative be replaced.
1137 (c)(d) If When the receiving or treatment facility selects
1138 a representative, first preference shall be given to a health
1139 care surrogate, if one has been previously selected by the
1140 patient. If the individual patient has not previously selected a
1141 health care surrogate, the selection, except for good cause
1142 documented in the patient's clinical record, shall be made from
1143 the following list in the order of listing:
1144 1. The individual’s patient's spouse.
1145 2. An adult child of the individual patient.
1146 3. A parent of the individual patient.
1147 4. The adult next of kin of the individual patient.
1148 5. An adult friend of the individual patient.
1149 6. The appropriate Florida local advocacy council as
1150 provided in s. 402.166.
1151 (d)(e) A licensed professional providing services to the
1152 individual patient under this part, an employee of a facility
1153 providing direct services to the individual patient under this
1154 part, a department employee, a person providing other
1155 substantial services to the individual patient in a professional
1156 or business capacity, or a creditor of the individual may
1157 patient shall not be appointed as the patient's representative.
1158 (e) The representative selected by the individual or
1159 designated by the facility has the right, authority, and
1160 responsibility to:
1161 1. Receive notice of the individual’s admission;
1162 2. Receive notice of proceedings affecting the individual;
1163 3. Have immediate access to the individual unless such
1164 access is documented to be detrimental to the individual;
1165 4. Receive notice of any restriction of the individual’s
1166 right to communicate or receive visitors;
1167 5. Receive a copy of the inventory of personal effects upon
1168 the individual’s admission and to request an amendment to the
1169 inventory at any time;
1170 6. Receive disposition of the individual’s clothing and
1171 personal effects if not returned to the individual, or to
1172 approve an alternate plan;
1173 7. Petition on behalf of the individual for a writ of
1174 habeas corpus to question the cause and legality of the
1175 individual’s detention or to allege that the individual is being
1176 unjustly denied a right or privilege granted herein, or that a
1177 procedure authorized herein is being abused;
1178 8. Apply for a change of venue for the individual’s
1179 involuntary placement hearing for the convenience of the parties
1180 or witnesses or because of the individual's condition;
1181 9. Receive written notice of any restriction of the
1182 individual’s right to inspect his or her clinical record;
1183 10. Receive notice of the release of the individual from a
1184 receiving facility where an involuntary examination was
1185 performed;
1186 11. Receive a copy of any petition for the individual’s
1187 involuntary placement filed with the court; and
1188 12. Be informed by the court of the individual’s right to
1189 an independent expert evaluation pursuant to involuntary
1190 placement procedures.
1191 Section 12. Section 394.4598, Florida Statutes, is amended
1192 to read:
1193 394.4598 Guardian advocate.—
1194 (1) The administrator may petition the court for the
1195 appointment of a guardian advocate based upon the opinion of a
1196 psychiatrist that an individual held for examination or admitted
1197 for mental health treatment the patient is incompetent to
1198 consent to treatment. If the court finds that the individual a
1199 patient is incompetent to consent to treatment and has not been
1200 adjudicated incapacitated and a guardian having with the
1201 authority to consent to mental health treatment has not been
1202 appointed, it shall appoint a guardian advocate. The individual
1203 patient has the right to have an attorney represent him or her
1204 at the hearing. If the individual person is indigent, the court
1205 shall appoint the office of the public defender to represent him
1206 or her at the hearing. The individual patient has the right to
1207 testify, cross-examine witnesses, and present witnesses. The
1208 proceeding must shall be recorded either electronically or
1209 stenographically, and testimony shall be provided under oath.
1210 One of the professionals authorized to give an opinion in
1211 support of a petition for involuntary placement, as described in
1212 s. 394.4655 or s. 394.467, must testify. The A guardian advocate
1213 must meet the qualifications of a guardian pursuant to contained
1214 in part IV of chapter 744., except that A professional providing
1215 services to the individual under referred to in this part, an
1216 employee of the facility providing direct services to the
1217 individual patient under this part, a departmental employee, a
1218 facility administrator, or a member of the Florida local
1219 advocacy council may shall not be appointed. A person who is
1220 appointed as a guardian advocate must agree to the appointment.
1221 (2) A facility requesting appointment of a guardian
1222 advocate must, prior to the appointment, provide the prospective
1223 guardian advocate with information concerning about the duties
1224 and responsibilities of guardian advocates, including the
1225 information about the ethics of medical decisionmaking. Before
1226 asking a guardian advocate to give consent to treatment for an
1227 individual held for examination or admitted for mental health
1228 treatment a patient, the facility must shall provide to the
1229 guardian advocate sufficient information so that the guardian
1230 advocate can decide whether to give express and informed consent
1231 to the treatment, including information that the treatment is
1232 essential to the care of the individual patient, and that the
1233 treatment does not present an unreasonable risk of serious,
1234 hazardous, or irreversible side effects. Before giving consent
1235 to treatment, the guardian advocate must meet and talk with the
1236 individual patient and the individual’s patient's physician
1237 face-to-face in person, if at all possible, and by telephone, if
1238 not. The guardian advocate shall make every effort to make the
1239 mental health care decision that he or she believes the
1240 individual would have made under the circumstances if the
1241 individual were capable of making such decision. The decision of
1242 the guardian advocate may be reviewed by the court, upon
1243 petition of the individual’s patient's attorney or, the
1244 patient's family, or the facility administrator.
1245 (3) Before Prior to a guardian advocate may exercise
1246 exercising his or her authority, the guardian advocate must
1247 shall attend a training course approved by the court. The This
1248 training course, of not less than 4 hours, must include, at
1249 minimum, information concerning individual about the patient
1250 rights, psychotropic medications, diagnosis of mental illness,
1251 the ethics of medical decisionmaking, and duties of guardian
1252 advocates. This training course shall take the place of the
1253 training required for guardians appointed under pursuant to
1254 chapter 744.
1255 (4) The information provided to be supplied to prospective
1256 guardian advocates before prior to their appointment and the
1257 training course for guardian advocates must be developed and
1258 completed through a course developed by the department and
1259 approved by the chief judge of the circuit court and taught by a
1260 court-approved organization. Court-approved organizations may
1261 include, but are not limited to, community or junior colleges,
1262 guardianship organizations, and the local bar association or The
1263 Florida Bar. The court may, in its discretion, waive some or all
1264 of the training requirements for guardian advocates or impose
1265 additional requirements. The court shall make its decision on a
1266 case-by-case basis and, in making its decision, shall consider
1267 the experience and education of the guardian advocate, the
1268 duties assigned to the guardian advocate, and the needs of the
1269 individual whom the guardian advocate represents patient.
1270 (5) In selecting a guardian advocate, the court shall give
1271 preference to a health care surrogate, if one has already been
1272 designated by the individual held for examination or admitted
1273 for mental health treatment patient. If the individual patient
1274 has not previously selected a health care surrogate, except for
1275 good cause documented in the court record, the selection shall
1276 be made from the following list in the order of listing:
1277 (a) The individual’s patient's spouse.
1278 (b) An adult child of the individual patient.
1279 (c) A parent of the individual patient.
1280 (d) The adult next of kin of the individual patient.
1281 (e) An adult friend of the individual patient.
1282 (f) An adult trained and willing to serve as guardian
1283 advocate for the individual patient.
1284 (6) If a guardian having with the authority to consent to
1285 medical treatment has not already been appointed, or if the
1286 individual held for examination or admitted for mental health
1287 treatment patient has not already designated a health care
1288 surrogate, the court may authorize the guardian advocate to
1289 consent to medical treatment, as well as mental health
1290 treatment. Unless otherwise limited by the court, a guardian
1291 advocate that has with authority to consent to medical treatment
1292 shall have the same authority to make health care decisions and
1293 be subject to the same restrictions as a proxy appointed under
1294 part IV of chapter 765. Unless the guardian advocate has sought
1295 and received express court approval in proceeding separate from
1296 the proceeding to determine the competence of the patient to
1297 consent to medical treatment, the guardian advocate may not
1298 consent to:
1299 (a) Abortion.
1300 (b) Sterilization.
1301 (c) Electroconvulsive treatment.
1302 (d) Psychosurgery.
1303 (e) Experimental treatments that have not been approved by
1304 a federally approved institutional review board in accordance
1305 with 45 C.F.R. part 46 or 21 C.F.R. part 56.
1306
1307 The court shall must base its decision on evidence that the
1308 treatment or procedure is essential to the care of the
1309 individual patient and that the treatment does not present an
1310 unreasonable risk of serious, hazardous, or irreversible side
1311 effects. The court shall follow the procedures set forth in
1312 subsection (1) of this section.
1313 (7) The guardian advocate shall be discharged when the
1314 individual whom he or she represents patient is discharged from
1315 an order for involuntary outpatient placement or involuntary
1316 inpatient placement or when the individual patient is
1317 transferred from involuntary to voluntary status. The court or a
1318 hearing officer shall consider the competence of the individual
1319 patient pursuant to subsection (1) and may consider an
1320 involuntarily placed individual’s patient's competence to
1321 consent to treatment at any hearing. Upon sufficient evidence,
1322 the court may restore, or the hearing officer may recommend that
1323 the court restore, the individual’s patient's competence. A copy
1324 of the order restoring competence or the certificate of
1325 discharge containing the restoration of competence shall be
1326 provided to the individual patient and the guardian advocate.
1327 Section 13. Section 394.4599, Florida Statutes, is amended
1328 to read:
1329 394.4599 Notice.—
1330 (1) VOLUNTARY ADMISSION PATIENTS.—Notice of an individual’s
1331 a voluntary patient's admission shall only be given only at the
1332 individual’s request of the patient, except that in an
1333 emergency, notice shall be given as determined by the facility.
1334 (2) INVOLUNTARY ADMISSION PATIENTS.—
1335 (a) If notice of involuntary admission Whenever notice is
1336 required to be given under this part, such notice shall be given
1337 to the individual admitted patient and his or her the patient's
1338 guardian, guardian advocate, attorney, and representative.
1339 1. If When notice is required to be given to an individual
1340 a patient, it shall be given both orally and in writing, in the
1341 language and terminology that the individual patient can
1342 understand, and, if needed, the facility shall provide an
1343 interpreter for the individual patient.
1344 2. Notice to an individual’s a patient's guardian, guardian
1345 advocate, attorney, and representative shall be given by United
1346 States mail and by registered or certified mail with the
1347 receipts attached to the patient's clinical record. Hand
1348 delivery by a facility employee may be used as an alternative,
1349 with delivery documented in the clinical record. If notice is
1350 given by a state attorney or an attorney for the department, a
1351 certificate of service is shall be sufficient to document
1352 service.
1353 (b) A receiving facility shall give prompt notice of the
1354 whereabouts of an individual a patient who is being
1355 involuntarily held for examination to the individual’s guardian
1356 or representative, by telephone or in person within 24 hours
1357 after the individual’s patient's arrival at the facility, unless
1358 the patient requests that no notification be made. Contact
1359 attempts must shall be documented in the individual’s patient's
1360 clinical record and shall begin as soon as reasonably possible
1361 after the individual’s patient's arrival. Notice that an
1362 individual is being involuntarily held must a patient is being
1363 admitted as an involuntary patient shall be given to the Florida
1364 local advocacy council by no later than the next working day
1365 after the individual patient is admitted.
1366 (c) The written notice of the filing of the petition for
1367 the involuntary placement of an individual being held must
1368 include contain the following:
1369 1. Notice that the petition has been filed with the circuit
1370 court in the county in which the individual patient is
1371 hospitalized and the court’s address of such court.
1372 2. Notice that the office of the public defender has been
1373 appointed to represent the individual patient in the proceeding,
1374 if the individual patient is not otherwise represented by
1375 counsel.
1376 3. The date, time, and place of the hearing and the name of
1377 each examining expert and every other person expected to testify
1378 in support of continued detention.
1379 4. Notice that the individual patient, the individual’s
1380 patient's guardian or representative, or the administrator may
1381 apply for a change of venue for the convenience of the parties
1382 or witnesses or because of the individual’s condition of the
1383 patient.
1384 5. Notice that the individual patient is entitled to an
1385 independent expert examination and, if the individual patient
1386 cannot afford such an examination, that the court will provide
1387 for one.
1388 (d) A treatment facility shall provide notice of an
1389 individual’s a patient's involuntary admission on the next
1390 regular working day after the individual’s patient's arrival at
1391 the facility.
1392 (e) If an individual When a patient is to be transferred
1393 from one facility to another, notice shall be given by the
1394 facility where the individual patient is located before prior to
1395 the transfer.
1396 Section 14. Section 394.460, Florida Statutes, is repealed.
1397 Section 15. Section 394.461, Florida Statutes, is amended
1398 to read:
1399 394.461 Designation of receiving and treatment facilities.
1400 The department may is authorized to designate and monitor
1401 receiving facilities and treatment facilities and may suspend or
1402 withdraw such designation for failure to comply with this part
1403 and rules adopted under this part. Only governmental facilities,
1404 and others Unless designated by the department, may facilities
1405 are not permitted to hold or treat individuals on an involuntary
1406 basis patients under this part.
1407 (1) RECEIVING FACILITY.—The department may designate any
1408 community facility as a receiving facility. Any other facility
1409 within the state, including a private facility, as a receiving
1410 facility if or a federal facility, may be so designated by the
1411 department, provided that such designation is agreed to by the
1412 governing body or authority of the facility.
1413 (2) TREATMENT FACILITY.—The department may designate any
1414 state-owned, state-operated, or state-supported facility as a
1415 state treatment facility. An individual may A civil patient
1416 shall not be admitted to a civil state treatment facility
1417 without previously undergoing a transfer evaluation. Before a
1418 court hearing for involuntary placement in a state treatment
1419 facility, the court shall receive and consider the information
1420 documented in the transfer evaluation. Any other facility,
1421 including a private facility or a federal facility, may be
1422 designated as a treatment facility by the department if,
1423 provided that such designation is agreed to by the appropriate
1424 governing body or authority of the facility.
1425 (3) GOVERNMENTAL FACILITIES.—Governmental facilities may
1426 provide voluntary and involuntary mental health examination and
1427 treatment for individuals in their care and custody and must
1428 protect the rights of these individuals, pursuant to this part.
1429 (4)(3) PRIVATE FACILITIES.—Private facilities designated as
1430 receiving and treatment facilities by the department may provide
1431 examination and treatment of individuals on an of involuntary or
1432 patients, as well as voluntary basis patients, and are subject
1433 to all the provisions of this part.
1434 (5)(4) REPORT.—
1435 (a) A facility designated as a public receiving or
1436 treatment facility under this section shall annually report to
1437 the department on an annual basis the following data to the
1438 department, unless such these data are currently being submitted
1439 to the Agency for Health Care Administration:
1440 1. Number of licensed beds.
1441 2. Number of contract days.
1442 3. Number of admissions by payor class and diagnoses.
1443 4. Number of bed days by payor class.
1444 5. Average length of stay by payor class.
1445 6. Total revenues by payor class.
1446 (b) For the purposes of this subsection, “payor class”
1447 means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private
1448 pay health insurance, private-pay health maintenance
1449 organization, private preferred provider organization, the
1450 Department of Children and Family Services, other government
1451 programs, self-pay individuals patients, and charity care.
1452 (c) The data required under this subsection shall be
1453 submitted to the department within no later than 90 days after
1454 following the end of the facility's fiscal year. A facility
1455 designated as a public receiving or treatment facility shall
1456 submit its initial report for the 6-month period ending June 30,
1457 2008.
1458 (d) The department shall issue an annual report based on
1459 the data collected required pursuant to this subsection, which
1460 must. The report shall include individual facilities' data by
1461 facility, as well as statewide totals. The report shall be
1462 submitted to the Governor, the President of the Senate, and the
1463 Speaker of the House of Representatives.
1464 (6)(5) RULES.—The department shall adopt rules relating to:
1465 (a) Procedures and criteria for receiving and evaluating
1466 facility applications for designation as a receiving or
1467 treatment facility, which may include an onsite facility
1468 inspection and evaluation of an applicant's licensing status and
1469 performance history, as well as consideration of local service
1470 needs.
1471 (b) Minimum standards consistent with this part that a
1472 facility must meet and maintain in order to be designated as a
1473 receiving or treatment facility, and procedures for monitoring
1474 continued adherence to such standards.
1475 (c) Procedures for receiving complaints against a
1476 designated facility and for initiating inspections and
1477 investigations of facilities alleged to have violated the
1478 provisions of this part or rules adopted under this part.
1479 (d) Procedures and criteria for the suspension or
1480 withdrawal of designation as a receiving or treatment facility.
1481 Section 16. Section 394.4611, Florida Statutes, is created
1482 to read:
1483 394.4611 Integrated adult mental health crisis
1484 stabilization unit and addictions receiving facility services.—
1485 (1) Beginning July 1, 2009, the Agency for Health Care
1486 Administration, in consultation with the department, may license
1487 facilities that integrate services provided in an adult mental
1488 health crisis stabilization unit with services provided in an
1489 adult addictions receiving facility. The services provided shall
1490 be designated as integrated adult mental health crisis
1491 stabilization unit and addictions receiving facility services,
1492 and the facility providing these services must be licensed as an
1493 adult crisis stabilization unit by the agency and must meet the
1494 license requirements for crisis stabilization units that provide
1495 these integrated services.
1496 (2) An integrated adult mental health crisis stabilization
1497 unit and addictions receiving facility may provide services to
1498 adults 18 years of age or older who:
1499 (a) Meet the requirements for voluntary admission for
1500 mental health treatment under s. 394.4625;
1501 (b) Meet the criteria for involuntary examination for
1502 mental illness under s. 394.463;
1503 (c) Qualify for voluntary admission for substance abuse
1504 treatment under s. 397.601; or
1505 (d) Meet the criteria for involuntary admission for
1506 substance abuse impairment under s. 397.675.
1507 (3) In consultation with the agency, the department shall
1508 adopt by rule minimum standards for eligibility; clinical
1509 procedures; staffing requirements; operational, administrative,
1510 and financing requirements; and procedures for the investigation
1511 of complaints. Standards for substance abuse treatment services
1512 must meet or exceed current standards for addictions receiving
1513 facilities as adopted by rule.
1514 Section 17. Section 394.4615, Florida Statutes, is amended
1515 to read:
1516 394.4615 Clinical records; confidentiality.—
1517 (1) A clinical record shall be maintained for each
1518 individual held for examination or admitted for mental health
1519 treatment patient. The record must shall include data pertaining
1520 to admission and such other information as may be required under
1521 rules of the department. A clinical record is confidential and
1522 exempt from the provisions of s. 119.07(1). Unless waived by the
1523 express and informed consent of the individual, by the patient
1524 or by his or her the patient's guardian or guardian advocate or,
1525 if the patient is deceased, by his or her the patient's personal
1526 representative or the family member who stands next in line of
1527 intestate succession, the confidential status of the clinical
1528 record is shall not be lost by either authorized or unauthorized
1529 disclosure to any person, organization, or agency.
1530 (2) The clinical record of an individual held for
1531 examination or admitted for mental health treatment shall be
1532 released if when:
1533 (a) The individual patient or the individual’s patient's
1534 guardian or guardian advocate authorizes the release. The
1535 guardian or guardian advocate shall be provided access to the
1536 appropriate clinical records of the patient. The individual
1537 patient or the individual’s patient's guardian or guardian
1538 advocate may authorize the release of information and clinical
1539 records to appropriate persons to ensure the continuity of the
1540 individual’s patient's health care or mental health care.
1541 (b) The individual patient is represented by counsel and
1542 the records are needed by such the patient's counsel for
1543 adequate representation.
1544 (c) The court orders such release. In determining whether
1545 there is good cause for disclosure, the court shall weigh the
1546 need for the information to be disclosed against the possible
1547 harm of disclosure to the individual person to whom such
1548 information pertains.
1549 (d) The individual patient is committed to, or is to be
1550 returned to, the Department of Corrections from the Department
1551 of Children and Family Services, and the Department of
1552 Corrections requests such records. The These records shall be
1553 furnished without charge to the Department of Corrections.
1554 (3) Information from the clinical record may be released if
1555 in the following circumstances:
1556 (a) The individual When a patient has declared an intention
1557 to harm other persons. If When such declaration has been made,
1558 the administrator may authorize the release of sufficient
1559 information to provide adequate warning to the person threatened
1560 with harm by the patient.
1561 (b) When The administrator of the facility or secretary of
1562 the department deems that release to a qualified researcher as
1563 defined in administrative rule, an aftercare treatment provider,
1564 or an employee or agent of the department is necessary for
1565 treatment of the individual patient, maintenance of adequate
1566 records, compilation of treatment data, aftercare planning, or
1567 evaluation of programs.
1568 (c) Necessary for the purpose of determining whether an
1569 individual a person meets the criteria for involuntary
1570 outpatient placement or for preparing the proposed treatment
1571 plan pursuant to s. 394.4655, the clinical record may be
1572 released to the state attorney, the public defender or the
1573 individual’s patient's private legal counsel, the court, and to
1574 the appropriate mental health professionals, including the
1575 service provider identified in s. 394.4655(6)(b)
1576 394.4655(6)(b)2., in accordance with state and federal law.
1577 (4) Information from clinical records may be used for
1578 statistical and research purposes if the information is
1579 abstracted in such a way as to protect the identity of
1580 individuals served and meets department policy.
1581 (5) Information from clinical records may be used by the
1582 Agency for Health Care Administration, the department, and the
1583 Florida advocacy councils for the purpose of monitoring facility
1584 activity and complaints concerning facilities.
1585 (6) Clinical records relating to a Medicaid recipient shall
1586 be furnished to the Medicaid Fraud Control Unit in the
1587 Department of Legal Affairs, upon request.
1588 (7) Any person, agency, or entity receiving information
1589 pursuant to this section shall maintain such information as
1590 confidential and exempt from the provisions of s. 119.07(1).
1591 (8) Any facility or private mental health practitioner who
1592 acts in good faith in releasing information pursuant to this
1593 section is not subject to civil or criminal liability for such
1594 release.
1595 (9) Nothing in This section does not is intended to
1596 prohibit the parent or next of kin of an individual a person who
1597 is held for examination in or admitted for treated under a
1598 mental health treatment facility or program from requesting and
1599 receiving information limited to a summary of that individual’s
1600 person's treatment plan and current physical and mental
1601 condition. Release of such information must shall be in
1602 accordance with the code of ethics of the profession involved.
1603 (10) An individual who is 18 years of age or older Patients
1604 shall have reasonable access to his or her their clinical
1605 records, unless such access is determined by the individual’s
1606 patient's physician to be harmful to the individual patient. If
1607 the individual’s patient's right to inspect his or her clinical
1608 record is restricted by the facility, written notice of the such
1609 restriction must shall be given to the individual patient and to
1610 his or her the patient's guardian, guardian advocate, attorney,
1611 and representative. In addition, the restriction must shall be
1612 recorded in the clinical record, together with the reasons for
1613 it. The restriction expires of a patient's right to inspect his
1614 or her clinical record shall expire after 7 days but may be
1615 renewed, after review, for subsequent 7-day periods.
1616 (11) Any person who fraudulently alters, defaces, or
1617 falsifies the clinical record of an individual any person
1618 receiving mental health services in a facility subject to this
1619 part, or causes or procures any of these offenses to be
1620 committed, commits a misdemeanor of the second degree,
1621 punishable as provided in s. 775.082 or s. 775.083.
1622 Section 18. Section 394.462, Florida Statutes, is amended
1623 to read:
1624 394.462 Transportation.—
1625 (1) TRANSPORTATION TO A RECEIVING FACILITY.—
1626 (a) Each county shall designate a single law enforcement
1627 agency within the county, or portions thereof, to take an
1628 individual a person into custody upon the entry of an ex parte
1629 order or the execution of a certificate for involuntary
1630 examination by an authorized professional and to transport that
1631 individual person to the nearest receiving facility, excluding a
1632 governmental facility, for examination. A law enforcement
1633 officer acting in good faith pursuant to this part may not be
1634 held criminally or civilly liable for false imprisonment. The
1635 designated law enforcement agency may decline to transport the
1636 individual person to a receiving facility only if:
1637 1. The county or jurisdiction designated by the county has
1638 contracted on an annual basis with an emergency medical
1639 transport service or private transport company for
1640 transportation of individuals persons to receiving facilities
1641 pursuant to this section at the sole cost of the county.; and
1642 2. The law enforcement agency and the emergency medical
1643 transport service or private transport company agree that the
1644 continued presence of law enforcement personnel is not necessary
1645 for the safety of the individual being transported person or
1646 others.
1647 3. The jurisdiction designated by the county seeks may seek
1648 reimbursement for transportation expenses. The individual being
1649 transported is party responsible for payment for such
1650 transportation is the person receiving the transportation. The
1651 county shall seek reimbursement from the following sources in
1652 the following order:
1653 a. From an insurance company, health care corporation, or
1654 other source, if the individual being transported person
1655 receiving the transportation is covered by an insurance policy
1656 or subscribes to a health care corporation or other source for
1657 payment of such expenses.
1658 b. From the individual being transported person receiving
1659 the transportation.
1660 c. From a financial settlement for medical care, treatment,
1661 hospitalization, or transportation payable or accruing to the
1662 injured party.
1663 (b) Any company that transports an individual a patient
1664 pursuant to this subsection is considered an independent
1665 contractor and is solely liable for the safe and dignified
1666 transportation of the individual patient. Such company must be
1667 insured and maintain at least provide no less than $100,000 in
1668 liability insurance with respect to such the transportation of
1669 patients.
1670 (c) Any company that contracts with a governing board of a
1671 county to transport individuals for examination or treatment
1672 must patients shall comply with the applicable rules of the
1673 department to ensure their the safety and dignity of the
1674 patients.
1675 (d) If When a law enforcement officer takes custody of an
1676 individual a person pursuant to this part, the officer may
1677 request assistance from emergency medical personnel if such
1678 assistance is needed for the safety of the officer or the
1679 individual person in custody.
1680 (e) If When a member of a mental health overlay program or
1681 a mobile crisis response service is a professional authorized to
1682 initiate an involuntary examination pursuant to s. 394.463 and
1683 that professional evaluates an individual a person and
1684 determines that transportation to a receiving facility is
1685 needed, the service, at its discretion, may transport the
1686 individual person to the facility or may call on the law
1687 enforcement agency or other transportation arrangement best
1688 suited to the needs of the individual being transported patient.
1689 (f) If a When any law enforcement officer has custody of an
1690 individual a person based on either noncriminal or minor
1691 criminal behavior that meets the statutory guidelines for
1692 involuntary examination under this part, the law enforcement
1693 officer shall transport the individual person to the nearest
1694 receiving facility for examination.
1695 (g) If a When any law enforcement officer has arrested an
1696 individual a person for a felony and it appears that the
1697 individual person meets the statutory guidelines for involuntary
1698 examination or placement under this part, the individual such
1699 person shall first be processed in the same manner as any other
1700 criminal suspect. The law enforcement agency shall thereafter
1701 immediately notify the nearest public receiving facility, which
1702 shall be responsible for promptly arranging for the examination
1703 and treatment of the individual person. A receiving facility is
1704 not required to admit an individual a person charged with a
1705 crime for whom the facility determines and documents that it is
1706 unable to provide adequate security, but shall provide mental
1707 health examination and treatment to the individual person where
1708 he or she is held.
1709 (h) If the appropriate law enforcement officer believes
1710 that an individual a person has an emergency medical condition
1711 as defined in s. 395.002, the individual person may be first
1712 transported to a hospital for emergency medical treatment,
1713 regardless of whether the hospital is a designated receiving
1714 facility.
1715 (i) The costs of transportation, evaluation,
1716 hospitalization, and treatment incurred under this subsection by
1717 individuals persons who have been arrested for violations of any
1718 state law or county or municipal ordinance may be recovered as
1719 provided in s. 901.35.
1720 (j) The nearest receiving facility must accept individuals
1721 persons brought by law enforcement officers for involuntary
1722 examination.
1723 (k) If When a jurisdiction has entered into a contract with
1724 an emergency medical transport service or a private transport
1725 company for transportation of individuals persons to receiving
1726 facilities, such service or company shall be given preference
1727 for transportation of individuals persons from nursing homes,
1728 assisted living facilities, adult day care centers, or adult
1729 family-care homes, unless the behavior of the individual person
1730 being transported is such that transportation by a law
1731 enforcement officer is necessary.
1732 (l) Nothing in This section does not shall be construed to
1733 limit emergency examination and treatment of incapacitated
1734 individuals persons provided in accordance with the provisions
1735 of s. 401.445.
1736 (2) TRANSPORTATION TO A TREATMENT FACILITY.—
1737 (a) If neither the individual held for examination or
1738 admitted for mental health treatment or patient nor any person
1739 legally obligated or responsible for the individual patient is
1740 not able to pay for the expense of transporting an individual a
1741 voluntary or involuntary patient to a treatment facility, the
1742 governing board of the county in which the individual patient is
1743 hospitalized shall arrange for the such required transportation
1744 and shall ensure the safe and dignified transportation of the
1745 individual patient. The governing board of each county may is
1746 authorized to contract with private transport companies for such
1747 the transportation of such patients to and from a treatment
1748 facility.
1749 (b) Any company that transports an individual a patient
1750 pursuant to this subsection is considered an independent
1751 contractor and is solely liable for the safe and dignified
1752 transportation of the individual patient. Such company must be
1753 insured and provide at least no less than $100,000 in liability
1754 insurance for such with respect to the transportation of
1755 patients.
1756 (c) Any company that contracts with the governing board of
1757 a county to transport individuals must patients shall comply
1758 with the applicable rules of the department to ensure the safety
1759 and dignity of the individuals transported patients.
1760 (d) County or municipal law enforcement and correctional
1761 personnel and equipment may shall not be used to transport
1762 individuals patients adjudicated incapacitated or found by the
1763 court to meet the criteria for involuntary placement under
1764 pursuant to s. 394.467, except in small rural counties where
1765 there are no cost-efficient alternatives.
1766 (3) EXCEPTIONS.—An exception to the requirements of this
1767 section may be granted by the secretary of the department for
1768 the purposes of improving service coordination or better meeting
1769 the special needs of individuals. A proposal for an exception
1770 shall must be submitted to the secretary by the circuit district
1771 administrator after being approved by the governing board of
1772 each affected county boards of any affected counties, prior to
1773 submission to the secretary.
1774 (a) A proposal for an exception must identify the specific
1775 provision from which an exception is requested,; describe how
1776 the proposal will be implemented by participating law
1777 enforcement agencies and transportation authorities,; and
1778 provide a plan for the coordination of services such as case
1779 management.
1780 (b) An The exception may be granted only for:
1781 1. An arrangement centralizing and improving the provision
1782 of services within a circuit district, which may include an
1783 exception to the requirement for transportation to the nearest
1784 receiving facility;
1785 2. An arrangement whereby by which a facility may provide,
1786 in addition to required psychiatric services, an environment and
1787 services that which are uniquely tailored to the needs of an
1788 identified group of individuals who have persons with special
1789 needs, such as persons who have with hearing impairments or
1790 visual impairments, or elderly persons who have with physical
1791 frailties; or
1792 3. A specialized transportation system that provides an
1793 efficient and humane method of transporting individuals patients
1794 to receiving facilities, among receiving facilities, and to
1795 treatment facilities.
1796 (c) Any exception approved pursuant to this subsection must
1797 shall be reviewed and approved every 5 years by the secretary.
1798 Section 19. Section 394.4625, Florida Statutes, is amended
1799 to read:
1800 394.4625 Voluntary admissions.—
1801 (1) EXAMINATION AND TREATMENT AUTHORITY TO RECEIVE
1802 PATIENTS.—
1803 (a) A facility may receive for observation, diagnosis, or
1804 treatment any individual person 18 years of age or older who
1805 makes making application by express and informed consent for
1806 admission or any minor person age 17 or under for whom such
1807 application is made by his or her guardian.
1808 1. If found to show evidence of mental illness, to be
1809 competent to provide express and informed consent, and to be
1810 suitable for treatment, an individual such person 18 years of
1811 age or older may be admitted to the facility.
1812 2. A minor person age 17 or under may be admitted only if
1813 the minor’s assent has been verified through an independent
1814 clinical assessment conducted by a professional licensed under
1815 chapter 458, chapter 459, or chapter 490. Assent must be
1816 obtained in conjunction with consent from the minor’s guardian.
1817 The minor’s assent means that the minor has affirmatively agreed
1818 to stay at the facility for examination and mental health
1819 treatment. Mere failure to object, absent affirmative agreement,
1820 is not assent. In determining if the minor assents, the
1821 examining professional must first provide the minor with an
1822 explanation of why the minor will be examined and treated, what
1823 the minor can expect while in the facility, and when the minor
1824 may expect to be released, in a language that is appropriate to
1825 the minor's age, experience, maturity, and condition. If assent
1826 is not verified, a petition for involuntary inpatient placement
1827 must be filed with the court within 1 working day after
1828 admission or the minor must be released to his or her guardian
1829 within 24 hours after admission only after a hearing to verify
1830 the voluntariness of the consent.
1831 (b) A mental health overlay program, or a mobile crisis
1832 response service, or a licensed professional who is authorized
1833 to initiate an involuntary examination pursuant to s. 394.463
1834 and is employed by a community mental health center or clinic
1835 must, pursuant to circuit district procedure approved by the
1836 respective circuit district administrator, conduct an initial
1837 assessment of the ability of the following individuals persons
1838 to give express and informed consent to treatment before such
1839 individuals persons may be admitted voluntarily:
1840 1. An individual A person 60 years of age or older for whom
1841 transfer is being sought from a nursing home, assisted living
1842 facility, adult day care center, or adult family-care home, if
1843 when such person has been diagnosed as suffering from dementia.
1844 2. An individual A person 60 years of age or older for whom
1845 transfer is being sought from a nursing home pursuant to s.
1846 400.0255(11) 400.0255(12).
1847 3. An individual A person for whom all decisions concerning
1848 medical treatment are currently being lawfully made by a the
1849 health care surrogate or proxy designated under chapter 765.
1850 (c) If When an initial assessment of the ability of an
1851 individual a person to give express and informed consent to
1852 treatment is required under this section, and a mobile crisis
1853 response service does not respond to a the request for an
1854 assessment within 2 hours after the request is made or informs
1855 the requesting facility that it will not be able to respond
1856 within 2 hours after the request is made, the requesting
1857 facility may arrange for assessment by a any licensed
1858 professional authorized to initiate an involuntary examination
1859 under pursuant to s. 394.463. The professional may not be who is
1860 not employed by or under contract with, or and does not have a
1861 financial interest in, either the facility initiating the
1862 transfer or the receiving facility to which the transfer may be
1863 made, and may not have a financial interest in the outcome of
1864 the assessment.
1865 (d) A facility may not admit an individual on as a
1866 voluntary status patient a person who has been adjudicated
1867 incapacitated, unless the condition of incapacity has been
1868 judicially removed. If a facility admits an individual on
1869 voluntary status as a voluntary patient a person who is later
1870 determined to have been adjudicated incapacitated, and the
1871 condition of incapacity had not been removed by the time of the
1872 admission, the facility must either discharge the patient or
1873 transfer the individual patient to involuntary status.
1874 (e) The health care surrogate or proxy of an individual on
1875 a voluntary status patient may not consent to the provision of
1876 mental health treatment for that individual the patient. An
1877 individual on voluntary status A voluntary patient who is
1878 unwilling or unable to provide express and informed consent to
1879 mental health treatment must either be discharged or transferred
1880 to involuntary status.
1881 (f) Within 24 hours after an individual’s voluntary
1882 admission of a voluntary patient, the admitting physician shall
1883 document in the patient's clinical record that the individual
1884 patient is able to give express and informed consent for
1885 admission. If the individual patient is not able to give express
1886 and informed consent for admission, the facility must shall
1887 either discharge the patient or transfer the individual patient
1888 to involuntary status pursuant to subsection (5).
1889 (2) DISCHARGE OF VOLUNTARY PATIENTS.—
1890 (a) A facility shall discharge an individual admitted on a
1891 voluntary status who patient:
1892 1. Who Has sufficiently improved so that retention in the
1893 facility is no longer desirable. The individual A patient may
1894 also be discharged to the care of a community facility.
1895 2. Who Has revoked revokes consent to admission or requests
1896 discharge. The individual A voluntary patient or his or her a
1897 relative, friend, or attorney of the patient may request
1898 discharge either orally or in writing at any time following
1899 admission to the facility. The individual patient must be
1900 discharged within 24 hours after of the request, unless the
1901 request is rescinded or the individual patient is transferred to
1902 involuntary status pursuant to this section. The 24-hour time
1903 period may be extended by a treatment facility if when necessary
1904 for adequate discharge planning, but may shall not exceed 3 days
1905 exclusive of weekends and holidays. If the individual patient,
1906 or another on his or her the patient's behalf, makes an oral
1907 request for discharge to a staff member, such request must shall
1908 be immediately entered in the patient's clinical record. If the
1909 request for discharge is made by a person other than the
1910 individual patient, the discharge may be conditioned upon the
1911 individual’s express and informed consent of the patient.
1912 (b) An individual on A voluntary status patient who has
1913 been admitted to a facility and who refuses to consent to or
1914 revokes consent to treatment must shall be discharged within 24
1915 hours after such refusal or revocation, unless transferred to
1916 involuntary status pursuant to this section or unless the
1917 refusal or revocation is freely and voluntarily rescinded by the
1918 individual patient.
1919 (c) An individual on voluntary status who has been charged
1920 with a crime shall be returned to the custody of a law
1921 enforcement officer upon discharge from a facility.
1922 (3) NOTICE OF RIGHT TO DISCHARGE.—At the time of admission
1923 and at least every 6 months thereafter, an individual on a
1924 voluntary status patient shall be notified in writing of his or
1925 her right to apply for a discharge.
1926 (4) TRANSFER TO VOLUNTARY STATUS.—An individual on
1927 involuntary status patient who has been certified by a physician
1928 or psychologist as competent to provide express and informed
1929 consent and who applies to be transferred to voluntary status
1930 shall be transferred to voluntary status immediately, unless the
1931 individual patient has been charged with a crime, or has been
1932 involuntarily placed for treatment by a court pursuant to s.
1933 394.467 and continues to meet the criteria for involuntary
1934 placement. When transfer to voluntary status occurs, notice
1935 shall be given as provided in s. 394.4599.
1936 (5) TRANSFER TO INVOLUNTARY STATUS.—If an individual on
1937 When a voluntary status patient, or an authorized person on the
1938 individual’s the patient's behalf, makes a request for
1939 discharge, the request for discharge, unless freely and
1940 voluntarily rescinded, must be communicated to a physician,
1941 clinical psychologist, or psychiatrist as quickly as possible,
1942 but within not later than 12 hours after the request is made. If
1943 the individual patient meets the criteria for involuntary
1944 placement, the administrator of the facility must file with the
1945 court a petition for involuntary placement, within 2 court
1946 working days after the request for discharge is made. If the
1947 petition is not filed within 2 court working days, the
1948 individual must patient shall be discharged. Pending the filing
1949 of the petition, the individual patient may be held and
1950 emergency treatment rendered in the least restrictive manner,
1951 upon the written order of a physician, if it is determined that
1952 such treatment is necessary for the safety of the individual
1953 patient or others.
1954 Section 20. Section 394.463, Florida Statutes, is amended
1955 to read:
1956 394.463 Involuntary examination.—
1957 (1) CRITERIA.—An individual A person may be taken to a
1958 receiving facility for involuntary examination if there is
1959 reason to believe that he or she the person has a mental illness
1960 and because of this his or her mental illness:
1961 (a)1. The individual person has refused voluntary
1962 examination after conscientious explanation and disclosure of
1963 the purpose of the examination; or
1964 2. The individual person is unable to determine for himself
1965 or herself whether examination is necessary; and
1966 (b)1. Without care or treatment, the individual person is
1967 likely to suffer from neglect or refuse to care for himself or
1968 herself; such neglect or refusal poses a real and present threat
1969 of substantial harm to his or her well-being; and it is not
1970 apparent that such harm may be avoided through the help of
1971 willing family members or friends or the provision of other
1972 services; or
1973 1.2. There is a substantial likelihood that without care or
1974 treatment the individual person will cause serious bodily harm
1975 to self himself or herself or others in the near future, as
1976 evidenced by recent behavior; and.
1977 2. There are no less restrictive alternatives available.
1978 (2) INVOLUNTARY EXAMINATION.—
1979 (a) An involuntary examination may be initiated by any one
1980 of the following means:
1981 1. A court may enter an ex parte order stating that an
1982 individual a person appears to meet the criteria for involuntary
1983 examination, giving the findings on which that conclusion is
1984 based. The ex parte order for involuntary examination must be
1985 based on sworn testimony, written or oral, which includes
1986 specific facts that support the finding that the criteria have
1987 been met. Any behavior relied on for the issuance of the ex
1988 parte order must have occurred within the preceding 14 days. If
1989 other less restrictive means are not available, such as
1990 voluntary appearance for outpatient evaluation, A law
1991 enforcement officer, or other designated agent of the court,
1992 shall take the individual person into custody and deliver him or
1993 her to the nearest receiving facility for involuntary
1994 examination. The order of the court order must shall be made a
1995 part of the patient's clinical record. A No fee may not shall be
1996 charged for the filing of an order under this subsection. Any
1997 receiving facility accepting the individual patient based on the
1998 this order must send a copy of the order to the Agency for
1999 Health Care Administration on the next working day. The order is
2000 shall be valid only until executed or, if not executed, for the
2001 period specified in the order itself. If a no time limit is not
2002 specified in the order, the order is shall be valid for 7 days
2003 after the date it that the order was signed.
2004 2. A law enforcement officer shall take an individual a
2005 person who appears to meet the criteria for involuntary
2006 examination into custody and deliver or arrange for the delivery
2007 of the individual the person or have him or her delivered to the
2008 nearest receiving facility for examination. The officer shall
2009 complete execute a written report detailing the circumstances
2010 under which the individual person was taken into custody., and
2011 The report must shall be made a part of the patient's clinical
2012 record. Any receiving facility accepting the individual patient
2013 based on the this report must send a copy of the report to the
2014 Agency for Health Care Administration on the next working day.
2015 3. A physician, clinical psychologist, psychiatric nurse,
2016 mental health counselor, marriage and family therapist, or
2017 clinical social worker, or physician assistant may execute a
2018 certificate stating that he or she has examined the individual a
2019 person within the preceding 48 hours and finds that the
2020 individual person appears to meet the criteria for involuntary
2021 examination and stating the observations upon which that
2022 conclusion is based. The certificate must be immediately
2023 executed and is valid only until executed or for up to 7
2024 calendar days, whichever occurs first. If other less restrictive
2025 means are not available, such as voluntary appearance for
2026 outpatient evaluation, A law enforcement officer shall take the
2027 individual person named in the certificate into custody and
2028 deliver him or her to the nearest receiving facility for
2029 involuntary examination. The law enforcement officer shall
2030 complete execute a written report detailing the circumstances
2031 under which the individual person was taken into custody. The
2032 report and certificate shall be made a part of the patient's
2033 clinical record. Any receiving facility accepting the individual
2034 patient based on the this certificate must send a copy of the
2035 certificate to the Agency for Health Care Administration on the
2036 next working day.
2037
2038 A person who initiates an involuntary examination of a minor
2039 shall make and document immediate attempts to notify the minor’s
2040 guardian of such examination. A receiving facility accepting a
2041 minor for involuntary examination must immediately notify the
2042 minor's guardian upon the minor’s arrival.
2043 (b) An individual may A person shall not be removed from a
2044 any program or residential placement licensed under chapter 400
2045 or chapter 429 and transported to a receiving facility for
2046 involuntary examination unless an ex parte order, a professional
2047 certificate, or a law enforcement officer's report is first
2048 prepared. If the condition of the individual person is such that
2049 preparation of a law enforcement officer's report is not
2050 practicable before removal, the report must shall be completed
2051 as soon as possible after removal, but in any case before the
2052 individual person is transported to a receiving facility. A
2053 receiving facility admitting an individual a person for
2054 involuntary examination who is not accompanied by the required
2055 ex parte order, professional certificate, or law enforcement
2056 officer's report must shall notify the Agency for Health Care
2057 Administration of such admission by certified mail by no later
2058 than the next working day. The provisions of this paragraph do
2059 not apply when transportation is provided by the patient's
2060 family or guardian.
2061 (c) A law enforcement officer acting in accordance with an
2062 ex parte order issued pursuant to this subsection may serve and
2063 execute such order on any day of the week, at any time of the
2064 day or night.
2065 (d) A law enforcement officer acting in accordance with an
2066 ex parte order issued pursuant to this subsection may use such
2067 reasonable physical force if as is necessary to gain entry to
2068 the premises, and any dwellings, buildings, or other structures
2069 located on the premises, and to take custody of the individual
2070 person who is the subject of the ex parte order.
2071 (e) The Agency for Health Care Administration shall receive
2072 and maintain the copies of ex parte orders, involuntary
2073 outpatient placement orders issued pursuant to s. 394.4655,
2074 involuntary inpatient placement orders issued pursuant to s.
2075 394.467, professional certificates, and law enforcement
2076 officers' reports. These documents shall be considered part of
2077 the clinical record, governed by the provisions of s. 394.4615.
2078 The agency shall prepare annual reports analyzing the data
2079 obtained from these documents, without information identifying
2080 individuals held for examination or admitted for mental health
2081 treatment patients, and shall provide copies of reports to the
2082 department, the President of the Senate, the Speaker of the
2083 House of Representatives, and the minority leaders of the Senate
2084 and the House of Representatives.
2085 (f) An individual A patient shall be examined by a
2086 physician or clinical psychologist at a receiving facility
2087 without unnecessary delay to determine if the criteria for
2088 involuntary inpatient placement is met. Emergency treatment may
2089 be provided and may, upon the order of a physician, be given
2090 emergency treatment if it is determined that such treatment is
2091 necessary for the safety of the patient or others. The patient
2092 may not be released by the receiving facility or its contractor
2093 without the documented approval of a psychiatrist, a clinical
2094 psychologist, or, if the receiving facility is a hospital, the
2095 release may also be approved by an attending emergency
2096 department physician with experience in the diagnosis and
2097 treatment of mental and nervous disorders and after completion
2098 of an involuntary examination pursuant to this subsection.
2099 However, a patient may not be held in a receiving facility for
2100 involuntary examination longer than 72 hours.
2101 (g) An individual may not be held for involuntary
2102 examination for more than 72 hours. Based on the individual’s
2103 needs, one of the following actions must be taken within the 72
2104 hour period:
2105 1. The individual shall be released after the completion of
2106 the involuntary examination with the documented approval of a
2107 psychiatrist or a clinical psychologist or, if the facility is a
2108 hospital, the release may be approved by an attending emergency
2109 department physician;
2110 2. The individual shall be asked to give express and
2111 informed consent for voluntary admission if a physician or
2112 clinical psychologist has determined that the individual is
2113 competent to consent to treatment; or
2114 3. A petition for involuntary placement shall be completed
2115 and filed in the circuit court if involuntary outpatient or
2116 inpatient treatment is deemed necessary. If the 72-hour period
2117 ends on a weekend or holiday, the petition must be filed by the
2118 next working day. If inpatient treatment is deemed necessary,
2119 the least restrictive treatment consistent with the optimum
2120 improvement of the individual’s condition must be made
2121 available. A petition for involuntary outpatient placement shall
2122 be filed by one of the petitioners specified in s.
2123 394.4655(3)(a), and a petition for involuntary inpatient
2124 placement shall be filed by the facility administrator.
2125 (h) An individual released from a receiving or treatment
2126 facility on a voluntary or involuntary basis who is charged with
2127 a crime shall be returned to the custody of a law enforcement
2128 officer.
2129 (i)(g) If an individual A person for whom an involuntary
2130 examination has been initiated who is also being evaluated or
2131 treated at a hospital for an emergency medical condition
2132 specified in s. 395.002, must be examined by a receiving
2133 facility within 72 hours. the 72-hour period begins when the
2134 individual patient arrives at the hospital and ceases when the
2135 attending physician documents that the patient has an emergency
2136 medical condition. The 72-hour period resumes when the physician
2137 documents that the emergency medical condition has stabilized or
2138 does not exist. If the patient is examined at a hospital
2139 providing emergency medical services by a professional qualified
2140 to perform an involuntary examination and is found as a result
2141 of that examination not to meet the criteria for involuntary
2142 outpatient placement pursuant to s. 394.4655(1) or involuntary
2143 inpatient placement pursuant to s. 394.467(1), the patient may
2144 be offered voluntary placement, if appropriate, or released
2145 directly from the hospital providing emergency medical services.
2146 The finding by the professional that the patient has been
2147 examined and does not meet the criteria for involuntary
2148 inpatient placement or involuntary outpatient placement must be
2149 entered into the patient's clinical record. Nothing in this
2150 paragraph is intended to prevent A hospital providing emergency
2151 medical services may transfer an individual from appropriately
2152 transferring a patient to another hospital before prior to
2153 stabilization if, provided the requirements of s. 395.1041(3)(c)
2154 are have been met.
2155 (h) One of the following must occur within 12 hours after
2156 the patient's attending physician documents that the
2157 individual's patient's medical condition has stabilized or that
2158 an emergency medical condition does not exist:
2159 1. The individual shall be examined by a physician or
2160 clinical psychologist and, if found not to meet the criteria for
2161 involuntary examination pursuant to s. 394.463, shall be
2162 released directly from the hospital providing the emergency
2163 medical services. The results of the examination, including the
2164 final disposition, shall be entered into the clinical record; or
2165 2. The individual shall be transferred to a receiving
2166 facility for examination if appropriate medical and mental
2167 health treatment are available. However, the receiving facility
2168 must be notified of the transfer within 2 hours after the
2169 individual’s condition has been stabilized or after
2170 determination that an emergency medical condition does not
2171 exist.
2172 1. The patient must be examined by a designated receiving
2173 facility and released; or
2174 2. The patient must be transferred to a designated
2175 receiving facility in which appropriate medical treatment is
2176 available. However, the receiving facility must be notified of
2177 the transfer within 2 hours after the patient's condition has
2178 been stabilized or after determination that an emergency medical
2179 condition does not exist.
2180 (i) Within the 72-hour examination period or, if the 72
2181 hours ends on a weekend or holiday, no later than the next
2182 working day thereafter, one of the following actions must be
2183 taken, based on the individual needs of the patient:
2184 1. The patient shall be released, unless he or she is
2185 charged with a crime, in which case the patient shall be
2186 returned to the custody of a law enforcement officer;
2187 2. The patient shall be released, subject to the provisions
2188 of subparagraph 1., for voluntary outpatient treatment;
2189 3. The patient, unless he or she is charged with a crime,
2190 shall be asked to give express and informed consent to placement
2191 as a voluntary patient, and, if such consent is given, the
2192 patient shall be admitted as a voluntary patient; or
2193 4. A petition for involuntary placement shall be filed in
2194 the circuit court when outpatient or inpatient treatment is
2195 deemed necessary. When inpatient treatment is deemed necessary,
2196 the least restrictive treatment consistent with the optimum
2197 improvement of the patient's condition shall be made available.
2198 When a petition is to be filed for involuntary outpatient
2199 placement, it shall be filed by one of the petitioners specified
2200 in s. 394.4655(3)(a). A petition for involuntary inpatient
2201 placement shall be filed by the facility administrator.
2202 (3) NOTICE OF RELEASE.—Notice of the release shall be given
2203 to the individual’s patient's guardian or representative, to any
2204 person who executed a certificate admitting the individual
2205 patient to the receiving facility, and to any court that which
2206 ordered the individual’s patient's evaluation.
2207 Section 21. Section 394.4655, Florida Statutes, is amended
2208 to read:
2209 394.4655 Involuntary outpatient placement.—
2210 (1) CRITERIA FOR INVOLUNTARY OUTPATIENT PLACEMENT.—An
2211 individual A person may be ordered to involuntary outpatient
2212 placement upon a finding of the court that by clear and
2213 convincing evidence that:
2214 (a) The individual person is 18 years of age or older;
2215 (b) The individual person has a mental illness;
2216 (c) The individual person is unlikely to survive safely in
2217 the community without supervision, based on a clinical
2218 determination;
2219 (d) The individual person has a history of lack of
2220 compliance with treatment for mental illness;
2221 (e) The individual person has:
2222 1. At least twice within the immediately preceding 36
2223 months been involuntarily admitted to a receiving or treatment
2224 facility as defined in s. 394.455, or has received mental health
2225 services in a forensic or correctional facility. The 36-month
2226 period does not include any period during which the individual
2227 person was admitted or incarcerated; or
2228 2. Engaged in one or more acts of serious violent behavior
2229 toward self or others, or attempts at serious bodily harm to
2230 self himself or herself or others, within the preceding 36
2231 months;
2232 (f) Due to The person is, as a result of his or her mental
2233 illness, the individual is unlikely to voluntarily participate
2234 in the recommended treatment plan and either he or she has
2235 refused voluntary placement for treatment after sufficient and
2236 conscientious explanation and disclosure of the purpose of
2237 placement for treatment or he or she is unable to determine for
2238 himself or herself whether placement is necessary;
2239 (g) In view of the individual’s person's treatment history
2240 and current behavior, the individual person is in need of
2241 involuntary outpatient placement in order to prevent a relapse
2242 or deterioration that would be likely to result in serious
2243 bodily harm to self himself or herself or others, or a
2244 substantial harm to his or her well-being as set forth in s.
2245 394.463(1);
2246 (h) It is likely that the individual person will benefit
2247 from involuntary outpatient placement; and
2248 (i) All available, less restrictive alternatives that would
2249 offer an opportunity for improvement of his or her condition
2250 have been judged to be inappropriate or unavailable.
2251 (2) INVOLUNTARY OUTPATIENT PLACEMENT.—
2252 (a)1. An individual who is being recommended for
2253 involuntary outpatient placement by A patient may be retained by
2254 a receiving facility upon the recommendation of the
2255 administrator of the a receiving facility where the individual
2256 patient has been examined may be retained by the facility and
2257 after adherence to the notice and of hearing procedures provided
2258 in s. 394.4599.
2259 1. The recommendation must be supported by the opinion of a
2260 psychiatrist and the second opinion of a clinical psychologist
2261 or another psychiatrist, both of whom have personally examined
2262 the individual patient within the preceding 72 hours, that the
2263 criteria for involuntary outpatient placement are met. However,
2264 in a county having a population of fewer than 50,000, if the
2265 administrator certifies that a no psychiatrist or clinical
2266 psychologist is not available to provide the second opinion, the
2267 second opinion may be provided by a licensed physician who has
2268 postgraduate training and experience in diagnosis and treatment
2269 of mental and nervous disorders or by a psychiatric nurse as
2270 defined in this chapter. Such a recommendation must be entered
2271 on an involuntary outpatient placement certificate that
2272 authorizes, which certificate must authorize the receiving
2273 facility to retain the individual patient pending completion of
2274 a hearing. The certificate shall be made a part of the patient's
2275 clinical record.
2276 2. If the individual patient has been stabilized and no
2277 longer meets the criteria for involuntary examination under
2278 pursuant to s. 394.463(1), he or she the patient must be
2279 released from the receiving facility while awaiting the hearing
2280 for involuntary outpatient placement.
2281 3. Before Prior to filing a petition for involuntary
2282 outpatient treatment, the administrator of the a receiving
2283 facility or a designated department representative shall
2284 identify the service provider that will have primary
2285 responsibility for service provision under an order for
2286 involuntary outpatient placement, unless the individual person
2287 is otherwise participating in outpatient psychiatric treatment
2288 and is not in need of public financing for that treatment, in
2289 which case the individual, if eligible, may be ordered to
2290 involuntary treatment pursuant to the existing psychiatric
2291 treatment relationship.
2292 4.3. The service provider shall prepare a written proposed
2293 treatment plan in consultation with the individual being held
2294 patient or his or her the patient's guardian advocate, if
2295 appointed, for the court's consideration for inclusion in the
2296 involuntary outpatient placement order. The service provider
2297 shall also provide a copy of the proposed treatment plan to the
2298 individual patient and the administrator of the receiving
2299 facility. The treatment plan must specify the nature and extent
2300 of the individual’s patient's mental illness,. The treatment
2301 plan must address the reduction of symptoms that necessitate
2302 involuntary outpatient placement, and include measurable goals
2303 and objectives for the services and treatment that are provided
2304 to treat the individual’s person's mental illness and to assist
2305 the individual person in living and functioning in the community
2306 or to attempt to prevent a relapse or deterioration. Service
2307 providers may select and supervise provide supervision to other
2308 service providers individuals to implement specific aspects of
2309 the treatment plan. The services in the treatment plan must be
2310 deemed to be clinically appropriate by a physician, clinical
2311 psychologist, psychiatric nurse, mental health counselor,
2312 marriage and family therapist, or clinical social worker, as
2313 defined in this chapter, who consults with, or is employed or
2314 contracted by, the service provider. The service provider must
2315 certify to the court in the proposed treatment plan whether
2316 sufficient services for improvement and stabilization are
2317 currently available and whether the service provider agrees to
2318 provide those services. If the service provider certifies that
2319 the services in the proposed treatment plan are not available,
2320 the petitioner may not file the petition.
2321 (b) If an individual a patient in involuntary inpatient
2322 placement meets the criteria for involuntary outpatient
2323 placement, the administrator of the treatment facility may,
2324 before the expiration of the period during which the treatment
2325 facility is authorized to retain the individual patient,
2326 recommend involuntary outpatient placement.
2327 1. The recommendation must be supported by the opinion of a
2328 psychiatrist and the second opinion of a clinical psychologist
2329 or another psychiatrist, both of whom have personally examined
2330 the individual patient within the preceding 72 hours, that the
2331 criteria for involuntary outpatient placement are met. However,
2332 in a county having a population of fewer than 50,000, if the
2333 administrator certifies that a no psychiatrist or clinical
2334 psychologist is not available to provide the second opinion, the
2335 second opinion may be provided by a licensed physician who has
2336 postgraduate training and experience in diagnosis and treatment
2337 of mental and nervous disorders or by a psychiatric nurse as
2338 defined in s. 394.455(23). Such a recommendation must be entered
2339 on an involuntary outpatient placement certificate, and the
2340 certificate shall be made a part of the patient's clinical
2341 record.
2342 (c)1. The administrator of the treatment facility shall
2343 provide a copy of the involuntary outpatient placement
2344 certificate and a copy of the state mental health discharge form
2345 to a department representative in the county where the
2346 individual patient will be residing. For persons who are leaving
2347 a state mental health treatment facility, the petition for
2348 involuntary outpatient placement must be filed in the county
2349 where the patient will be residing.
2350 2. The service provider that will have primary
2351 responsibility for service provision shall be identified by the
2352 designated department representative prior to the order for
2353 involuntary outpatient placement and shall must, before prior to
2354 filing a petition for involuntary outpatient placement, certify
2355 to the court whether the services recommended in the
2356 individual’s patient's discharge plan are available in the local
2357 community and whether the service provider agrees to provide
2358 those services. The service provider shall must develop with the
2359 individual patient, or the individual’s patient's guardian
2360 advocate, if one is appointed, a treatment or service plan that
2361 addresses the needs identified in the discharge plan. The plan
2362 must be deemed to be clinically appropriate by a physician,
2363 clinical psychologist, psychiatric nurse, mental health
2364 counselor, marriage and family therapist, or clinical social
2365 worker, as defined in this chapter, who consults with, or is
2366 employed or contracted by, the service provider.
2367 3. If the service provider certifies that the services in
2368 the proposed treatment or service plan are not available, the
2369 petitioner may not file the petition.
2370 (3) PETITION FOR INVOLUNTARY OUTPATIENT PLACEMENT.—
2371 (a) A petition for involuntary outpatient placement may be
2372 filed by:
2373 1. The administrator of a receiving facility; or
2374 2. The administrator of a treatment facility.
2375 (b) Each required criterion for involuntary outpatient
2376 placement must be alleged and substantiated in the petition for
2377 involuntary outpatient placement. A copy of the certificate
2378 recommending involuntary outpatient placement completed by a
2379 qualified professional specified in subsection (2) must be
2380 attached to the petition. A copy of the proposed treatment plan
2381 must be attached to the petition. Before the petition is filed,
2382 the service provider shall certify that the services in the
2383 proposed treatment plan are available. If the necessary services
2384 are not available in the patient's local community where the
2385 individual will reside to respond to the person's individual
2386 needs, the petition may not be filed.
2387 (c) A The petition for involuntary outpatient placement
2388 must be filed in the county where the individual who is the
2389 subject of the petition patient is located, unless the
2390 individual the patient is being placed from a state treatment
2391 facility, in which case the petition must be filed in the county
2392 where the individual patient will reside. When the petition is
2393 has been filed, the clerk of the court shall provide copies of
2394 the petition and the proposed treatment plan to the department,
2395 the individual patient, the individual’s patient's guardian or
2396 representative, the state attorney, and the public defender or
2397 the patient's private counsel representing the individual. A fee
2398 may not be charged for filing a petition under this subsection.
2399 (4) APPOINTMENT OF COUNSEL.—Within 1 court working day
2400 after the filing of a petition for involuntary outpatient
2401 placement, the court shall appoint a the public defender to
2402 represent the individual person who is the subject of the
2403 petition, unless the individual person is otherwise represented
2404 by counsel. The clerk of the court shall immediately notify the
2405 public defender of the appointment. The public defender shall
2406 represent the individual person until the petition is dismissed,
2407 the court order expires, or the individual patient is discharged
2408 from involuntary outpatient placement. An attorney who
2409 represents the individual patient shall have access to the
2410 individual patient, witnesses, and records relevant to the
2411 presentation of the individual’s patient's case and shall
2412 represent the interests of the individual patient, regardless of
2413 the source of payment to the attorney.
2414 (5) CONTINUANCE OF HEARING.—The patient is entitled, with
2415 the concurrence of the patient's counsel, to at least one
2416 continuance of the hearing. The continuance shall be for a
2417 period of up to 4 weeks.
2418 (5)(6) HEARING ON INVOLUNTARY OUTPATIENT PLACEMENT.—
2419 (a)1. The court shall hold the hearing on involuntary
2420 outpatient placement within 5 working days after the filing of
2421 the petition, unless a continuance is granted. The hearing shall
2422 be held in the county where the petition is filed, shall be as
2423 convenient to the individual who is the subject of the petition
2424 patient as is consistent with orderly procedure, and shall be
2425 conducted in physical settings not likely to be injurious to the
2426 individual’s patient's condition. If the court finds that the
2427 individual’s patient's attendance at the hearing is not
2428 consistent with the individual's best interests, of the patient
2429 and if the individual’s patient's counsel does not object, the
2430 court may waive the presence of the individual patient from all
2431 or any portion of the hearing. The state attorney for the
2432 circuit in which the individual patient is located shall
2433 represent the state, rather than the petitioner, as the real
2434 party in interest in the proceeding.
2435 (b)2. The court may appoint a magistrate master to preside
2436 at the hearing. One of the professionals who executed the
2437 involuntary outpatient placement certificate shall be a witness.
2438 The individual who is the subject of the petition patient and
2439 his or her the patient's guardian or representative shall be
2440 informed by the court of the right to an independent expert
2441 examination. If the individual patient cannot afford such an
2442 examination, the court shall provide for one. The independent
2443 expert's report is shall be confidential and not discoverable,
2444 unless the expert is to be called as a witness for the
2445 individual patient at the hearing. The court shall allow
2446 testimony from persons individuals, including family members,
2447 deemed by the court to be relevant under state law, regarding
2448 the individual’s person's prior history and how that prior
2449 history relates to the individual’s person's current condition.
2450 The testimony in the hearing must be given under oath, and the
2451 proceedings must be recorded. The individual patient may refuse
2452 to testify at the hearing.
2453 (c) At the hearing on involuntary outpatient placement, the
2454 court shall consider testimony and evidence regarding the
2455 competence of the individual being held to consent to treatment.
2456 If the court finds that the individual is incompetent to
2457 consent, it shall appoint a guardian advocate as provided in s.
2458 394.4598.
2459 (d) The individual who is the subject of the petition is
2460 entitled to at least one continuance of the hearing for up to 4
2461 weeks, with the concurrence of the individual’s counsel.
2462 (6) COURT ORDER.—
2463 (a)(b)1. If the court concludes that the individual who is
2464 the subject of the petition patient meets the criteria for
2465 involuntary outpatient placement under pursuant to subsection
2466 (1), the court shall issue an order for involuntary outpatient
2467 placement. The court order may shall be for a period of up to 6
2468 months. The order must specify the nature and extent of the
2469 individual’s patient's mental illness. The court order of the
2470 court and the treatment plan must shall be made part of the
2471 patient's clinical record. The service provider shall discharge
2472 an individual a patient from involuntary outpatient placement
2473 when the order expires or any time the individual patient no
2474 longer meets the criteria for involuntary placement. Upon
2475 discharge, the service provider shall send a certificate of
2476 discharge to the court.
2477 (b)2. The court may not order the department or the service
2478 provider to provide services if the program or service is not
2479 available in the patient's local community of the individual
2480 being served, if there is no space available in the program or
2481 service for the individual patient, or if funding is not
2482 available for the program or service. A copy of the order must
2483 be sent to the Agency for Health Care Administration by the
2484 service provider within 1 working day after it is received from
2485 the court. After the placement order is issued, the service
2486 provider and the individual patient may modify provisions of the
2487 treatment plan. For any material modification of the treatment
2488 plan to which the individual patient or the individual’s
2489 patient's guardian advocate, if appointed, agrees does agree,
2490 the service provider shall send notice of the modification to
2491 the court. Any material modifications of the treatment plan
2492 which are contested by the individual patient or the
2493 individual’s patient's guardian advocate, if appointed, must be
2494 approved or disapproved by the court consistent with the
2495 requirements of subsection (2).
2496 (c)3. If, in the clinical judgment of a physician, the
2497 individual being served patient has failed or has refused to
2498 comply with the treatment ordered by the court, and, in the
2499 clinical judgment of the physician, efforts were made to solicit
2500 compliance and the individual patient may meet the criteria for
2501 involuntary examination, the individual a person may be brought
2502 to a receiving facility pursuant to s. 394.463 for involuntary
2503 examination. If, after examination, the individual patient does
2504 not meet the criteria for involuntary inpatient placement under
2505 pursuant to s. 394.467, the individual patient must be
2506 discharged from the receiving facility. The involuntary
2507 outpatient placement order remains shall remain in effect unless
2508 the service provider determines that the individual patient no
2509 longer meets the criteria for involuntary outpatient placement
2510 or until the order expires. The service provider shall must
2511 determine whether modifications should be made to the existing
2512 treatment plan and must continue to attempt to continue to
2513 engage the individual patient in treatment. For any material
2514 modification of the treatment plan to which the individual
2515 patient or the individual’s patient's guardian advocate, if
2516 appointed, agrees does agree, the service provider shall send
2517 notice of the modification to the court. Any material
2518 modifications of the treatment plan which are contested by the
2519 individual patient or the individual’s patient's guardian
2520 advocate, if appointed, must be approved or disapproved by the
2521 court consistent with the requirements of subsection (2).
2522 (d)(c) If, at any time before the conclusion of the initial
2523 hearing on involuntary outpatient placement, it appears to the
2524 court that the individual person does not meet the criteria for
2525 involuntary outpatient placement under this section but,
2526 instead, meets the criteria for involuntary inpatient placement,
2527 the court may order the individual person admitted for
2528 involuntary inpatient examination under s. 394.463. If the
2529 individual person instead meets the criteria for involuntary
2530 assessment, protective custody, or involuntary admission under
2531 pursuant to s. 397.675, the court may order the individual
2532 person to be admitted for involuntary assessment for a period of
2533 5 days pursuant to s. 397.6811. Thereafter, all proceedings are
2534 shall be governed by chapter 397.
2535 (d) At the hearing on involuntary outpatient placement, the
2536 court shall consider testimony and evidence regarding the
2537 patient's competence to consent to treatment. If the court finds
2538 that the patient is incompetent to consent to treatment, it
2539 shall appoint a guardian advocate as provided in s. 394.4598.
2540 The guardian advocate shall be appointed or discharged in
2541 accordance with s. 394.4598.
2542 (e) The administrator of the receiving facility or the
2543 designated department representative shall provide a copy of the
2544 court order and adequate documentation of an individual’s a
2545 patient's mental illness to the service provider for involuntary
2546 outpatient placement. Such documentation must include any
2547 advance directives made by the individual patient, a psychiatric
2548 evaluation of the individual patient, and any evaluations of the
2549 individual patient performed by a clinical psychologist or a
2550 clinical social worker.
2551 (7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
2552 PLACEMENT.—
2553 (a)1. If an individual the person continues to meet the
2554 criteria for involuntary outpatient placement, the service
2555 provider shall, before the expiration of the period during which
2556 the placement treatment is ordered for the person, file in the
2557 circuit court a petition for continued involuntary outpatient
2558 placement.
2559 1.2. The existing involuntary outpatient placement order
2560 remains in effect until disposition of on the petition for
2561 continued involuntary outpatient placement.
2562 2.3. A certificate must shall be attached to the petition
2563 which includes a statement from the individual’s person's
2564 physician or clinical psychologist justifying the request, a
2565 brief description of the individual’s patient's treatment during
2566 the time he or she was involuntarily placed, and a personalized
2567 an individualized plan of continued treatment.
2568 3.4. The service provider shall develop the individualized
2569 plan of continued treatment in consultation with the individual
2570 patient or his or her the patient's guardian advocate, if
2571 appointed. When the petition has been filed, the clerk of the
2572 court shall provide copies of the certificate and the
2573 individualized plan of continued treatment to the department,
2574 the individual patient, the individual’s patient's guardian
2575 advocate, the state attorney, and the individual’s patient's
2576 private counsel or the public defender.
2577 (b) Within 1 court working day after the filing of a
2578 petition for continued involuntary outpatient placement, the
2579 court shall appoint the public defender to represent the
2580 individual person who is the subject of the petition, unless the
2581 individual person is otherwise represented by counsel. The clerk
2582 of the court shall immediately notify the public defender of
2583 such appointment. The public defender shall represent the
2584 individual person until the petition is dismissed, or the court
2585 order expires, or the individual patient is discharged from
2586 involuntary outpatient placement. An Any attorney representing
2587 the individual must patient shall have access to the individual
2588 patient, witnesses, and records relevant to the presentation of
2589 the individual’s patient's case and shall represent the
2590 interests of the individual patient, regardless of the source of
2591 payment to the attorney.
2592 (c) The court shall inform the individual who is the
2593 subject of the petition and his or her guardian, guardian
2594 advocate, or representative of the individual’s right to an
2595 independent expert examination. If the individual cannot afford
2596 such an examination, the court shall provide one.
2597 (d)(c) Hearings on petitions for continued involuntary
2598 outpatient placement are shall be before the circuit court. The
2599 court may appoint a magistrate master to preside at the hearing.
2600 The procedures for obtaining an order pursuant to this paragraph
2601 must shall be in accordance with subsection (6), except that the
2602 time period included in paragraph (1)(e) is not applicable for
2603 in determining the appropriateness of additional periods of
2604 involuntary outpatient placement.
2605 (e)(d) Notice of the hearing shall be provided in
2606 accordance with as set forth in s. 394.4599. The individual
2607 being served patient and the individual’s patient's attorney may
2608 agree to a period of continued outpatient placement without a
2609 court hearing.
2610 (f)(e) The same procedure must shall be repeated before the
2611 expiration of each additional period the individual being served
2612 patient is placed in treatment.
2613 (g)(f) If the individual in involuntary outpatient
2614 placement patient has previously been found incompetent to
2615 consent to treatment, the court shall consider testimony and
2616 evidence regarding the individual’s patient's competence.
2617 Section 394.4598 governs the discharge of the guardian advocate
2618 if the individual’s patient's competency to consent to treatment
2619 has been restored.
2620 Section 22. Section 394.467, Florida Statutes, is amended
2621 to read:
2622 394.467 Involuntary inpatient placement.—
2623 (1) CRITERIA.—An individual A person may be placed in
2624 involuntary inpatient placement for treatment upon a finding of
2625 the court by clear and convincing evidence that:
2626 (a) He or she is mentally ill and because of his or her
2627 mental illness:
2628 1.a. He or she has refused voluntary placement for
2629 treatment after sufficient and conscientious explanation and
2630 disclosure of the purpose of placement for treatment; or
2631 b. He or she is unable to determine for himself or herself
2632 whether placement is necessary; and
2633 2.a. He or she is manifestly incapable of surviving alone
2634 or with the help of willing and responsible family or friends,
2635 including available alternative services, and, without
2636 treatment, is likely to suffer from neglect or refuse to care
2637 for himself or herself, and such neglect or refusal poses a real
2638 and present threat of substantial harm to his or her well-being;
2639 or
2640 b. There is substantial likelihood that in the near future
2641 he or she will inflict serious bodily harm on self or others
2642 himself or herself or another person, as evidenced by recent
2643 behavior causing, attempting, or threatening such harm; and
2644 (b) All available less restrictive treatment alternatives
2645 that which would offer an opportunity for improvement of his or
2646 her condition have been judged to be inappropriate.
2647 (2) ADMISSION TO A TREATMENT FACILITY.—An individual A
2648 patient may be retained by a receiving facility or involuntarily
2649 placed in a treatment facility upon the recommendation of the
2650 administrator of a receiving facility where the individual
2651 patient has been examined and after adherence to the notice and
2652 hearing procedures provided in s. 394.4599. The recommendation
2653 must be supported by the opinion of a psychiatrist and the
2654 second opinion of a clinical psychologist or another
2655 psychiatrist, both of whom have personally examined the
2656 individual patient within the preceding 72 hours, that the
2657 criteria for involuntary inpatient placement are met. However,
2658 in counties that have a population of fewer less than 50,000
2659 population, if the administrator certifies that a no
2660 psychiatrist or clinical psychologist is not available to
2661 provide the second opinion, the such second opinion may be
2662 provided by a licensed physician with postgraduate training and
2663 experience in diagnosis and treatment of mental and nervous
2664 disorders or by a psychiatric nurse as defined in s.
2665 394.455(23). Such recommendation must shall be entered on an
2666 involuntary inpatient placement certificate that authorizes,
2667 which certificate shall authorize the receiving facility to
2668 retain the individual being held patient pending transfer to a
2669 treatment facility or completion of a hearing.
2670 (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.—
2671 (a) The administrator of the facility shall file a petition
2672 for involuntary inpatient placement in the court in the county
2673 where the individual patient is located. Upon filing, the clerk
2674 of the court shall provide copies to the department, the
2675 individual patient, the individual’s patient's guardian or
2676 representative, and the state attorney and public defender of
2677 the judicial circuit in which the individual patient is located.
2678 A No fee may not shall be charged for the filing of a petition
2679 under this subsection.
2680 (b) A receiving or treatment facility filing a petition for
2681 involuntary inpatient placement shall send a copy of the
2682 petition to the Agency for Health Care Administration by the
2683 next working day.
2684 (4) APPOINTMENT OF COUNSEL.—
2685 (a) Within 1 court working day after the filing of a
2686 petition for involuntary inpatient placement, the court shall
2687 appoint the public defender to represent the individual person
2688 who is the subject of the petition, unless the individual person
2689 is otherwise represented by counsel. The clerk of the court
2690 shall immediately notify the public defender of such
2691 appointment. Any attorney representing the individual patient
2692 shall have access to the individual patient, witnesses, and
2693 records relevant to the presentation of the individual’s
2694 patient's case and shall represent the interests of the
2695 individual patient, regardless of the source of payment to the
2696 attorney. An attorney representing an individual in involuntary
2697 placement proceedings shall represent the individual’s expressed
2698 desires.
2699 (b) The state attorney for the circuit in which the
2700 individual is located shall represent the state rather than the
2701 petitioning facility administrator as the real party in interest
2702 in the proceeding. The state attorney shall independently
2703 evaluate and confirm the allegations set forth in the petition
2704 for involuntary placement. If the allegations are substantiated,
2705 the state attorney shall vigorously prosecute the petition. If
2706 the allegations are not substantiated, the state attorney shall
2707 withdraw the petition. The state attorney shall be present and
2708 actively participate in all hearings on the involuntary
2709 placement.
2710 (5) CONTINUANCE OF HEARING.—The individual patient is
2711 entitled, with the concurrence of the individual’s patient's
2712 counsel, to at least one continuance of the hearing. Requests
2713 for a continuance from parties other than the individual or his
2714 or her counsel may not be granted. The continuance shall be for
2715 a period of up to 4 weeks. At the time the court is considering
2716 a motion for continuance, the court shall also conduct a hearing
2717 to consider the capacity of the individual to consent to
2718 treatment if there is a pending petition for adjudication of
2719 incompetence to consent to treatment. If the court finds that
2720 the individual is not competent to consent to treatment, a
2721 guardian advocate shall be appointed at the time the involuntary
2722 placement hearing is continued to make mental health decisions
2723 for the individual.
2724 (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.—
2725 (a)1. The court shall hold the hearing on involuntary
2726 inpatient placement within 5 working days after the petition is
2727 filed, unless a continuance is granted.
2728 1. Except for good cause documented in the court file, the
2729 hearing shall be held in the receiving or treatment facility
2730 county where the individual patient is located. If the hearing
2731 cannot be held in the receiving or treatment facility, it must
2732 held in a location and shall be as convenient to the individual
2733 patient as is may be consistent with orderly procedure and which
2734 is shall be conducted in physical settings not likely to be
2735 injurious to the individual’s patient's condition. If the court
2736 finds that the individual’s patient's attendance at the hearing
2737 is not consistent with his or her the best interests of the
2738 patient, and the individual’s patient's counsel does not object,
2739 the court may waive the presence of the individual patient from
2740 all or any portion of the hearing. The state attorney for the
2741 circuit in which the patient is located shall represent the
2742 state, rather than the petitioning facility administrator, as
2743 the real party in interest in the proceeding.
2744 2. The court may appoint a general or special magistrate to
2745 preside at the hearing. One of the professionals who executed
2746 the involuntary inpatient placement certificate shall be a
2747 witness. The individual patient and the individual’s patient's
2748 guardian or representative shall be informed by the court of the
2749 right to an independent expert examination. If the individual
2750 patient cannot afford such an examination, the court shall
2751 provide for one. The independent expert's report is shall be
2752 confidential and not discoverable, unless the expert is to be
2753 called as a witness for the individual patient at the hearing.
2754 The testimony in the hearing must be given under oath, and the
2755 proceedings must be recorded. The individual patient may refuse
2756 to testify at the hearing.
2757 3. The court shall allow testimony from persons, including
2758 family members, deemed by the court to be relevant regarding the
2759 individual’s prior history and how that prior history relates to
2760 the individual’s current condition.
2761 (b) If the court concludes that the individual patient
2762 meets the criteria for involuntary inpatient placement, it shall
2763 order that the individual patient be transferred to a treatment
2764 facility or, if the individual patient is at a treatment
2765 facility, that the individual patient be retained there or be
2766 treated at any other appropriate receiving or treatment
2767 facility, or that the individual patient receive services from a
2768 receiving or treatment facility, on an involuntary basis, for a
2769 period of up to 6 months. The order must shall specify the
2770 nature and extent of the individual’s patient's mental illness.
2771 The facility shall discharge the individual a patient any time
2772 the individual patient no longer meets the criteria for
2773 involuntary inpatient placement, unless the individual patient
2774 has transferred to voluntary status.
2775 (c) If at any time before prior to the conclusion of the
2776 hearing on involuntary inpatient placement it appears to the
2777 court that the individual person does not meet the criteria for
2778 involuntary inpatient placement under this section, but instead
2779 meets the criteria for involuntary outpatient placement, the
2780 court may order the individual person evaluated for involuntary
2781 outpatient placement pursuant to s. 394.4655. The petition and
2782 hearing procedures set forth in s. 394.4655 shall apply. If the
2783 individual person instead meets the criteria for involuntary
2784 assessment, protective custody, or involuntary admission
2785 pursuant to s. 397.675, then the court may order the individual
2786 person to be admitted for involuntary assessment for up to a
2787 period of 5 days pursuant to s. 397.6811. Thereafter, all
2788 proceedings are shall be governed by chapter 397.
2789 (d) At the hearing on involuntary inpatient placement, the
2790 court shall consider testimony and evidence regarding the
2791 individual’s patient's competence to consent to treatment. If
2792 the court finds that the individual patient is incompetent to
2793 consent to treatment, it shall appoint a guardian advocate as
2794 provided in s. 394.4598.
2795 (e) The administrator of the receiving facility shall
2796 provide a copy of the court order and adequate documentation of
2797 an individual’s a patient's mental illness to the administrator
2798 of a treatment facility if the individual whenever a patient is
2799 ordered for involuntary inpatient placement, whether by civil or
2800 criminal court. The documentation must shall include any advance
2801 directives made by the individual patient, a psychiatric
2802 evaluation of the individual patient, and any evaluations of the
2803 individual patient performed by a clinical psychologist, a
2804 marriage and family therapist, a mental health counselor, or a
2805 clinical social worker. The administrator of a treatment
2806 facility may refuse admission to an individual any patient
2807 directed to its facilities on an involuntary basis, whether by
2808 civil or criminal court order, who is not accompanied at the
2809 same time by adequate orders and documentation.
2810 (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT
2811 PLACEMENT.—
2812 (a) Hearings on petitions for continued involuntary
2813 inpatient placement shall be administrative hearings and shall
2814 be conducted in accordance with the provisions of s. 120.57(1),
2815 except that an any order entered by an the administrative law
2816 judge is shall be final and subject to judicial review in
2817 accordance with s. 120.68. Orders concerning an individual
2818 patients committed after successfully pleading not guilty by
2819 reason of insanity are shall be governed by the provisions of s.
2820 916.15.
2821 (b) If the individual patient continues to meet the
2822 criteria for involuntary inpatient placement, the administrator
2823 shall, before prior to the expiration of the period during which
2824 the treatment facility is authorized to retain the individual
2825 patient, file a petition requesting authorization for continued
2826 involuntary inpatient placement. The request must shall be
2827 accompanied by a statement from the individual’s patient's
2828 physician or clinical psychologist justifying the request, a
2829 brief description of the individual’s patient's treatment during
2830 the time he or she was involuntarily placed, and a personalized
2831 an individualized plan of continued treatment. Notice of the
2832 hearing must shall be provided in accordance with as set forth
2833 in s. 394.4599. If at the hearing the administrative law judge
2834 finds that attendance at the hearing is not consistent with the
2835 individual’s best interests of the patient, the administrative
2836 law judge may waive the presence of the individual patient from
2837 all or any portion of the hearing, unless the individual
2838 patient, through counsel, objects to the waiver of presence. The
2839 testimony in the hearing must be under oath, and the proceedings
2840 must be recorded.
2841 (c) Unless the individual patient is otherwise represented
2842 or is ineligible, he or she shall be represented at the hearing
2843 on the petition for continued involuntary inpatient placement by
2844 the public defender of the circuit in which the facility is
2845 located.
2846 (d) The Division of Administrative Hearings shall inform
2847 the individual and his or her guardian, guardian advocate, or
2848 representative of the right to an independent expert
2849 examination. If the individual cannot afford such an
2850 examination, the administrative law judge shall appoint one and
2851 the county of the individual’s residence shall be billed for the
2852 cost of the examination.
2853 (e)(d) If at a hearing it is shown that the individual
2854 patient continues to meet the criteria for involuntary inpatient
2855 placement, the administrative law judge shall sign the order for
2856 continued involuntary inpatient placement for a period of up to
2857 not to exceed 6 months. The same procedure must shall be
2858 repeated before prior to the expiration of each additional
2859 period the individual patient is retained.
2860 (f)(e) If continued involuntary inpatient placement is
2861 necessary for an individual a patient admitted while serving a
2862 criminal sentence, but whose sentence is about to expire, or for
2863 a minor patient involuntarily placed while a minor but who is
2864 about to reach the age of 18, the administrator shall petition
2865 the administrative law judge for an order authorizing continued
2866 involuntary inpatient placement.
2867 (g)(f) If the individual patient has been previously found
2868 incompetent to consent to treatment, the administrative law
2869 judge shall consider testimony and evidence regarding the
2870 individual’s patient's competence. If the administrative law
2871 judge finds evidence that the individual patient is now
2872 competent to consent to treatment, the administrative law judge
2873 may issue a recommended order to the court that found the
2874 individual patient incompetent to consent to treatment that the
2875 individual’s patient's competence be restored and that any
2876 guardian advocate previously appointed be discharged.
2877 (8) RETURN TO FACILITY OF PATIENTS.—If an individual held
2878 When a patient at a treatment facility leaves the facility
2879 without authorization, the administrator may authorize a search
2880 for, the patient and the return of, the individual patient to
2881 the facility. The administrator may request the assistance of a
2882 law enforcement agency in the search for and return of the
2883 patient.
2884 Section 23. Section 394.46715, Florida Statutes, is amended
2885 to read:
2886 394.46715 Rulemaking authority.—The department may adopt
2887 rules to administer of Children and Family Services shall have
2888 rulemaking authority to implement the provisions of ss. 394.455,
2889 394.4598, 394.4615, 394.463, 394.4655, and 394.467 as amended or
2890 created by this act. These rules are shall be for the purpose of
2891 protecting the health, safety, and well-being of individuals
2892 persons examined, treated, or placed under this part act.
2893 Section 24. Section 394.4672, Florida Statutes, is amended
2894 to read:
2895 394.4672 Procedure for placement of veteran with federal
2896 agency.—
2897 (1) If a Whenever it is determined by the court determines
2898 that an individual a person meets the criteria for involuntary
2899 placement and he or she it appears that such person is eligible
2900 for care or treatment by the United States Department of
2901 Veterans Affairs or other agency of the United States
2902 Government, the court, upon receipt of a certificate from the
2903 United States Department of Veterans Affairs or such other
2904 agency showing that facilities are available and that the
2905 individual person is eligible for care or treatment therein, may
2906 place that individual person with the United States Department
2907 of Veterans Affairs or other federal agency. The individual
2908 person whose placement is sought shall be personally served with
2909 notice of the pending placement proceeding in the manner as
2910 provided in this part., and nothing in This section does not
2911 shall affect the individual’s his or her right to appear and be
2912 heard in the proceeding. Upon placement, the individual is
2913 person shall be subject to the rules and regulations of the
2914 United States Department of Veterans Affairs or other federal
2915 agency.
2916 (2) The judgment or order of placement issued by a court of
2917 competent jurisdiction of another state or of the District of
2918 Columbia that places an individual,placing a person with the
2919 United States Department of Veterans Affairs or other federal
2920 agency for care or treatment has, shall have the same force and
2921 effect in this state as in the jurisdiction of the court
2922 entering the judgment or making the order.; and The courts of
2923 the placing state or of the District of Columbia shall retain be
2924 deemed to have retained jurisdiction over of the individual
2925 person so placed. Consent is hereby given to the application of
2926 the law of the placing state or district with respect to the
2927 authority of the chief officer of any facility of the United
2928 States Department of Veterans Affairs or other federal agency
2929 operated in this state to retain custody or to transfer, parole,
2930 or discharge the individual person.
2931 (3) Upon receipt of a certificate of the United States
2932 Department of Veterans Affairs or another such other federal
2933 agency that facilities are available for the care or treatment
2934 individuals who have mental illness of mentally ill persons and
2935 that the individual person is eligible for that care or
2936 treatment, the administrator of the receiving or treatment
2937 facility may cause the transfer of that individual person to the
2938 United States Department of Veterans Affairs or other federal
2939 agency. Upon effecting such transfer, the committing court shall
2940 be notified by the transferring agency. An individual may not No
2941 person shall be transferred to the United States Department of
2942 Veterans Affairs or other federal agency if he or she is
2943 confined pursuant to the conviction of any felony or misdemeanor
2944 or if he or she has been acquitted of the charge solely on the
2945 ground of insanity, unless prior to transfer the court placing
2946 the individual such person enters an order for the transfer
2947 after appropriate motion and hearing and without objection by
2948 the United States Department of Veterans Affairs.
2949 (4) An individual Any person transferred as provided in
2950 this section shall be deemed to be placed with the United States
2951 Department of Veterans Affairs or other federal agency pursuant
2952 to the original placement.
2953 Section 25. Section 394.4674, Florida Statutes, is
2954 repealed.
2955 Section 26. Section 394.4685, Florida Statutes, is amended
2956 to read:
2957 394.4685 Transfer between of patients among facilities.—
2958 (1) TRANSFER BETWEEN PUBLIC FACILITIES.—
2959 (a) An individual A patient who has been admitted to a
2960 public receiving facility, or his or her the family member,
2961 guardian, or guardian advocate of such patient, may request the
2962 transfer of the individual patient to another public receiving
2963 facility. An individual A patient who has been admitted to a
2964 public treatment facility, or his or her the family member,
2965 guardian, or guardian advocate of such patient, may request the
2966 transfer of the individual patient to another public treatment
2967 facility. Depending on the medical treatment or mental health
2968 treatment needs of the individual patient and the availability
2969 of appropriate facility resources, the individual patient may be
2970 transferred at the discretion of the department. If the
2971 department approves the transfer of an individual on involuntary
2972 status patient, notice in accordance with according to the
2973 provisions of s. 394.4599 must shall be given before prior to
2974 the transfer by the transferring facility. The department shall
2975 respond to the request for transfer within 2 working days after
2976 receipt of the request by the facility administrator.
2977 (b) If When required by the medical treatment or mental
2978 health treatment needs of the individual patient or the
2979 efficient use utilization of a public receiving or public
2980 treatment facility, an individual a patient may be transferred
2981 from one receiving facility to another, or one treatment
2982 facility to another, at the department's discretion, or, with
2983 the express and informed consent of the individual patient or
2984 the individual’s patient's guardian or guardian advocate, to a
2985 facility in another state. Notice in accordance with according
2986 to the provisions of s. 394.4599 must shall be given before
2987 prior to the transfer by the transferring facility. If prior
2988 notice is not possible, notice of the transfer must shall be
2989 provided as soon as practicable after the transfer.
2990 (2) TRANSFER FROM PUBLIC TO PRIVATE FACILITIES.—
2991 (a) An individual A patient who has been admitted to a
2992 public receiving or public treatment facility and has requested,
2993 either personally or through his or her guardian or guardian
2994 advocate, and is able to pay for treatment in a private facility
2995 shall be transferred at the individual’s patient's expense to a
2996 private facility upon acceptance of the individual patient by
2997 the private facility.
2998 (b) A public facility may request the transfer of an
2999 individual from the facility to a private facility, and the
3000 individual may be transferred upon acceptance of the individual
3001 by the private facility.
3002 (3) TRANSFER FROM PRIVATE TO PUBLIC FACILITIES.—
3003 (a) An individual A patient or his or her the patient's
3004 guardian or guardian advocate may request the transfer of the
3005 individual patient from a private to a public facility, and the
3006 individual patient may be so transferred upon acceptance of the
3007 individual patient by the public facility.
3008 (b) A private facility may request the transfer of an
3009 individual a patient from the facility to a public facility, and
3010 the individual patient may be so transferred upon acceptance of
3011 the individual patient by the public facility. The cost of such
3012 transfer is shall be the responsibility of the transferring
3013 facility.
3014 (c) A public facility must respond to a request for the
3015 transfer of an individual a patient within 2 working days after
3016 receipt of the request.
3017 (4) TRANSFER BETWEEN PRIVATE FACILITIES.—An individual
3018 being held A patient in a private facility or his or her the
3019 patient's guardian or guardian advocate may request the transfer
3020 of the individual patient to another private facility at any
3021 time, and the individual patient shall be transferred upon
3022 acceptance of the individual patient by the facility to which
3023 transfer is sought.
3024 Section 27. Section 394.469, Florida Statutes, is amended
3025 to read:
3026 394.469 Discharge of involuntary placements patients.—
3027 (1) POWER TO DISCHARGE.—At any time an individual a patient
3028 is found to no longer meet the criteria for involuntary
3029 placement, the administrator shall:
3030 (a) Discharge the individual patient, unless the patient is
3031 under a criminal charge, in which case the patient shall be
3032 transferred to the custody of the appropriate law enforcement
3033 officer;
3034 (b) Transfer the individual patient to voluntary status on
3035 his or her own authority or at the individual’s patient's
3036 request, unless the individual patient is under criminal charge
3037 or adjudicated incapacitated; or
3038 (c) Return an individual released from a receiving or
3039 treatment facility on voluntary or involuntary status who is
3040 charged with a crime to the custody of a law enforcement officer
3041 Place an improved patient, except a patient under a criminal
3042 charge, on convalescent status in the care of a community
3043 facility.
3044 (2) NOTICE.—Notice of discharge or transfer of an
3045 individual must be provided in accordance with a patient shall
3046 be given as provided in s. 394.4599.
3047 Section 28. Section 394.473, Florida Statutes, is amended
3048 to read:
3049 394.473 Attorney's fee; expert witness fee.—
3050 (1) In the case of an indigent person for whom An attorney
3051 is appointed to represent an indigent individual pursuant to the
3052 provisions of this part, the attorney shall be compensated by
3053 the state pursuant to s. 27.5304. In the case of an indigent
3054 person, The court may appoint a public defender for an indigent
3055 individual. The public defender shall receive no additional
3056 compensation other than that usually paid his or her office.
3057 (2) An In the case of an indigent person for whom expert
3058 whose testimony is required for an indigent individual in a
3059 court hearing pursuant to the provisions of this part act, the
3060 expert, except one who is classified as a full-time employee of
3061 the state or who is receiving remuneration from the state for
3062 his or her time in attendance at the hearing, shall be
3063 compensated by the state pursuant to s. 27.5304.
3064 Section 29. Section 394.475, Florida Statutes, is amended
3065 to read:
3066 394.475 Acceptance, examination, and involuntary placement
3067 of Florida residents from out-of-state mental health
3068 authorities.—
3069 (1) Upon the request of the state mental health authority
3070 of another state, the department may is authorized to accept an
3071 individual as a patient, for up to a period of not more than 15
3072 days, a person who is and has been a bona fide resident of this
3073 state for at least a period of not less than 1 year.
3074 (2) An individual Any person received pursuant to
3075 subsection (1) shall be examined by the staff of the state
3076 facility where the individual such patient has been admitted
3077 accepted, which examination shall be completed during the 15-day
3078 period.
3079 (3) If, upon examination, the individual such a person
3080 requires continued involuntary placement, a petition for a
3081 hearing regarding involuntary placement shall be filed with the
3082 court of the county where wherein the treatment facility
3083 receiving the individual patient is located or the county where
3084 the individual patient is a resident.
3085 (4) During the pendency of the examination period and the
3086 pendency of the involuntary placement proceedings, an individual
3087 such person may continue to be held in the treatment facility
3088 unless the court having jurisdiction enters an order to the
3089 contrary.
3090 Section 30. Section 394.4785, Florida Statutes, is amended
3091 to read:
3092 394.4785 Children and adolescents; admission and placement
3093 in mental health facilities.—
3094 (1) A child or adolescent as defined in s. 394.492 may not
3095 be admitted to a state-owned or state-operated mental health
3096 treatment facility. A child may be admitted pursuant to s.
3097 394.4625 or s. 394.467 to a crisis stabilization unit or a
3098 residential treatment center licensed under this chapter or a
3099 hospital licensed under chapter 395. The treatment center, unit,
3100 or hospital must provide the least restrictive available
3101 treatment that is appropriate to the individual needs of the
3102 child or adolescent and must adhere to the guiding principles,
3103 system of care, and service planning provisions of contained in
3104 part III of this chapter.
3105 (2) A child or adolescent, as defined in s. 394.492, who is
3106 younger than person under the age of 14 years of age and who is
3107 admitted to a any hospital licensed pursuant to chapter 395 may
3108 not be admitted to a bed in a room or ward with an adult patient
3109 in a mental health unit or share common areas with an adult
3110 patient in a mental health unit. However, an adolescent a person
3111 14 years of age or older may be admitted to a bed in a room or
3112 ward in the mental health unit with an adult if the admitting
3113 physician documents in the case record that such placement is
3114 medically indicated or for reasons of safety. Such placement
3115 shall be reviewed by the attending physician or a designee or
3116 on-call physician each day and documented in the clinical case
3117 record.
3118 Section 31. Subsection (2) of section 394.4786, Florida
3119 Statutes, is amended to read:
3120 394.4786 Intent.—
3121 (2) Further, the Legislature intends that a specialty
3122 psychiatric hospital that provides health care to specified
3123 indigent individuals patients be eligible for reimbursement up
3124 to the amount that hospital contributed to the Public Medical
3125 Assistance Trust Fund in the previous fiscal year.
3126 Section 32. Subsections (2) and (3) of section 394.47865,
3127 Florida Statutes, are amended to read:
3128 394.47865 South Florida State Hospital; privatization.—
3129 (2) The contractor shall operate South Florida State
3130 Hospital as a mental health treatment facility that serves
3131 voluntarily and involuntarily committed indigent individuals 18
3132 years of age or older adults who meet the criteria of this part
3133 I of this chapter and who reside in the South Florida State
3134 Hospital service area.
3135 (a) South Florida State Hospital shall remain a participant
3136 in the mental health disproportionate share program so long as
3137 such individuals the residents receive eligible services.
3138 (b) The department and the contractor shall ensure that the
3139 treatment facility is operated as a part of a total continuum of
3140 care for individuals persons who are mentally ill. The
3141 contractor shall have as its primary goal for the treatment
3142 facility to effectively treat and assist individuals held at the
3143 facility residents to return to the community as quickly as
3144 possible.
3145 (3)(a) Current South Florida State Hospital employees who
3146 are affected by the privatization shall be given first
3147 preference for continued employment by the contractor. The
3148 department shall make reasonable efforts to find suitable job
3149 placements for employees who wish to remain within the state
3150 Career Service System.
3151 (b) Any savings that result from the privatization of South
3152 Florida State Hospital shall be directed to the department's
3153 service districts 9, 10, and 11 for the delivery of community
3154 mental health services.
3155 Section 33. Section 394.4787, Florida Statutes, is amended
3156 to read:
3157 394.4787 Definitions; ss. 394.4786, 394.4787, 394.4788, and
3158 394.4789.—As used in sections 394.4786-394.4789, the term this
3159 section and ss. 394.4786, 394.4788, and 394.4789:
3160 (1) “Acute mental health services” means mental health
3161 services provided through inpatient hospitalization.
3162 (2) “Agency” means the Agency for Health Care
3163 Administration.
3164 (3) “Charity care” means that portion of hospital charges
3165 for care provided to an individual a patient whose family income
3166 for the 12 months preceding the determination is equal to or
3167 below 150 percent of the current federal nonfarm poverty
3168 guideline or the amount of hospital charges due from the
3169 individual patient which exceeds 25 percent of the annual family
3170 income and for which there is no compensation. Charity care does
3171 shall not include administrative or courtesy discounts,
3172 contractual allowances to third party payors, or failure of a
3173 hospital to collect full charges due to partial payment by
3174 governmental programs.
3175 (4) “Indigent” means an individual whose financial status
3176 would qualify him or her for charity care.
3177 (5) “Operating expense” means all common and accepted costs
3178 appropriate in developing and maintaining the operating of the
3179 patient care facility and its activities.
3180 (6) “PMATF” means the Public Medical Assistance Trust Fund.
3181 (7) “Specialty psychiatric hospital” has the same meaning
3182 as in means a hospital licensed by the agency pursuant to s.
3183 395.002(28), and includes facilities licensed under and part II
3184 of chapter 408 as a specialty psychiatric hospitals hospital.
3185 Section 34. Subsections (1), (2), and (6) of section
3186 394.4788, Florida Statutes, are amended to read:
3187 394.4788 Use of certain PMATF funds for the purchase of
3188 acute care mental health services.—
3189 (1) A hospital may be eligible to be reimbursed an amount
3190 no greater than the hospital's previous year contribution to the
3191 PMATF for acute mental health services provided to indigent
3192 mentally ill individuals persons who have been determined by the
3193 agency or its agent to require such treatment and who:
3194 (a) Do not meet Medicaid eligibility criteria, unless the
3195 agency makes a referral for a Medicaid eligible individual
3196 patient pursuant to s. 394.4789;
3197 (b) Meet the criteria for mental illness under this part;
3198 and
3199 (c) Meet the definition of charity care.
3200 (2) The agency shall annually calculate a per diem
3201 reimbursement rate for each specialty psychiatric hospital to be
3202 paid to the specialty psychiatric hospitals for the provision of
3203 acute mental health services provided to indigent mentally ill
3204 individual’s patients who meet the criteria in subsection (1).
3205 After the first rate period, providers shall be notified of new
3206 reimbursement rates for each new state fiscal year by June 1.
3207 The new reimbursement rates shall commence on July 1.
3208 (6) Hospitals that agree to participate in the program set
3209 forth in this section and ss. 394.4786, 394.4787, and 394.4789
3210 shall agree that payment from the PMATF is payment in full for
3211 all individuals patients for which reimbursement is received
3212 under this section and ss. 394.4786, 394.4787, and 394.4789,
3213 until the funds for this program are no longer available.
3214 Section 35. Section 394.4789, Florida Statutes, is amended
3215 to read:
3216 394.4789 Establishment of referral process and eligibility
3217 determination.—
3218 (1) The department shall adopt by rule a referral process
3219 that provides which shall provide each participating specialty
3220 psychiatric hospital with a system for accepting into the
3221 hospital's care indigent mentally ill individuals persons
3222 referred by the department. It is the intent of the Legislature
3223 that a hospital that which seeks payment under s. 394.4788 shall
3224 accept referrals from the department. However, a hospital may
3225 shall have the right to refuse the admission of an individual a
3226 patient due to lack of functional bed space or lack of services
3227 appropriate to a patient's specific treatment and is not no
3228 hospital shall be required to accept referrals if the costs for
3229 treating the referred patient are no longer reimbursable because
3230 the hospital has reached the level of contribution made to the
3231 PMATF in the previous fiscal year. Furthermore, a hospital that
3232 does not seek compensation for indigent mentally ill patients
3233 under the provisions of this part is act shall not be obliged to
3234 accept department referrals, notwithstanding any agreements it
3235 may have entered into with the department. The right of refusal
3236 in this subsection does shall not affect a hospital's
3237 requirement to provide emergency care pursuant to s. 395.1041 or
3238 other state or federal law statutory requirements related to the
3239 provision of emergency care.
3240 (2) The department shall adopt by rule a patient
3241 eligibility form and is shall be responsible for eligibility
3242 determination. However, the department may contract with
3243 participating psychiatric hospitals for eligibility
3244 determination. The eligibility form must shall provide the
3245 mechanism for determining a patient's eligibility according to
3246 the requirements of s. 394.4788(1).
3247 (a) A specialty psychiatric hospital is shall be eligible
3248 for reimbursement only if when an eligibility form has been
3249 completed for each indigent mentally ill individual person for
3250 whom reimbursement is sought.
3251 (b) As part of eligibility determination, every effort
3252 shall be made by the hospital to determine if any third party
3253 insurance coverage is available.
3254 Section 36. Paragraph (a) of subsection (3) of section
3255 39.407, Florida Statutes, is amended to read:
3256 39.407 Medical, psychiatric, and psychological examination
3257 and treatment of child; physical, mental, or substance abuse
3258 examination of person with or requesting child custody.—
3259 (3)(a)1. Except as otherwise provided in subparagraph (b)1.
3260 or paragraph (e), before the department provides psychotropic
3261 medications to a child in its custody, the prescribing physician
3262 shall attempt to obtain express and informed consent, as defined
3263 in s. 394.455 394.455(9) and as described in s. 394.459(3)
3264 394.459(3)(a), from the child's parent or legal guardian. The
3265 department shall must take steps necessary to facilitate the
3266 inclusion of the parent in the child's consultation with the
3267 physician. However, if the parental rights of the parent have
3268 been terminated, the parent's location or identity is unknown or
3269 cannot reasonably be ascertained, or the parent declines to give
3270 express and informed consent, the department may, after
3271 consultation with the prescribing physician, seek court
3272 authorization to provide the psychotropic medications to the
3273 child. Unless parental rights have been terminated and if it is
3274 possible to do so, the department shall continue to involve the
3275 parent in the decisionmaking process regarding the provision of
3276 psychotropic medications. If, at any time, a parent whose
3277 parental rights have not been terminated provides express and
3278 informed consent to the provision of a psychotropic medication,
3279 the requirements of this section that the department seek court
3280 authorization do not apply to that medication until such time as
3281 the parent no longer consents.
3282 2. If Any time the department seeks a medical evaluation to
3283 determine the need to initiate or continue a psychotropic
3284 medication for a child, the department must provide to the
3285 evaluating physician all pertinent medical information known to
3286 the department concerning that child.
3287 Section 37. Subsection (3) of section 394.495, Florida
3288 Statutes, is amended to read:
3289 394.495 Child and adolescent mental health system of care;
3290 programs and services.—
3291 (3) Assessments shall must be performed by:
3292 (a) A clinical psychologist, clinical social worker,
3293 physician, psychiatric nurse, or psychiatrist professional as
3294 defined in s. 394.455 394.455(2), (4), (21), (23), or (24);
3295 (b) A professional licensed under chapter 491; or
3296 (c) A person who is under the direct supervision of a
3297 professional listed in paragraph (a) or paragraph (b) as defined
3298 in s. 394.455(2), (4), (21), (23), or (24) or a professional
3299 licensed under chapter 491.
3300
3301 The department shall adopt by rule statewide standards for
3302 mental health assessments, which are must be based on current
3303 relevant professional and accreditation standards.
3304 Section 38. Subsection (6) of section 394.496, Florida
3305 Statutes, is amended to read:
3306 394.496 Service planning.—
3307 (6) A clinical psychologist, clinical social worker,
3308 physician, psychiatric nurse, or psychiatrist professional as
3309 defined in s. 394.455, 394.455(2), (4), (21), (23), or (24) or a
3310 professional licensed under chapter 491, must be included among
3311 those persons developing the services plan.
3312 Section 39. Subsection (6) of section 394.9085, Florida
3313 Statutes, is amended to read:
3314 394.9085 Behavioral provider liability.—
3315 (6) For purposes of this section, the terms “detoxification
3316 program,” “addictions receiving facility,” and “receiving
3317 facility” have the same meanings as those provided in ss.
3318 397.311(18)(b), 397.311(18)(a), and 394.455 394.455(26),
3319 respectively.
3320 Section 40. Paragraph (d) of subsection (1) of section
3321 419.001, Florida Statutes, is amended to read:
3322 419.001 Site selection of community residential homes.—
3323 (1) For the purposes of this section, the following
3324 definitions shall apply:
3325 (d) “Resident” means any of the following: a frail elder as
3326 defined in s. 429.65; a physically disabled or handicapped
3327 person as defined in s. 760.22(7)(a); a developmentally disabled
3328 person as defined in s. 393.063; a nondangerous individual who
3329 has a mental illness as defined in s. 394.455 mentally ill
3330 person as defined in s. 394.455(18); or a child who is found to
3331 be dependent as defined in s. 39.01 or s. 984.03, or a child in
3332 need of services as defined in s. 984.03 or s. 985.03.
3333 Section 41. Subsection (7) of section 744.704, Florida
3334 Statutes, is amended to read:
3335 744.704 Powers and duties.—
3336 (7) A public guardian may shall not commit a ward to a
3337 mental health treatment facility, as defined in s. 394.455
3338 394.455(32), without an involuntary placement proceeding as
3339 provided by law.
3340 Section 42. This act shall take effect July 1, 2009.