Florida Senate - 2010 SB 2678
By Senator Storms
10-00842D-10 20102678__
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 revising requirements for a physical examination and
18 psychiatric evaluation and requiring the examination
19 to be documented in the clinical record; requiring
20 facilities to provide procedures for reporting events
21 that place individuals receiving services at risk of
22 harm; requiring facilities to provide information and
23 assist individuals with advance directives; amending
24 ss. 394.4593 and 394.4595, F.S.; conforming terms;
25 amending s. 394.4597, F.S.; conforming terms; adding a
26 health care surrogate to list of persons to be noted
27 in clinical record; specifying the rights, authority,
28 and responsibilities of a representative; amending s.
29 394.4598, F.S.; conforming terms; requiring a guardian
30 advocate to make every effort to make the decision the
31 individual would have made; amending s. 394.4599,
32 F.S.; conforming terms; adding the health care
33 surrogate or proxy to list of persons to receive
34 notice of involuntary admission; repealing s. 394.460,
35 F.S., relating to the rights of professionals;
36 amending s. 394.461, F.S.; conforming terms;
37 specifying that only governmental facilities may serve
38 as receiving and treatment facilities; revising
39 facility data that must be submitted to the Agency for
40 Health Care Administration; amending s. 394.4615,
41 F.S.; conforming terms; adding a health care surrogate
42 or proxy to list of persons that may waive
43 confidentiality of a clinical record; providing
44 additional grounds for releasing a clinical record;
45 amending s. 394.462, F.S.; conforming terms; providing
46 that a law enforcement officer acting in good faith
47 may not be held liable for false imprisonment;
48 specifying when a county or law enforcement agency may
49 be reimbursed for transportation expenses; authorizing
50 the Department of Corrections to transport an
51 individual under certain circumstances; amending s.
52 394.4625, F.S.; conforming terms; requiring a minor’s
53 assent to voluntary admission; requiring an individual
54 who has been voluntarily admitted and charged with a
55 crime to be returned to the custody of a law
56 enforcement agency after discharge; amending s.
57 394.463, F.S.; conforming terms; requiring an ex parte
58 order for involuntary examination to be based on
59 specific facts and have occurred within the last 14
60 days; providing that a certificate for involuntary
61 examination is valid only until the individual is
62 delivered to a receiving facility or for 7 days after
63 the certificate is executed; providing notification
64 requirements to guardians of minors who are
65 involuntarily examined; revising the procedures for
66 holding a person for involuntary examination and for
67 emergency situations; amending s. 394.4655, F.S.;
68 conforming terms; revising criteria for requesting a
69 continuance for a hearing on involuntary outpatient
70 placement; amending s. 394.467, F.S.; conforming
71 terms; requiring a facility to send a copy of the
72 petition for involuntary inpatient placement to the
73 Agency for Health Care Administration; requiring an
74 attorney representing an individual in involuntary
75 placement to represent the individual’s expressed
76 desires and be present at all hearings; requiring the
77 state attorney to participate in all hearings on
78 involuntary placement; prohibiting continuance
79 requests from parties other than the individual;
80 requiring the court to also conduct a hearing on
81 capacity to consent to treatment; providing for the
82 appointment of a guardian advocate if an individual is
83 found incompetent; requiring the court to determine
84 that an individual has knowingly waived his or her
85 attendance at the hearing; requiring the court to
86 allow certain testimony at hearings on involuntary
87 placement if a continuance is granted; requiring the
88 Division of Administrative Hearings to inform an
89 individual of his or her right to an independent
90 expert examination; amending ss. 394.46715 and
91 394.4672, F.S.; conforming terms; repealing s.
92 394.4674, F.S., relating to a plan and report on the
93 deinstitutionalization of patients in treatment
94 facilities; amending s. 394.4685, F.S.; conforming
95 terms; authorizing a public facility to request the
96 transfer of an individual to a private facility;
97 amending s. 394.469, F.S.; conforming terms; requiring
98 a discharged individual who is charged with a crime to
99 be returned to the custody of a law enforcement
100 agency; amending ss. 394.473, 394.475, 394.4785,
101 394.4786, 394.47865, 394.4787, 394.4788, and 394.4789,
102 F.S.; conforming terms; amending ss. 39.407, 394.495,
103 394.496, 394.9085, 419.001, and 744.704, F.S.;
104 conforming cross-references; providing an effective
105 date.
106
107 Be It Enacted by the Legislature of the State of Florida:
108
109 Section 1. Section 394.453, Florida Statutes, is amended to
110 read:
111 394.453 Legislative intent.—It is the intent of the
112 Legislature to authorize and direct the Department of Children
113 and Family Services to evaluate, research, plan, and recommend
114 to the Governor and the Legislature programs designed to reduce
115 the occurrence, severity, duration, and disabling aspects of
116 mental, emotional, and behavioral disorders. It is the intent of
117 the Legislature that treatment programs for such disorders shall
118 include, but not be limited to, comprehensive health, social,
119 educational, and rehabilitative services for individuals to
120 persons requiring intensive short-term and continued treatment
121 in order to encourage them to assume responsibility for their
122 treatment and recovery. It is intended that such individuals
123 persons be provided with emergency service and temporary
124 detention for evaluation if when required; that they be admitted
125 to treatment facilities if on a voluntary basis when extended or
126 continuing care is needed and unavailable in the community; that
127 involuntary placement be provided only if when expert evaluation
128 determines that it is necessary; that any involuntary treatment
129 or examination be accomplished in a setting that which is
130 clinically appropriate and most likely to facilitate the
131 individual’s person’s return to the community as soon as
132 possible; and that individual dignity and human rights be
133 guaranteed to all individuals persons who are admitted to mental
134 health facilities or who are being held under s. 394.463. It is
135 the further intent of the Legislature that the least restrictive
136 means of intervention be employed based on the individual’s
137 individual needs of each person, within the scope of available
138 services. It is the policy of this state that the use of
139 restraint and seclusion on clients is justified only as an
140 emergency safety measure to be used in response to imminent
141 danger to the individual client or others. It is, therefore, the
142 intent of the Legislature to achieve an ongoing reduction in the
143 use of restraint and seclusion in programs and facilities
144 serving individuals who have persons with mental illness.
145 Section 2. Section 394.455, Florida Statutes, is amended to
146 read:
147 394.455 Definitions.—As used in this part, unless the
148 context clearly requires otherwise, the term:
149 (1) “Administrator” means the chief administrative officer
150 of a receiving or treatment facility or his or her designee.
151 (2) “Adult” means an individual who is 18 years of age or
152 older or who has had the disabilities of nonage removed pursuant
153 to s. 743.01 or s. 743.015.
154 (3) “Advance directive” has the same meaning as in s.
155 765.101.
156 (4)(2) “Clinical psychologist” means a psychologist as
157 defined in s. 490.003 490.003(7) with 3 years of postdoctoral
158 experience in the practice of clinical psychology, inclusive of
159 the experience required for licensure, or a psychologist
160 employed by a facility operated by the United States Department
161 of Veterans Affairs or the United States Department of Defense
162 that qualifies as a receiving or treatment facility under this
163 part.
164 (5)(3) “Clinical record” means all parts of the record
165 required to be maintained and includes all medical records,
166 progress notes, charts, and admission and discharge data, and
167 all other information recorded by a facility staff which
168 pertains to an individual’s the patient’s hospitalization or
169 treatment.
170 (6)(4) “Clinical social worker” has the same meaning as in
171 s. 491.003 means a person licensed as a clinical social worker
172 under chapter 491.
173 (7)(5) “Community facility” means a any community service
174 provider contracting with the department to furnish substance
175 abuse or mental health services under part IV of this chapter.
176 (8)(6) “Community mental health center or clinic” means a
177 publicly funded, not-for-profit center that which contracts with
178 the department for the provision of inpatient, outpatient, day
179 treatment, or emergency services.
180 (9)(7) “Court,” unless otherwise specified, means the
181 circuit court.
182 (10)(8) “Department” means the Department of Children and
183 Family Services.
184 (11) “Electronic means” means a form of telecommunication
185 that requires all parties to maintain visual as well as audio
186 communication.
187 (12)(9) “Express and informed consent” means consent
188 voluntarily given in writing, by a competent individual person,
189 after sufficient explanation and disclosure of the subject
190 matter involved to enable the individual person to make a
191 knowing and willful decision without any element of force,
192 fraud, deceit, duress, or other form of constraint or coercion.
193 (13)(10) “Facility” means a any hospital, community
194 facility, public or private facility, or receiving or treatment
195 facility providing for the evaluation, diagnosis, care,
196 treatment, training, or hospitalization of individuals persons
197 who appear to have a mental illness or who have been diagnosed
198 as having a mental illness. The term “Facility” does not include
199 a any program or entity licensed under pursuant to chapter 400
200 or chapter 429.
201 (14) ”Government facility” means a facility owned,
202 operated, or administered by the Department of Corrections or
203 the United States Department of Veterans Affairs.
204 (15)(11) “Guardian” means the natural guardian of a minor,
205 or a person appointed by a court to act on behalf of a ward’s
206 person if the ward is a minor or has been adjudicated
207 incapacitated.
208 (16)(12) “Guardian advocate” means a person appointed by a
209 court to make decisions regarding mental health treatment on
210 behalf of an individual a patient who has been found incompetent
211 to consent to treatment pursuant to this part. The guardian
212 advocate may be granted specific additional powers by written
213 order of the court, as provided in this part.
214 (17)(13) “Hospital” means a hospital facility as defined in
215 s. 395.002 and licensed under chapter 395 and part II of chapter
216 408.
217 (18)(14) “Incapacitated” means that an individual a person
218 has been adjudicated incapacitated pursuant to part V of chapter
219 744 and a guardian of the person has been appointed.
220 (19)(15) “Incompetent to consent to treatment” means that
221 an individual’s a person’s judgment is so affected by his or her
222 mental illness that he or she the person lacks the capacity to
223 make a well-reasoned, willful, and knowing decision concerning
224 his or her medical or mental health treatment.
225 (20) “Involuntary examination” means an examination
226 performed under s. 394.463 to determine if an individual
227 qualifies for involuntary inpatient treatment under s. 394.467
228 or involuntary outpatient treatment under s. 394.4655.
229 (21) “Involuntary placement” means involuntary outpatient
230 treatment pursuant to s. 394.4655 or involuntary inpatient
231 treatment pursuant to s. 394.467.
232 (22)(16) “Law enforcement officer” has the same meaning as
233 means a law enforcement officer as defined in s. 943.10.
234 (23) “Marriage and family therapist” has the same meaning
235 as in s. 491.003.
236 (24) “Mental health counselor” has the same meaning as in
237 s. 491.003.
238 (25)(17) “Mental health overlay program” means a mobile
239 service that which provides an independent examination for
240 voluntary admission admissions and a range of supplemental
241 onsite services to an individual who has persons with a mental
242 illness in a residential setting such as a nursing home,
243 assisted living facility, adult family-care home, or a
244 nonresidential setting such as an adult day care center.
245 Independent examinations provided pursuant to this part through
246 a mental health overlay program must only be provided only under
247 contract with the department for this service or be attached to
248 a public receiving facility that is also a community mental
249 health center.
250 (26)(18) “Mental illness” means an impairment of the mental
251 or emotional processes that exercise conscious control of one’s
252 actions or of the ability to perceive or understand reality,
253 which impairment substantially interferes with the a person’s
254 ability to meet the ordinary demands of living, regardless of
255 etiology. For the purposes of this part, the term does not
256 include a retardation or developmental disability as defined in
257 chapter 393, intoxication, brain injury, dementia, or conditions
258 manifested only by antisocial behavior or substance abuse
259 impairment.
260 (27) “Minor” means an individual who is 17 years of age or
261 younger and who has not had the disabilities of nonage removed
262 pursuant to s. 743.01 or s. 743.015.
263 (28)(19) “Mobile crisis response service” means a
264 nonresidential crisis service attached to a public receiving
265 facility and available 24 hours a day, 7 days a week, through
266 which provides immediate intensive assessments and
267 interventions, including screening for admission into a
268 receiving facility, take place for the purpose of identifying
269 appropriate treatment services.
270 (20) “Patient” means any person who is held or accepted for
271 mental health treatment.
272 (29)(21) “Physician” means a medical practitioner licensed
273 under chapter 458 or chapter 459 who has experience in the
274 diagnosis and treatment of mental and nervous disorders or a
275 physician employed by a facility operated by the United States
276 Department of Veterans Affairs or the United States Department
277 of Defense which qualifies as a receiving or treatment facility
278 under this part.
279 (30) “Physician assistant” means a person licensed as a
280 physician assistant under chapter 458 or chapter 459.
281 (31)(22) “Private facility” means any hospital or facility
282 operated by a for-profit or not-for-profit corporation or
283 association that provides mental health services and is not a
284 public facility.
285 (32)(23) “Psychiatric nurse” means an advanced a registered
286 nurse practitioner licensed under part I of chapter 464 who has
287 a national advanced practice certification from an approved
288 nursing specialty board and a collaborative practice agreement
289 with a psychiatrist on file with the Board of Nursing master’s
290 degree or a doctorate in psychiatric nursing and 2 years of
291 post-master’s clinical experience under the supervision of a
292 physician.
293 (33)(24) “Psychiatrist” means a medical practitioner
294 licensed under chapter 458 or chapter 459 who has primarily
295 diagnosed and treated mental and nervous disorders for at least
296 a period of not less than 3 years, inclusive of psychiatric
297 residency.
298 (34)(25) “Public facility” means any facility that has
299 contracted with the department to provide mental health services
300 to all individuals persons, regardless of their ability to pay,
301 and is receiving state funds for such purpose.
302 (35)(26) “Receiving facility” means any public or private
303 facility expressly designated by the department to receive and
304 hold individuals involuntarily involuntary patients under
305 emergency conditions or for psychiatric evaluation and to
306 provide short-term treatment. The term does not include a county
307 jail.
308 (36)(27) “Representative” means a person selected pursuant
309 to s. 394.4597(2) to receive notice of proceedings during the
310 time a patient is held in or admitted to a receiving or
311 treatment facility.
312 (37)(28)(a) “Restraint” means a physical device, method, or
313 drug used to control behavior.
314 (a) A physical restraint is any manual method or physical
315 or mechanical device, material, or equipment attached or
316 adjacent to an the individual’s body so that he or she cannot
317 easily remove the restraint and which restricts freedom of
318 movement or normal access to one’s body.
319 (b) A drug used as a restraint is a medication used to
320 control an individual’s the person’s behavior or to restrict his
321 or her freedom of movement and is not part of the standard
322 treatment regimen for an individual having of a person with a
323 diagnosed mental illness who is a client of the department.
324 Physically holding an individual a person during a procedure to
325 forcibly administer psychotropic medication is a physical
326 restraint.
327 (c) Restraint does not include physical devices, such as
328 orthopedically prescribed appliances, surgical dressings and
329 bandages, supportive body bands, or other physical holding when
330 necessary for routine physical examinations and tests; or for
331 purposes of orthopedic, surgical, or other similar medical
332 treatment; when used to provide support for the achievement of
333 functional body position or proper balance; or when used to
334 protect an individual a person from falling out of bed.
335 (38)(29) “Seclusion” means the physical segregation of a
336 person in any fashion or involuntary isolation of an individual
337 a person in a room or area from which the individual person is
338 prevented from leaving. The prevention may be by physical
339 barrier or by a staff member who is acting in a manner, or who
340 is physically situated, so as to prevent the individual person
341 from leaving the room or area. For purposes of this chapter, the
342 term does not mean isolation due to an individual’s a person’s
343 medical condition or symptoms.
344 (39)(30) “Secretary” means the Secretary of Children and
345 Family Services.
346 (40) “Service provider” means a public or private receiving
347 facility, an entity under contract with the department to
348 provide mental health services, a community mental health center
349 or clinic, a clinical psychologist, a clinical social worker, a
350 marriage and family therapist, a mental health counselor, a
351 physician, or a psychiatric nurse.
352 (41)(31) “Transfer evaluation” means the process, as
353 approved by the appropriate district office of the department,
354 during which an individual whereby a person who is being
355 considered for placement in a state treatment facility is first
356 evaluated for appropriateness of admission to a state treatment
357 the facility by a community-based public receiving facility or
358 by a community mental health center or clinic if the public
359 receiving facility is not a community mental health center or
360 clinic.
361 (42)(32) “Treatment facility” means a any state-owned,
362 state-operated, or state-supported hospital, or a community
363 mental health center, or clinic, designated by the department
364 for extended treatment and hospitalization of individuals who
365 have a mental illness, beyond that provided for by a receiving
366 facility or a, of persons who have a mental illness, including
367 facilities of the United States Government, and any private
368 facility designated by the department when rendering such
369 services to a person pursuant to the provisions of this part.
370 Patients treated in facilities of the United States Government
371 shall be solely those whose care is the responsibility of the
372 United States Department of Veterans Affairs.
373 (33) “Service provider” means any public or private
374 receiving facility, an entity under contract with the department
375 of Children and Family Services to provide mental health
376 services, a clinical psychologist, a clinical social worker, a
377 marriage and family therapist, a mental health counselor, a
378 physician, a psychiatric nurse as defined in subsection (23), or
379 a community mental health center or clinic as defined in this
380 part.
381 (34) “Involuntary examination” means an examination
382 performed under s. 394.463 to determine if an individual
383 qualifies for involuntary inpatient treatment under s.
384 394.467(1) or involuntary outpatient treatment under s.
385 394.4655(1).
386 (35) “Involuntary placement” means either involuntary
387 outpatient treatment pursuant to s. 394.4655 or involuntary
388 inpatient treatment pursuant to s. 394.467.
389 (36) “Marriage and family therapist” means a person
390 licensed as a marriage and family therapist under chapter 491.
391 (37) “Mental health counselor” means a person licensed as a
392 mental health counselor under chapter 491.
393 (38) “Electronic means” means a form of telecommunication
394 that requires all parties to maintain visual as well as audio
395 communication.
396 Section 3. Section 394.457, Florida Statutes, is amended to
397 read:
398 394.457 Operation and administration.—
399 (1) ADMINISTRATION.—The Department of Children and Family
400 Services is designated the “Mental Health Authority” of Florida.
401 The department and the Agency for Health Care Administration
402 shall exercise executive and administrative supervision over all
403 mental health facilities, programs, and services.
404 (2) RESPONSIBILITIES OF THE DEPARTMENT.—The department is
405 responsible for:
406 (a) The planning, evaluation, and implementation of a
407 complete and comprehensive statewide program of mental health,
408 including community services, receiving and treatment
409 facilities, child services, research, and training as authorized
410 and approved by the Legislature, based on the annual program
411 budget of the department. The department is also responsible for
412 the coordination of efforts with other departments and divisions
413 of the state government, county and municipal governments, and
414 private agencies concerned with and providing mental health
415 services. It is responsible for establishing standards,
416 providing technical assistance, and supervising exercising
417 supervision of mental health programs of, and the treatment of
418 individuals patients at, community facilities, other facilities
419 serving individuals for persons who have a mental illness, and
420 any agency or facility providing services under to patients
421 pursuant to this part.
422 (b) The publication and distribution of an information
423 handbook to facilitate the understanding of this part, the
424 policies and procedures involved in the implementation of this
425 part, and the responsibilities of the various service providers
426 of services under this part. The department It shall stimulate
427 research by public and private agencies, institutions of higher
428 learning, and hospitals in the interest of the elimination and
429 amelioration of mental illness.
430 (3) POWER TO CONTRACT.—The department may contract to
431 provide, and be provided with, services and facilities in order
432 to carry out its responsibilities under this part with respect
433 to the following agencies: public and private hospitals;
434 receiving and treatment facilities; clinics; laboratories;
435 departments, divisions, and other units of state government; the
436 state colleges and universities; the community colleges; private
437 colleges and universities; counties, municipalities, and any
438 other political subdivisions governmental unit, including
439 facilities of the United States Government; and any other public
440 or private entity that which provides or needs facilities or
441 services. Baker Act funds for community inpatient, crisis
442 stabilization, short-term residential treatment, and screening
443 services under this part must be allocated to each county
444 pursuant to the department’s funding allocation methodology.
445 Notwithstanding the provisions of s. 287.057(5)(f), contracts
446 for community-based Baker Act services for inpatient, crisis
447 stabilization, short-term residential treatment, and screening
448 provided under this part, other than those with other units of
449 government, to be provided for the department must be awarded
450 using competitive solicitation if sealed bids when the county
451 commission of the county receiving the services makes a request
452 to the department’s circuit district office by January 15 of the
453 contracting year. The office may district shall not enter into a
454 competitively bid contract under this provision if such action
455 will result in increases of state or local expenditures for
456 Baker Act services within the circuit district. Contracts for
457 these Baker Act services using competitive sealed bids are will
458 be effective for 3 years. The department shall adopt rules
459 establishing minimum standards for such contracted services and
460 facilities and shall make periodic audits and inspections to
461 assure that the contracted services are provided and meet the
462 standards of the department.
463 (4) APPLICATION FOR AND ACCEPTANCE OF GIFTS AND GRANTS.—The
464 department may apply for and accept any funds, grants, gifts, or
465 services made available to it by any agency or department of the
466 Federal Government or any other public or private agency or
467 person individual in aid of mental health programs. All such
468 moneys must shall be deposited in the State Treasury and shall
469 be disbursed as provided by law.
470 (5) RULES.—The department shall adopt rules:
471 (a) The department shall adopt rules Establishing forms and
472 procedures relating to the rights and privileges of individuals
473 receiving patients seeking mental health examination or
474 treatment from facilities under this part.
475 (b) The department shall adopt rules Necessary for the
476 implementation and administration of the provisions of this
477 part., and A program subject to the provisions of this part may
478 shall not be permitted to operate unless rules designed to
479 ensure the protection of the health, safety, and welfare of the
480 individuals examined and patients treated under through such
481 program have been adopted. Such rules adopted under this
482 subsection must include provisions governing the use of
483 restraint and seclusion which are consistent with recognized
484 best practices and professional judgment; prohibit inherently
485 dangerous restraint or seclusion procedures; establish
486 limitations on the use and duration of restraint and seclusion;
487 establish measures to ensure the safety of program participants
488 and staff during an incident of restraint or seclusion;
489 establish procedures for staff to follow before, during, and
490 after incidents of restraint or seclusion; establish
491 professional qualifications of and training for staff who may
492 order or be engaged in the use of restraint or seclusion; and
493 establish mandatory reporting, data collection, and data
494 dissemination procedures and requirements. Such rules adopted
495 under this subsection must require that each instance of the use
496 of restraint or seclusion be documented in the clinical record
497 of the individual who has been restrained or secluded patient.
498 (c) The department shall adopt rules Establishing minimum
499 standards for services provided by a mental health overlay
500 program or a mobile crisis response service.
501 (6) PERSONNEL.—
502 (a) The department shall, by rule, establish minimum
503 standards of education and experience for professional and
504 technical personnel employed in mental health programs,
505 including members of a mobile crisis response service.
506 (b) The department shall design and distribute appropriate
507 materials for the orientation and training of persons actively
508 engaged in implementing the provisions of this part relating to
509 the involuntary examination and placement of individuals persons
510 who are believed to have a mental illness.
511 (7) PAYMENT FOR CARE OF PATIENTS.—Fees and fee collections
512 for individuals receiving treatment or services patients in
513 state-owned, state-operated, or state-supported treatment
514 facilities must shall be in accordance with according to s.
515 402.33.
516 Section 4. Section 394.4572, Florida Statutes, is amended
517 to read:
518 394.4572 Screening of mental health personnel.—
519 (1)(a) The department and the Agency for Health Care
520 Administration shall require employment screening for mental
521 health personnel using the standards for level 2 screening
522 standards provided in s. 435.04 set forth in chapter 435.
523 “Mental health personnel” includes all program directors,
524 professional clinicians, staff members, and volunteers working
525 in public or private mental health programs and facilities who
526 have direct contact with individuals held for examination or
527 admitted for mental health treatment unmarried patients under
528 the age of 18 years. For purposes of this chapter, employment
529 screening of mental health personnel shall also include, but is
530 not limited to, employment screening as provided under chapter
531 435.
532 (a)(b) Students in the health care professions who are
533 interning in a mental health facility licensed under chapter
534 395, where the primary purpose of the facility is not the
535 treatment of minors, are exempt from the fingerprinting and
536 screening requirements if, provided they are under direct
537 supervision in the actual physical presence of a licensed health
538 care professional.
539 (c) Mental health personnel working in a facility licensed
540 under chapter 395 who have less than 15 hours per week of direct
541 contact with patients or who are health care professionals
542 licensed by the Agency for Health Care Administration or a board
543 thereunder are exempt from the fingerprinting and screening
544 requirements, except for persons working in mental health
545 facilities where the primary purpose of the facility is the
546 treatment of minors.
547 (b)(d) A volunteer who assists on an intermittent basis for
548 less than 40 hours per month is exempt from the fingerprinting
549 and screening requirements if, provided the volunteer is under
550 direct and constant supervision by persons who meet the
551 screening requirements of this section paragraph (a).
552 (2) The department or the Agency for Health Care
553 Administration may grant exemptions from disqualification as
554 provided in s. 435.07 435.06.
555 (3) Prospective mental health personnel who have previously
556 been fingerprinted or screened pursuant to this chapter, chapter
557 393, chapter 397, chapter 402, or chapter 409, or teachers who
558 have been fingerprinted pursuant to chapter 1012, who have not
559 been unemployed for more than 90 days thereafter, and who under
560 the penalty of perjury attest to the completion of such
561 fingerprinting or screening and to compliance with the
562 provisions of this section and the standards for level 1
563 screening under contained in chapter 435, are shall not be
564 required to be refingerprinted or rescreened in order to comply
565 with the any screening requirements of this part.
566 Section 5. Section 394.4573, Florida Statutes, is amended
567 to read:
568 394.4573 Continuity of care management system; measures of
569 performance; reports.—
570 (1) For the purposes of this section:
571 (a) “Case management” means those activities aimed at
572 assessing the client needs, planning services, linking the
573 service system to a client, coordinating the various system
574 components, monitoring service delivery, and evaluating the
575 effect of service delivery for individuals eligible for publicly
576 funded mental health services.
577 (b) “Case manager” means a person an individual who works
578 with individuals who are eligible for publicly funded mental
579 health services clients, and their families and significant
580 others, to provide case management.
581 (c) “Client manager” means an employee of the department
582 who is assigned to specific provider agencies and geographic
583 areas to ensure that the full range of needed services is
584 available to individuals who are eligible for publicly funded
585 mental health services clients.
586 (d) “Continuity of care management system” means a system
587 that assures, within available resources, that individuals who
588 are eligible for publicly funded mental health services clients
589 have access to the full array of services within the mental
590 health services delivery system.
591 (2) The department shall is directed to implement a
592 continuity of care management system for the provision of mental
593 health care, through the provision of client and case
594 management, including individuals clients referred from state
595 treatment facilities to community mental health facilities. Such
596 system must shall include a statewide network of client managers
597 and case managers throughout the state designed to:
598 (a) Reduce the possibility of an individual’s a client’s
599 admission or readmission to a state treatment facility.
600 (b) Provide for the creation or designation of an agency in
601 each county to provide single intake services for each
602 individual person seeking mental health services. Such agency
603 shall provide information and referral services necessary to
604 ensure that such individuals clients receive the most
605 appropriate and least restrictive form of care, based on the
606 individual’s individual needs of the person seeking treatment.
607 Such agency shall have a single telephone number, operating 24
608 hours per day, 7 days per week, if where practicable, at a
609 central location, where each individual receiving mental health
610 services has client will have a client central record.
611 (c) Advocate on behalf of the individual receiving mental
612 health services client to ensure that all appropriate services
613 are provided afforded to the client in a timely and dignified
614 manner.
615 (d) Require a that any public receiving facility initiating
616 an individual’s a patient transfer to a licensed hospital for
617 acute care mental health services not accessible through the
618 public receiving facility to shall notify the hospital of the
619 such transfer and send all records relating to the emergency
620 psychiatric or medical condition.
621 (3) The department shall is directed to develop and include
622 performance measures in contracts with service providers
623 relating to measures of performance with regard to goals and
624 objectives as specified in the state plan. Such measures shall
625 use, To the extent practical, such measures must use existing
626 data collection methods and reports and may shall not require,
627 as a result of this subsection, additional reports on the part
628 of service providers. The department shall plan monitoring
629 visits of community mental health facilities with other state,
630 federal, and local governmental and private agencies charged
631 with monitoring such facilities.
632 (4) The department is directed to submit a report to the
633 Legislature, prior to April 1 of each year, outlining
634 departmental progress towards the implementation of the minimum
635 staffing patterns’ standards in state mental health treatment
636 facilities. The report shall contain, by treatment facility,
637 information regarding goals and objectives and departmental
638 performance toward meeting each such goal and objective.
639 Section 6. Paragraph (a) of subsection (2) and subsection
640 (3) of section 394.4574, Florida Statutes, are amended to read:
641 394.4574 Department responsibilities for a mental health
642 resident who resides in an assisted living facility that holds a
643 limited mental health license.—
644 (2) The department must ensure that:
645 (a) A mental health resident has been assessed by a
646 psychiatrist, clinical psychologist, clinical social worker, or
647 psychiatric nurse, or an individual who is supervised by one of
648 these professionals, and determined to be appropriate to reside
649 in an assisted living facility. The documentation must be
650 provided to the administrator of the facility within 30 days
651 after the mental health resident has been admitted to the
652 facility. An evaluation completed upon discharge from a state
653 mental health treatment facility hospital meets the requirements
654 of this subsection related to appropriateness for placement as a
655 mental health resident if it was completed within 90 days before
656 prior to admission to the facility.
657 (3) The secretary of Children and Family Services, in
658 consultation with the Agency for Health Care Administration,
659 shall annually require each circuit district administrator to
660 develop, with community input, detailed plans that demonstrate
661 how the circuit district will ensure the provision of state
662 funded mental health and substance abuse treatment services to
663 residents of assisted living facilities that hold a limited
664 mental health license. These plans must be consistent with the
665 substance abuse and mental health circuit district plan
666 developed pursuant to s. 394.75 and must address case management
667 services; access to consumer-operated drop-in centers; access to
668 services during evenings, weekends, and holidays; supervision of
669 the clinical needs of the residents; and access to emergency
670 psychiatric care.
671 Section 7. Subsection (1) of section 394.458, Florida
672 Statutes, is amended to read:
673 394.458 Introduction or removal of certain articles
674 unlawful; penalty.—
675 (1)(a) Except as authorized by law or as specifically
676 authorized by the person in charge of a receiving or treatment
677 facility each hospital providing mental health services under
678 this part, it is unlawful to:
679 (a) Introduce into or upon the grounds of such facility
680 hospital, or to take or attempt to take or send from the
681 facility therefrom, any of the following articles, which are
682 hereby declared to be contraband for the purposes of this
683 section:
684 1. An Any intoxicating beverage or beverage that which
685 causes or may cause an intoxicating effect;
686 2. A Any controlled substance as defined in chapter 893; or
687 3. A firearm Any firearms or deadly weapon.
688 (b) It is unlawful to Transmit to, or attempt to transmit
689 to, or cause or attempt to cause to be transmitted to, or
690 received by, any individual receiving mental health services
691 from a receiving or treatment facility patient of any hospital
692 providing mental health services under this part any article or
693 thing declared by this section to be contraband, at any place
694 which is outside of the grounds of such facility hospital,
695 except as authorized by law or as specifically authorized by the
696 person in charge of such hospital.
697 Section 8. Section 394.459, Florida Statutes, is amended to
698 read:
699 394.459 Rights of individuals receiving treatment and
700 services patients.—
701 (1) RIGHT TO INDIVIDUAL DIGNITY.—It is the policy of this
702 state that the individual dignity of all individuals held for
703 examination or admitted for mental health treatment the patient
704 shall be respected at all times and upon all occasions,
705 including any occasion when the individual patient is taken into
706 custody, held, or transported. Procedures, facilities, vehicles,
707 and restraining devices used utilized for criminals or those
708 accused of a crime may shall not be used in connection with
709 individuals persons who have a mental illness, except for the
710 protection of that individual the patient or others. Individuals
711 Persons who have a mental illness but who are not charged with a
712 criminal offense may shall not be detained or incarcerated in
713 the jails of this state. An individual A person who is receiving
714 treatment for mental illness may shall not be deprived of any
715 constitutional rights. However, if such individual a person is
716 adjudicated incapacitated, his or her rights may be limited to
717 the same extent that the rights of any incapacitated person are
718 limited by law.
719 (2) RIGHT TO TREATMENT.—Each individual held for
720 examination or admitted for mental health treatment:
721 (a) May A person shall not be denied treatment for mental
722 illness, and services may shall not be delayed at a receiving or
723 treatment facility because of inability to pay. However, every
724 reasonable effort to collect appropriate reimbursement for the
725 cost of providing mental health services from individuals to
726 persons able to pay for services, including insurance or third
727 party payers payments, shall be made by facilities providing
728 services under pursuant to this part.
729 (b) Shall be provided It is further the policy of the state
730 that the least restrictive appropriate available treatment, be
731 utilized based on the individual’s individual needs and best
732 interests, of the patient and consistent with the optimum
733 improvement of the individual’s patient’s condition.
734 (c) Each person who remains at a receiving or treatment
735 facility for more than 12 hours Shall be given a physical
736 examination and psychiatric evaluation by a health practitioners
737 practitioner authorized by law to give such examinations, within
738 24 hours after arrival at such facility if they have not been or
739 released or discharged pursuant to s. 394.463(2)(h) or s.
740 394.469. The physical examination and psychiatric evaluation
741 must be documented in the clinical record.
742 (d) Every patient in a facility Shall be afforded the
743 opportunity to participate in activities designed to enhance
744 self-image and the beneficial effects of other treatments, as
745 determined by the facility.
746 (e) Not more than 5 days after admission to a facility,
747 each patient Shall have and receive an individualized treatment
748 plan in writing, which the individual patient has had an
749 opportunity to assist in preparing and to review prior to its
750 implementation, within 5 days after admission to a facility. The
751 plan must shall include a space for the individual’s patient’s
752 comments and signature.
753 (3) RIGHT TO EXPRESS AND INFORMED PATIENT CONSENT.—
754 (a)1. Each individual patient entering treatment shall be
755 asked to give express and informed consent for admission or
756 treatment.
757 1. If the individual patient has been adjudicated
758 incapacitated or found to be incompetent to consent to
759 treatment, express and informed consent must to treatment shall
760 be sought instead from his or her the patient’s guardian or
761 guardian advocate. If the individual patient is a minor, express
762 and informed consent for admission or treatment must be obtained
763 shall also be requested from the patient’s guardian. Express and
764 informed consent for admission or treatment of a patient under
765 18 years of age shall be required from the minor’s patient’s
766 guardian, unless the minor is seeking outpatient crisis
767 intervention services under s. 394.4784. Express and informed
768 consent for admission or treatment given by a patient who is
769 under 18 years of age shall not be a condition of admission when
770 the patient’s guardian gives express and informed consent for
771 the patient’s admission pursuant to s. 394.463 or s. 394.467.
772 2. Before giving express and informed consent, the
773 following information shall be provided and explained in plain
774 language to the individual patient, or to his or her the
775 patient’s guardian if the individual patient is an adult 18
776 years of age or older and has been adjudicated incapacitated, or
777 to his or her the patient’s guardian advocate if the individual
778 patient has been found to be incompetent to consent to
779 treatment, or to both the individual patient and the guardian if
780 the individual patient is a minor: the reason for admission or
781 treatment; the proposed treatment; the purpose of the treatment
782 to be provided; the common risks, benefits, and side effects
783 thereof; the specific dosage range for the medication, when
784 applicable; alternative treatment modalities; the approximate
785 length of care; the potential effects of stopping treatment; how
786 treatment will be monitored; and that any consent given for
787 treatment may be revoked orally or in writing before or during
788 the treatment period by the individual receiving the treatment
789 patient or by a person who is legally authorized to make health
790 care decisions on the individual’s behalf of the patient.
791 (b) Before performing a medical procedure In the case of
792 medical procedures requiring the use of a general anesthetic or
793 electroconvulsive treatment, and prior to performing the
794 procedure, express and informed consent must shall be obtained
795 from the individual subject to the procedure patient if the
796 individual patient is legally competent, from the guardian of a
797 minor patient, from the guardian of an individual a patient who
798 has been adjudicated incapacitated, or from the individual’s
799 guardian advocate of the patient if the guardian advocate has
800 been given express court authority to consent to medical
801 procedures or electroconvulsive treatment as provided under s.
802 394.4598.
803 (c) If When the department is the legal guardian of a
804 patient, or is the custodian of an individual a patient whose
805 physician is unwilling to perform a medical procedure, including
806 an electroconvulsive treatment, based solely on the individual’s
807 patient’s consent and whose guardian or guardian advocate is
808 unknown or unlocatable, the court shall hold a hearing to
809 determine the medical necessity of the medical procedure. The
810 individual subject to the procedure must patient shall be
811 physically present, unless his or her the patient’s medical
812 condition precludes such presence, represented by counsel, and
813 provided the right and opportunity to be confronted with, and to
814 cross-examine, all witnesses alleging the medical necessity of
815 such procedure. In such proceedings, the burden of proof by
816 clear and convincing evidence is shall be on the party alleging
817 the medical necessity of the procedure.
818 (d) The administrator of a receiving or treatment facility
819 may, upon the recommendation of an individual’s the patient’s
820 attending physician, authorize emergency medical treatment,
821 including a surgical procedure, if such treatment is deemed
822 lifesaving, or if the situation threatens serious bodily harm to
823 the individual patient, and the permission of the individual
824 patient or his or her the patient’s guardian or guardian
825 advocate cannot be obtained.
826 (4) QUALITY OF TREATMENT.—
827 (a) Each individual held for examination or admitted for
828 mental health treatment, or receiving involuntary outpatient
829 treatment patient shall receive services, including, for a
830 patient placed under s. 394.4655, shall receive those services
831 that are included in the court order which are suited to his or
832 her needs, and which shall be administered skillfully, safely,
833 and humanely with full respect for the individual’s patient’s
834 dignity and personal integrity. Each individual must patient
835 shall receive such medical, vocational, social, educational, and
836 rehabilitative services as his or her condition requires in
837 order to live successfully in the community. In order to achieve
838 this goal, the department shall is directed to coordinate its
839 mental health programs with all other programs of the department
840 and other state agencies.
841 (b) Facilities shall develop and maintain, in a form
842 accessible to and readily understandable by individuals held for
843 examination or admitted for mental health treatment, patients
844 and consistent with rules adopted by the department, the
845 following:
846 1. Criteria, procedures, and required staff training for
847 the any use of close or elevated levels of supervision;, of
848 restraint, seclusion, or isolation;, or of emergency treatment
849 orders;, and for the use of bodily control and physical
850 management techniques.
851 2. Procedures for documenting, monitoring, and requiring
852 clinical review of all uses of the procedures described in
853 subparagraph 1. and for documenting and requiring review of any
854 incidents resulting in injury to individuals receiving services
855 patients.
856 3. A system for investigating, tracking, managing, and
857 responding to complaints by individuals persons receiving
858 services or persons individuals acting on their behalf.
859 4. Procedures for reporting events that place individuals
860 receiving services at risk of harm. Such events must be reported
861 to the department in accordance with department operating
862 procedures after discovery and include, but are not limited to:
863 a. An individual whose life terminates due to a natural,
864 unnatural, expected, or unexpected cause while in the facility
865 or within 72 hours after release.
866 b. An injury sustained, or allegedly sustained, due to an
867 accident, act of abuse, neglect, or suicide attempt requiring
868 medical treatment by a licensed health care practitioner in an
869 acute care medical facility.
870 c. The unauthorized departure or absence of an individual
871 from a facility in which he or she has been held for involuntary
872 examination or involuntary placement.
873 d. An unusual occurrence or circumstance precipitated by
874 something uncommon, abnormal, or out of the ordinary, such as a
875 tornado, kidnapping, riot, or hostage situation that jeopardizes
876 the health, safety, or welfare of the individual.
877 e. An allegation of sexual battery upon the individual.
878 (c) A facility may not use seclusion or restraint for
879 punishment, to compensate for inadequate staffing, or for the
880 convenience of staff. Facilities shall ensure that all staff are
881 made aware of these restrictions on the use of seclusion and
882 restraint and shall make and maintain records that which
883 demonstrate that this information has been conveyed to each
884 individual staff member members.
885 (5) COMMUNICATION, ABUSE REPORTING, AND VISITS.—
886 (a) Each individual held for examination or admitted for
887 mental health treatment person receiving services in a facility
888 providing mental health services under this part has the right
889 to communicate freely and privately with persons outside the
890 facility unless it is determined that such communication is
891 likely to be harmful to the individual person or others. Each
892 facility shall make available as soon as reasonably possible to
893 persons receiving services a telephone that allows for free
894 local calls and access to a long-distance service available to
895 the individual as soon as reasonably possible. A facility is not
896 required to pay the costs of the individual’s a patient’s long
897 distance calls. The telephone must shall be readily accessible
898 to the patient and shall be placed so that the individual
899 patient may use it to communicate privately and confidentially.
900 The facility may establish reasonable rules for the use of this
901 telephone which, provided that the rules do not interfere with
902 an individual’s a patient’s access to a telephone to report
903 abuse pursuant to paragraph (e).
904 (b) Each individual patient admitted to a facility under
905 the provisions of this part shall be allowed to receive, send,
906 and mail sealed, unopened correspondence; and the individual’s
907 no patient’s incoming or outgoing correspondence may not shall
908 be opened, delayed, held, or censored by the facility unless
909 there is reason to believe that it contains items or substances
910 that which may be harmful to the individual patient or others,
911 in which case the administrator may direct reasonable
912 examination of such mail and may regulate the disposition of
913 such items or substances.
914 (c) Each facility shall allow must permit immediate access
915 to an individual held for examination or admitted for mental
916 health treatment any patient, subject to the patient’s right to
917 deny or withdraw consent at any time, by the individual, or by
918 the individual’s patient’s family members, guardian, guardian
919 advocate, representative, Florida statewide or local advocacy
920 council, or attorney, unless such access would be detrimental to
921 the individual patient. If the a patient’s right to communicate
922 or to receive visitors is restricted by the facility, written
923 notice of such restriction and the reasons for the restriction
924 shall be served on the individual and patient, the individual’s
925 patient’s attorney, and the patient’s guardian, guardian
926 advocate, or representative,; and such restriction, and the
927 reasons for the restriction, must shall be recorded in on the
928 patient’s clinical record with the reasons therefor. The
929 restriction must of a patient’s right to communicate or to
930 receive visitors shall be reviewed at least every 7 days. The
931 right to communicate or receive visitors may shall not be
932 restricted as a means of punishment. Nothing in This paragraph
933 does not shall be construed to limit the provisions of paragraph
934 (d).
935 (d) Each facility shall establish reasonable rules
936 governing visitors, visiting hours, and the use of telephones by
937 individuals held for examination or admitted for mental health
938 treatment patients in the least restrictive possible manner. An
939 individual has Patients shall have the right to contact and to
940 receive communication from their attorneys at any reasonable
941 time.
942 (e) Each individual held for examination or admitted for
943 patient receiving mental health treatment in any facility shall
944 have ready access to a telephone in order to report an alleged
945 abuse. The facility staff shall orally and in writing inform
946 each individual patient of the procedure for reporting abuse and
947 shall make every reasonable effort to present the information in
948 a language the individual patient understands. A written copy of
949 that procedure, including the telephone number of the central
950 abuse hotline and reporting forms, must shall be posted in plain
951 view.
952 (f) The department shall adopt rules providing a procedure
953 for reporting abuse. Facility staff shall be required, as a
954 condition of employment, must to become familiar with the
955 requirements and procedures for the reporting of abuse.
956 (6) CARE AND CUSTODY OF PERSONAL EFFECTS OF PATIENTS.—The
957 rights of an individual held for examination or admitted for
958 mental health treatment A patient’s right to the possession of
959 his or her clothing and personal effects shall be respected. The
960 facility may take temporary custody of such effects if when
961 required for medical and safety reasons. The A patient’s
962 clothing and personal effects shall be inventoried upon their
963 removal into temporary custody. Copies of this inventory shall
964 be given to the individual patient and to his or her the
965 patient’s guardian, guardian advocate, or representative and
966 shall be recorded in the patient’s clinical record. This
967 inventory may be amended upon the request of the individual
968 patient or his or her the patient’s guardian, guardian advocate,
969 or representative. The inventory and any amendments to it must
970 be witnessed by two members of the facility staff and by the
971 individual patient, if he or she is able. All of the a patient’s
972 clothing and personal effects held by the facility must shall be
973 returned to the individual patient immediately upon his or her
974 the discharge or transfer of the patient from the facility,
975 unless such return would be detrimental to the individual
976 patient. If personal effects are not returned to the patient,
977 the reason must be documented in the clinical record along with
978 the disposition of the clothing and personal effects, which may
979 be given instead to the individual’s patient’s guardian,
980 guardian advocate, or representative. As soon as practicable
981 after an emergency transfer of a patient, the individual’s
982 patient’s clothing and personal effects shall be transferred to
983 the individual’s patient’s new location, together with a copy of
984 the inventory and any amendments, unless an alternate plan is
985 approved by the individual patient, if he or she is able, and by
986 his or her the patient’s guardian, guardian advocate, or
987 representative.
988 (7) VOTING IN PUBLIC ELECTIONS.—An individual A patient who
989 is eligible to vote according to the laws of the state, and who
990 has not been declared incompetent to proceed under chapter 916,
991 has the right to vote in the primary and general elections. The
992 department shall establish rules to enable such individuals
993 patients to obtain voter registration forms, applications for
994 absentee ballots, and absentee ballots.
995 (8) HABEAS CORPUS.—
996 (a) At any time, and without notice, an individual a person
997 held for examination in a receiving or treatment facility, or a
998 relative, friend, guardian, guardian advocate, representative,
999 or attorney, or the department, on behalf of such individual
1000 person, may petition for a writ of habeas corpus to question the
1001 cause and legality of such detention and request that the court
1002 order a return to the writ in accordance with chapter 79. Each
1003 individual patient held in a facility shall receive a written
1004 notice of the right to petition for a writ of habeas corpus.
1005 (b) At any time, and without notice, an individual admitted
1006 for mental health treatment a person who is a patient in a
1007 receiving or treatment facility, or a relative, friend,
1008 guardian, guardian advocate, representative, or attorney, or the
1009 department, on behalf of such individual person, may file a
1010 petition in the circuit court in the county where the individual
1011 patient is being held alleging that he or she the patient is
1012 being unjustly denied a right or privilege granted herein or
1013 that a procedure authorized herein is being abused. Upon the
1014 filing of such a petition, the court may shall have the
1015 authority to conduct a judicial inquiry and to issue an any
1016 order needed to correct an abuse of the provisions of this part.
1017 (c) The administrator of any receiving or treatment
1018 facility receiving a petition under this subsection shall file
1019 the petition with the clerk of the court on the next court
1020 working day.
1021 (d) A No fee may not shall be charged for the filing of a
1022 petition under this subsection.
1023 (9) VIOLATIONS.—The department shall report to the Agency
1024 for Health Care Administration any violation of the rights or
1025 privileges of individuals patients, or of any procedures
1026 provided under this part, by any facility or professional
1027 licensed or regulated by the agency. The agency may is
1028 authorized to impose any sanction authorized for violation of
1029 this part, based solely on the investigation and findings of the
1030 department.
1031 (10) LIABILITY FOR VIOLATIONS.—Any person who violates or
1032 abuses the any rights or privileges of individuals held for
1033 examination or admitted for mental health treatment patients
1034 provided under by this part is liable for damages as determined
1035 by law. Any person who acts reasonably, in good faith, and
1036 without negligence in compliance with the provisions of this
1037 part is immune from civil or criminal liability for his or her
1038 actions in connection with the preparation or execution of
1039 petitions, applications, certificates, reports, or other
1040 documents initiating admission to a facility or the
1041 apprehension, detention, transportation, examination, admission,
1042 diagnosis, treatment, or discharge of an individual a patient to
1043 or from a facility. However, this section does not relieve any
1044 person from liability if such person commits negligence.
1045 (11) RIGHT TO PARTICIPATE IN TREATMENT AND DISCHARGE
1046 PLANNING.—An individual held for examination or admitted for
1047 mental health treatment The patient shall have the opportunity
1048 to participate in treatment and discharge planning and shall be
1049 notified in writing of his or her right, upon discharge from the
1050 facility, to seek treatment from the professional or agency of
1051 the individual’s patient’s choice.
1052 (12) ADVANCE DIRECTIVES.—All receiving and treatment
1053 facilities and other service providers shall provide information
1054 concerning advance directives, and assist individuals who are
1055 competent and willing to complete an advance directive. The
1056 directive may include instructions regarding mental health care.
1057 Receiving and treatment facilities and service providers must
1058 honor the advance directive of an individual admitted to or
1059 served by the facility or provider.
1060 (13)(12) POSTING OF NOTICE OF RIGHTS OF PATIENTS.—Each
1061 facility shall post a notice, which lists and describes in
1062 listing and describing, in the language and terminology that the
1063 individual persons to whom the notice is addressed can
1064 understand, of the rights provided in this section. This notice
1065 must shall include a statement that provisions of the federal
1066 Americans with Disabilities Act apply and the name and telephone
1067 number of a person to contact for further information. The This
1068 notice must shall be posted in a place readily accessible to
1069 patients and in a format easily seen by the individuals served
1070 patients. The This notice must shall include the telephone
1071 numbers of the Florida local advocacy council and Advocacy
1072 Center for Persons with Disabilities, Inc.
1073 Section 9. Subsections (1), (2), (3), and (4) of section
1074 394.4593, Florida Statutes, are amended to read:
1075 394.4593 Sexual misconduct prohibited; reporting required;
1076 penalties.—
1077 (1) As used in this section, the term:
1078 (a) “Employee” includes any paid staff member, volunteer,
1079 or intern of the department; any person under contract with the
1080 department; and any person providing care or support to an
1081 individual a client on behalf of the department or its service
1082 providers.
1083 (b) “Sexual activity” means:
1084 1. Fondling the genital area, groin, inner thighs,
1085 buttocks, or breasts of an individual a person.
1086 2. The oral, anal, or vaginal penetration by or union with
1087 the sexual organ of another or the anal or vaginal penetration
1088 of another by any other object.
1089 3. Intentionally touching in a lewd or lascivious manner
1090 the breasts, genitals, the genital area, or buttocks, or the
1091 clothing covering them, of an individual a person, or forcing or
1092 enticing an individual a person to touch the perpetrator.
1093 4. Intentionally masturbating in the presence of another
1094 person.
1095 5. Intentionally exposing the genitals in a lewd or
1096 lascivious manner in the presence of another individual person.
1097 6. Intentionally committing any other sexual act that does
1098 not involve actual physical or sexual contact with another
1099 individual the victim, including, but not limited to,
1100 sadomasochistic abuse, sexual bestiality, or the simulation of
1101 any act involving sexual activity in the presence of the
1102 individual a victim.
1103 (c) “Sexual misconduct” means any sexual activity between
1104 an employee and an individual held for examination or admitted
1105 for mental health treatment a patient, regardless of the consent
1106 of that individual the patient. The term does not include an act
1107 done for a bona fide medical purpose or an internal search
1108 conducted in the lawful performance of duty by an employee.
1109 (2) An employee who engages in sexual misconduct with an
1110 individual a patient who:
1111 (a) Is in the custody of the department; or
1112 (b) Resides in a receiving facility or a treatment
1113 facility, as those terms are defined in s. 394.455,
1114
1115 commits a felony of the second degree, punishable as provided in
1116 s. 775.082, s. 775.083, or s. 775.084. An employee may be found
1117 guilty of violating this subsection without having committed the
1118 crime of sexual battery.
1119 (3) The consent of an individual held for examination or
1120 admitted for treatment the patient to the sexual activity is not
1121 a defense to prosecution under this section.
1122 (4) This section does not apply to an employee who:
1123 (a) Is legally married to the individual patient; or
1124 (b) Has no reason to believe that the person with whom the
1125 employee engaged in sexual misconduct is an individual a patient
1126 receiving services as described in subsection (2).
1127 Section 10. Section 394.4595, Florida Statutes, is amended
1128 to read:
1129 394.4595 Florida statewide and local advocacy council
1130 councils; access to patients and records.—Any facility
1131 designated by the department as a receiving or treatment
1132 facility must allow access to any individual held for
1133 examination or admitted for mental health treatment patient and
1134 his or her the clinical and legal records of any patient
1135 admitted pursuant to the provisions of this act by members of
1136 the Florida statewide and local advocacy councils.
1137 Section 11. Section 394.4597, Florida Statutes, is amended
1138 to read:
1139 394.4597 Persons to be notified; appointment of a patient’s
1140 representative.—
1141 (1) VOLUNTARY ADMISSION PATIENTS.—At the time an individual
1142 a patient is voluntarily admitted to a receiving or treatment
1143 facility, the identity and contact information of the a person
1144 to be notified in case of an emergency shall be entered in the
1145 patient’s clinical record.
1146 (2) INVOLUNTARY ADMISSION PATIENTS.—
1147 (a) At the time an individual a patient is admitted to a
1148 facility for involuntary examination or placement, or when a
1149 petition for involuntary placement is filed, the names,
1150 addresses, and telephone numbers of the individual’s patient’s
1151 guardian or guardian advocate, or representative if he or she
1152 the patient has no guardian or guardian advocate, health care
1153 surrogate, and the patient’s attorney shall be entered in the
1154 patient’s clinical record.
1155 (a)(b) If the individual patient has no guardian or
1156 guardian advocate, he or she the patient shall be asked to
1157 designate a representative. If the individual patient is unable
1158 or unwilling to designate a representative, the facility shall
1159 select a representative.
1160 (b)(c) The individual patient shall be consulted with
1161 regard to the selection of a representative by the receiving or
1162 treatment facility and may shall have authority to request that
1163 the any such representative be replaced.
1164 (c)(d) If When the receiving or treatment facility selects
1165 a representative, first preference shall be given to a health
1166 care surrogate, if one has been previously selected by the
1167 patient. If the individual patient has not previously selected a
1168 health care surrogate, the selection, except for good cause
1169 documented in the patient’s clinical record, shall be made from
1170 the following list in the order of listing:
1171 1. The individual’s patient’s spouse.
1172 2. An adult child of the individual patient.
1173 3. A parent of the individual patient.
1174 4. The adult next of kin of the individual patient.
1175 5. An adult friend of the individual patient.
1176 6. The appropriate Florida local advocacy council as
1177 provided in s. 402.166.
1178 (d)(e) A licensed professional providing services to the
1179 individual patient under this part, an employee of a facility
1180 providing direct services to the individual patient under this
1181 part, a department employee, a person providing other
1182 substantial services to the individual patient in a professional
1183 or business capacity, or a creditor of the individual may
1184 patient shall not be appointed as the patient’s representative.
1185 (e) The representative selected by the individual or
1186 designated by the facility has the right, authority, and
1187 responsibility to:
1188 1. Receive notice of the individual’s admission;
1189 2. Receive notice of proceedings affecting the individual;
1190 3. Have immediate access to the individual unless such
1191 access is documented to be detrimental to the individual;
1192 4. Receive notice of any restriction of the individual’s
1193 right to communicate or receive visitors;
1194 5. Receive a copy of the inventory of personal effects upon
1195 the individual’s admission and to request an amendment to the
1196 inventory at any time;
1197 6. Receive disposition of the individual’s clothing and
1198 personal effects if not returned to the individual, or to
1199 approve an alternate plan;
1200 7. Petition on behalf of the individual for a writ of
1201 habeas corpus to question the cause and legality of the
1202 individual’s detention or to allege that the individual is being
1203 unjustly denied a right or privilege granted herein, or that a
1204 procedure authorized herein is being abused;
1205 8. Apply for a change of venue for the individual’s
1206 involuntary placement hearing for the convenience of the parties
1207 or witnesses or because of the individual’s condition;
1208 9. Receive written notice of any restriction of the
1209 individual’s right to inspect his or her clinical record;
1210 10. Receive notice of the release of the individual from a
1211 receiving facility where an involuntary examination was
1212 performed;
1213 11. Receive a copy of any petition for the individual’s
1214 involuntary placement filed with the court; and
1215 12. Be informed by the court of the individual’s right to
1216 an independent expert evaluation pursuant to involuntary
1217 placement procedures.
1218 Section 12. Section 394.4598, Florida Statutes, is amended
1219 to read:
1220 394.4598 Guardian advocate.—
1221 (1) The administrator may petition the court for the
1222 appointment of a guardian advocate based upon the opinion of a
1223 psychiatrist that an individual held for examination or admitted
1224 for mental health treatment the patient is incompetent to
1225 consent to treatment. If the court finds that the individual a
1226 patient is incompetent to consent to treatment and has not been
1227 adjudicated incapacitated and a guardian having with the
1228 authority to consent to mental health treatment has not been
1229 appointed, it shall appoint a guardian advocate. The individual
1230 patient has the right to have an attorney represent him or her
1231 at the hearing. If the individual person is indigent, the court
1232 shall appoint the office of the public defender to represent him
1233 or her at the hearing. The individual patient has the right to
1234 testify, cross-examine witnesses, and present witnesses. The
1235 proceeding must shall be recorded either electronically or
1236 stenographically, and testimony shall be provided under oath.
1237 One of the professionals authorized to give an opinion in
1238 support of a petition for involuntary placement, as described in
1239 s. 394.4655 or s. 394.467, must testify. The A guardian advocate
1240 must meet the qualifications of a guardian pursuant to contained
1241 in part IV of chapter 744., except that A professional providing
1242 services to the individual under referred to in this part, an
1243 employee of the facility providing direct services to the
1244 individual patient under this part, a departmental employee, a
1245 facility administrator, or a member of the Florida local
1246 advocacy council may shall not be appointed. A person who is
1247 appointed as a guardian advocate must agree to the appointment.
1248 (2) A facility requesting appointment of a guardian
1249 advocate must, prior to the appointment, provide the prospective
1250 guardian advocate with information concerning about the duties
1251 and responsibilities of guardian advocates, including the
1252 information about the ethics of medical decisionmaking. Before
1253 asking a guardian advocate to give consent to treatment for an
1254 individual held for examination or admitted for mental health
1255 treatment a patient, the facility must shall provide to the
1256 guardian advocate sufficient information so that the guardian
1257 advocate can decide whether to give express and informed consent
1258 to the treatment, including information that the treatment is
1259 essential to the care of the individual patient, and that the
1260 treatment does not present an unreasonable risk of serious,
1261 hazardous, or irreversible side effects. Before giving consent
1262 to treatment, the guardian advocate must meet and talk with the
1263 individual patient and the individual’s patient’s physician
1264 face-to-face in person, if at all possible, and by telephone, if
1265 not. The guardian advocate shall make every effort to make the
1266 mental health care decision that he or she believes the
1267 individual would have made under the circumstances if the
1268 individual were capable of making such decision. The decision of
1269 the guardian advocate may be reviewed by the court, upon
1270 petition of the individual’s patient’s attorney or, the
1271 patient’s family, or the facility administrator.
1272 (3) Before Prior to a guardian advocate may exercise
1273 exercising his or her authority, the guardian advocate must
1274 complete shall attend a training course approved by the court.
1275 The This training course, of not less than 4 hours, must
1276 include, at minimum, information concerning individual about the
1277 patient rights, psychotropic medications, diagnosis of mental
1278 illness, the ethics of medical decisionmaking, and duties of
1279 guardian advocates. This training course shall take the place of
1280 the training required for guardians appointed under pursuant to
1281 chapter 744.
1282 (4) The information provided to be supplied to prospective
1283 guardian advocates before prior to their appointment and the
1284 training course for guardian advocates must be developed and
1285 completed through a course developed by the department and
1286 approved by the chief judge of the circuit court and taught by a
1287 court-approved organization. Court-approved organizations may
1288 include, but are not limited to, community or junior colleges,
1289 guardianship organizations, and the local bar association or The
1290 Florida Bar. The court may, in its discretion, waive some or all
1291 of the training requirements for guardian advocates or impose
1292 additional requirements. The court shall make its decision on a
1293 case-by-case basis and, in making its decision, shall consider
1294 the experience and education of the guardian advocate, the
1295 duties assigned to the guardian advocate, and the needs of the
1296 individual whom the guardian advocate represents patient.
1297 (5) In selecting a guardian advocate, the court shall give
1298 preference to a health care surrogate, if one has already been
1299 designated by the individual held for examination or admitted
1300 for mental health treatment patient. If the individual patient
1301 has not previously selected a health care surrogate, except for
1302 good cause documented in the court record, the selection shall
1303 be made from the following list in the order of listing:
1304 (a) The individual’s patient’s spouse.
1305 (b) An adult child of the individual patient.
1306 (c) A parent of the individual patient.
1307 (d) The adult next of kin of the individual patient.
1308 (e) An adult friend of the individual patient.
1309 (f) An adult trained and willing to serve as guardian
1310 advocate for the individual patient.
1311 (6) If a guardian having with the authority to consent to
1312 medical treatment has not already been appointed, or if the
1313 individual held for examination or admitted for mental health
1314 treatment patient has not already designated a health care
1315 surrogate, the court may authorize the guardian advocate to
1316 consent to medical treatment, as well as mental health
1317 treatment. Unless otherwise limited by the court, a guardian
1318 advocate that has with authority to consent to medical treatment
1319 shall have the same authority to make health care decisions and
1320 be subject to the same restrictions as a proxy appointed under
1321 part IV of chapter 765. Unless the guardian advocate has sought
1322 and received express court approval in proceeding separate from
1323 the proceeding to determine the competence of the patient to
1324 consent to medical treatment, the guardian advocate may not
1325 consent to:
1326 (a) Abortion.
1327 (b) Sterilization.
1328 (c) Electroconvulsive treatment.
1329 (d) Psychosurgery.
1330 (e) Experimental treatments that have not been approved by
1331 a federally approved institutional review board in accordance
1332 with 45 C.F.R. part 46 or 21 C.F.R. part 56.
1333
1334 The court shall must base its decision on evidence that the
1335 treatment or procedure is essential to the care of the
1336 individual patient and that the treatment does not present an
1337 unreasonable risk of serious, hazardous, or irreversible side
1338 effects. The court shall follow the procedures set forth in
1339 subsection (1) of this section.
1340 (7) The guardian advocate shall be discharged when the
1341 individual whom he or she represents patient is discharged from
1342 an order for involuntary outpatient placement or involuntary
1343 inpatient placement or when the individual patient is
1344 transferred from involuntary to voluntary status. The court or a
1345 hearing officer shall consider the competence of the individual
1346 patient pursuant to subsection (1) and may consider an
1347 involuntarily placed individual’s patient’s competence to
1348 consent to treatment at any hearing. Upon sufficient evidence,
1349 the court may restore, or the magistrate hearing officer may
1350 recommend that the court restore, the individual’s patient’s
1351 competence. A copy of the order restoring competence or the
1352 certificate of discharge containing the restoration of
1353 competence shall be provided to the individual patient and the
1354 guardian advocate.
1355 Section 13. Section 394.4599, Florida Statutes, is amended
1356 to read:
1357 394.4599 Notice.—
1358 (1) VOLUNTARY ADMISSION PATIENTS.—Notice of an individual’s
1359 a voluntary patient’s admission shall only be given only at the
1360 individual’s request of the patient, except that in an
1361 emergency, notice shall be given as determined by the facility.
1362 (2) INVOLUNTARY ADMISSION PATIENTS.—
1363 (a) If notice of involuntary admission Whenever notice is
1364 required to be given under this part, such notice shall be given
1365 to the individual admitted patient and his or her the patient’s
1366 guardian, guardian advocate, attorney, and representative.
1367 1. If When notice is required to be given to an individual
1368 a patient, it shall be given both orally and in writing, in the
1369 language and terminology that the individual patient can
1370 understand, and, if needed, the facility shall provide an
1371 interpreter for the individual patient.
1372 2. Notice to an individual’s a patient’s guardian, guardian
1373 advocate, health care surrogate or proxy, attorney, and
1374 representative shall be given by United States mail and by
1375 registered or certified mail with the receipts attached to the
1376 patient’s clinical record. Hand delivery by a facility employee
1377 may be used as an alternative, with delivery documented in the
1378 clinical record. If notice is given by a state attorney or an
1379 attorney for the department, a certificate of service is shall
1380 be sufficient to document service.
1381 (b) A receiving facility shall give prompt notice of the
1382 whereabouts of an individual a patient who is being
1383 involuntarily held for examination to the individual’s guardian
1384 or representative, by telephone or in person within 24 hours
1385 after the individual’s patient’s arrival at the facility, unless
1386 the patient requests that no notification be made. Contact
1387 attempts must shall be documented in the individual’s patient’s
1388 clinical record and shall begin as soon as reasonably possible
1389 after the individual’s patient’s arrival. Notice that an
1390 individual is being involuntarily held must a patient is being
1391 admitted as an involuntary patient shall be given to the Florida
1392 local advocacy council by no later than the next working day
1393 after the individual patient is admitted.
1394 (c) The written notice of the filing of the petition for
1395 the involuntary placement of an individual being held must
1396 include contain the following:
1397 1. Notice that the petition has been filed with the circuit
1398 court in the county in which the individual patient is
1399 hospitalized and the court’s address of such court.
1400 2. Notice that the office of the public defender has been
1401 appointed to represent the individual patient in the proceeding,
1402 if the individual patient is not otherwise represented by
1403 counsel.
1404 3. The date, time, and place of the hearing and the name of
1405 each examining expert and every other person expected to testify
1406 in support of continued detention.
1407 4. Notice that the individual patient, the individual’s
1408 patient’s guardian or representative, or the administrator may
1409 apply for a change of venue for the convenience of the parties
1410 or witnesses or because of the individual’s condition of the
1411 patient.
1412 5. Notice that the individual patient is entitled to an
1413 independent expert examination and, if the individual patient
1414 cannot afford such an examination, that the court will provide
1415 for one.
1416 (d) A treatment facility shall provide notice of an
1417 individual’s a patient’s involuntary admission on the next
1418 regular working day after the individual’s patient’s arrival at
1419 the facility.
1420 (e) If an individual When a patient is to be transferred
1421 from one facility to another, notice shall be given by the
1422 facility where the individual patient is located before prior to
1423 the transfer.
1424 Section 14. Section 394.460, Florida Statutes, is repealed.
1425 Section 15. Section 394.461, Florida Statutes, is amended
1426 to read:
1427 394.461 Designation of receiving and treatment facilities.
1428 The department may is authorized to designate and monitor
1429 receiving facilities and treatment facilities and may suspend or
1430 withdraw such designation for failure to comply with this part
1431 and rules adopted under this part. Only governmental facilities,
1432 and others Unless designated by the department, may facilities
1433 are not permitted to hold or treat individuals on an involuntary
1434 basis patients under this part.
1435 (1) RECEIVING FACILITY.—The department may designate any
1436 community facility as a receiving facility. Any other facility
1437 within the state, including a private facility, as a receiving
1438 facility if or a federal facility, may be so designated by the
1439 department, provided that such designation is agreed to by the
1440 governing body or authority of the facility.
1441 (2) TREATMENT FACILITY.—The department may designate any
1442 state-owned, state-operated, or state-supported facility as a
1443 state treatment facility. An individual may A civil patient
1444 shall not be admitted to a civil state treatment facility
1445 without previously undergoing a transfer evaluation. Before a
1446 court hearing for involuntary placement in a state treatment
1447 facility, the court shall receive and consider the information
1448 documented in the transfer evaluation. Any other facility,
1449 including a private facility or a federal facility, may be
1450 designated as a treatment facility by the department if,
1451 provided that such designation is agreed to by the appropriate
1452 governing body or authority of the facility.
1453 (3) GOVERNMENTAL FACILITIES.—Governmental facilities may
1454 provide voluntary and involuntary mental health examination and
1455 treatment for individuals in their care and custody and must
1456 protect the rights of these individuals, pursuant to this part.
1457 (4)(3) PRIVATE FACILITIES.—Private facilities designated as
1458 receiving and treatment facilities by the department may provide
1459 examination and treatment of individuals on an of involuntary or
1460 patients, as well as voluntary basis patients, and are subject
1461 to all the provisions of this part.
1462 (5)(4) REPORT.—
1463 (a) A facility designated as a public receiving or
1464 treatment facility under this section shall annually report to
1465 the department on an annual basis the following data to the
1466 department, unless such these data are currently being submitted
1467 to the Agency for Health Care Administration:
1468 1. Number of licensed beds by payor class.
1469 2. Number of contract days by payor class.
1470 3. Number of persons served admissions by payor class and
1471 diagnoses.
1472 4. Number of bed days by payor class.
1473 5. Average length of stay by payor class.
1474 6. Total revenues by payor class.
1475 (b) For the purposes of this subsection, “payor class”
1476 means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private
1477 pay health insurance, private-pay health maintenance
1478 organization, private preferred provider organization, the
1479 Department of Children and Family Services, other government
1480 programs, self-pay individuals patients, and charity care.
1481 (c) The data required under this subsection shall be
1482 submitted to the department within no later than 90 days after
1483 following the end of the facility’s fiscal year. A facility
1484 designated as a public receiving or treatment facility shall
1485 submit its initial report for the 6-month period ending June 30,
1486 2008.
1487 (d) The department shall issue an annual report based on
1488 the data collected required pursuant to this subsection, which
1489 must. The report shall include individual facilities’ data by
1490 facility, as well as statewide totals. The report shall be
1491 submitted to the Governor, the President of the Senate, and the
1492 Speaker of the House of Representatives.
1493 (6)(5) RULES.—The department shall adopt rules relating to:
1494 (a) Procedures and criteria for receiving and evaluating
1495 facility applications for designation as a receiving or
1496 treatment facility, which may include an onsite facility
1497 inspection and evaluation of an applicant’s licensing status and
1498 performance history, as well as consideration of local service
1499 needs.
1500 (b) Minimum standards consistent with this part which that
1501 a facility must meet and maintain in order to be designated as a
1502 receiving or treatment facility, and procedures for monitoring
1503 continued adherence to such standards.
1504 (c) Procedures for receiving complaints against a
1505 designated facility and for initiating inspections and
1506 investigations of facilities alleged to have violated the
1507 provisions of this part or rules adopted under this part.
1508 (d) Procedures and criteria for the suspension or
1509 withdrawal of designation as a receiving or treatment facility.
1510 Section 16. Section 394.4615, Florida Statutes, is amended
1511 to read:
1512 394.4615 Clinical records; confidentiality.—
1513 (1) A clinical record shall be maintained for each
1514 individual held for examination or admitted for mental health
1515 treatment patient. The record must shall include data pertaining
1516 to admission and such other information as may be required under
1517 rules of the department. A clinical record is confidential and
1518 exempt from the provisions of s. 119.07(1). Unless waived by the
1519 express and informed consent of the individual, by the patient
1520 or by his or her the patient’s guardian, or guardian advocate,
1521 health care surrogate or proxy, or, if the patient is deceased,
1522 by his or her the patient’s personal representative or the
1523 family member who stands next in line of intestate succession,
1524 the confidential status of the clinical record is shall not be
1525 lost by either authorized or unauthorized disclosure to any
1526 person, organization, or agency.
1527 (2) The clinical record of an individual held for
1528 examination or admitted for mental health treatment shall be
1529 released if when:
1530 (a) The individual patient or the individual’s patient’s
1531 guardian, guardian advocate, or health care surrogate or proxy
1532 authorizes the release. The guardian, or guardian advocate, or
1533 surrogate shall be provided access to the appropriate clinical
1534 records of the patient. The individual patient or the
1535 individual’s patient’s guardian, or guardian advocate, or
1536 surrogate or proxy may authorize the release of information and
1537 clinical records to appropriate persons to ensure the continuity
1538 of the individual’s patient’s health care or mental health care.
1539 (b) The individual patient is represented by counsel and
1540 the records are needed by such the patient’s counsel for
1541 adequate representation.
1542 (c) A petition for involuntary placement is filed and the
1543 records are needed by the state attorney to evaluate and confirm
1544 the allegations set forth in the petition or to prosecute the
1545 petition.
1546 (d)(c) The court orders such release. In determining
1547 whether there is good cause for disclosure, the court shall
1548 weigh the need for the information to be disclosed against the
1549 possible harm of disclosure to the individual person to whom
1550 such information pertains.
1551 (e)(d) The individual patient is committed to, or is to be
1552 returned to, the Department of Corrections from the Department
1553 of Children and Family Services, and the Department of
1554 Corrections requests such records. The These records shall be
1555 furnished without charge to the Department of Corrections.
1556 (3) Information from the clinical record may be released if
1557 in the following circumstances:
1558 (a) The individual When a patient has declared an intention
1559 to harm other persons. If When such declaration has been made,
1560 the administrator may authorize the release of sufficient
1561 information to provide adequate warning to the person threatened
1562 with harm by the patient.
1563 (b) When The administrator of the facility or secretary of
1564 the department deems that release to a qualified researcher as
1565 defined in administrative rule, an aftercare treatment provider,
1566 or an employee or agent of the department is necessary for
1567 treatment of the individual patient, maintenance of adequate
1568 records, compilation of treatment data, aftercare planning, or
1569 evaluation of programs.
1570 (c) Necessary for the purpose of determining whether an
1571 individual a person meets the criteria for involuntary
1572 outpatient placement or for preparing the proposed treatment
1573 plan pursuant to s. 394.4655, the clinical record may be
1574 released to the state attorney, the public defender or the
1575 individual’s patient’s private legal counsel, the court, and to
1576 the appropriate mental health professionals, including the
1577 service provider identified in s. 394.4655(6)(b)
1578 394.4655(6)(b)2., in accordance with state and federal law.
1579 (4) Information from clinical records may be used for
1580 statistical and research purposes if the information is
1581 abstracted in such a way as to protect the identity of
1582 individuals served and meets department policy.
1583 (5) Information from clinical records may be used by the
1584 Agency for Health Care Administration, the department, and the
1585 Florida advocacy councils for the purpose of monitoring facility
1586 activity and complaints concerning facilities.
1587 (6) Clinical records relating to a Medicaid recipient shall
1588 be furnished to the Medicaid Fraud Control Unit in the
1589 Department of Legal Affairs, upon request.
1590 (7) Any person, agency, or entity receiving information
1591 pursuant to this section shall maintain such information as
1592 confidential and exempt from the provisions of s. 119.07(1).
1593 (8) Any facility or private mental health practitioner who
1594 acts in good faith in releasing information pursuant to this
1595 section is not subject to civil or criminal liability for such
1596 release.
1597 (9) Nothing in This section does not is intended to
1598 prohibit the parent or next of kin of an individual a person who
1599 is held for examination in or admitted for treated under a
1600 mental health treatment facility or program from requesting and
1601 receiving information limited to a summary of that individual’s
1602 person’s treatment plan and current physical and mental
1603 condition. Release of such information must shall be in
1604 accordance with the code of ethics of the profession involved.
1605 (10) An adult individual Patients shall have reasonable
1606 access to his or her their clinical records, unless such access
1607 is determined by the individual’s patient’s physician to be
1608 harmful to the individual patient. If the individual’s patient’s
1609 right to inspect his or her clinical record is restricted by the
1610 facility, written notice of the such restriction must shall be
1611 given to the individual patient and to his or her the patient’s
1612 guardian, guardian advocate, attorney, and representative. In
1613 addition, the restriction must shall be recorded in the clinical
1614 record, together with the reasons for it. The restriction
1615 expires of a patient’s right to inspect his or her clinical
1616 record shall expire after 7 days but may be renewed, after
1617 review, for subsequent 7-day periods.
1618 (11) Any person who fraudulently alters, defaces, or
1619 falsifies the clinical record of an individual any person
1620 receiving mental health services in a facility subject to this
1621 part, or causes or procures any of these offenses to be
1622 committed, commits a misdemeanor of the second degree,
1623 punishable as provided in s. 775.082 or s. 775.083.
1624 Section 17. Section 394.462, Florida Statutes, is amended
1625 to read:
1626 394.462 Transportation.—
1627 (1) TRANSPORTATION TO A RECEIVING FACILITY.—
1628 (a) Each county shall designate a single law enforcement
1629 agency within the county, or portions thereof, to take an
1630 individual a person into custody upon the entry of an ex parte
1631 order or the execution of a certificate for involuntary
1632 examination by an authorized professional and to transport that
1633 individual person to the nearest receiving facility, excluding a
1634 governmental facility, for examination. A law enforcement
1635 officer acting in good faith pursuant to this part may not be
1636 held criminally or civilly liable for false imprisonment. The
1637 designated law enforcement agency may decline to transport the
1638 individual person to a receiving facility only if:
1639 1. The county or jurisdiction designated by the county has
1640 contracted on an annual basis with an emergency medical
1641 transport service or private transport company for
1642 transportation of individuals persons to receiving facilities
1643 pursuant to this section at the sole cost of the county; and
1644 2. The law enforcement agency and the emergency medical
1645 transport service or private transport company agree that the
1646 continued presence of law enforcement personnel is not necessary
1647 for the safety of the individual being transported person or
1648 others.
1649 (b)3. If transportation for involuntary examination is
1650 provided by an emergency medical transport service or private
1651 transport company, the county or law enforcement agency The
1652 jurisdiction designated by the county may seek reimbursement for
1653 transportation expenses. The individual being transported is
1654 party responsible for payment for such transportation is the
1655 person receiving the transportation. The county shall seek
1656 reimbursement from the following sources in the following order:
1657 1.a. From an insurance company, health care corporation, or
1658 other source, if the individual being transported person
1659 receiving the transportation is covered by an insurance policy
1660 or subscribes to a health care corporation or other source for
1661 payment of such expenses.
1662 2.b. From the individual being transported person receiving
1663 the transportation.
1664 3.c. From a financial settlement for medical care,
1665 treatment, hospitalization, or transportation payable or
1666 accruing to the injured party.
1667 (c)(b) Any company that transports an individual a patient
1668 pursuant to this subsection is considered an independent
1669 contractor and is solely liable for the safe and dignified
1670 transportation of the individual patient. Such company must be
1671 insured and maintain at least provide no less than $100,000 in
1672 liability insurance with respect to such the transportation of
1673 patients.
1674 (d)(c) Any company that contracts with a governing board of
1675 a county to transport individuals for examination or treatment
1676 must patients shall comply with the applicable rules of the
1677 department to ensure their the safety and dignity of the
1678 patients.
1679 (e)(d) If When a law enforcement officer takes custody of
1680 an individual a person pursuant to this part, the officer may
1681 request assistance from emergency medical personnel if such
1682 assistance is needed for the safety of the officer or the
1683 individual person in custody.
1684 (f)(e) If When a member of a mental health overlay program
1685 or a mobile crisis response service is a professional authorized
1686 to initiate an involuntary examination pursuant to s. 394.463
1687 and that professional evaluates an individual a person and
1688 determines that transportation to a receiving facility is
1689 needed, the service, at its discretion, may transport the
1690 individual person to the facility or may call on the law
1691 enforcement agency or other transportation arrangement best
1692 suited to the needs of the individual being transported patient.
1693 (g)(f) If a When any law enforcement officer has custody of
1694 an individual a person based on either noncriminal or minor
1695 criminal behavior that meets the statutory guidelines for
1696 involuntary examination under this part, the law enforcement
1697 officer shall transport the individual person to the nearest
1698 receiving facility for examination.
1699 (h)(g) If a When any law enforcement officer has arrested
1700 an adult a person for a felony and it appears that the adult
1701 arrested person meets the statutory guidelines for involuntary
1702 examination or placement under this part, the adult such person
1703 shall first be processed in the same manner as any other
1704 criminal suspect. The law enforcement agency shall thereafter
1705 immediately notify the nearest public receiving facility, which
1706 shall be responsible for promptly arranging for the examination
1707 and treatment of the adult person. A receiving facility is not
1708 required to admit an adult a person charged with a felony crime
1709 for whom the facility determines and documents that it is unable
1710 to provide adequate security, but shall provide mental health
1711 examination and treatment to the adult person where he or she is
1712 held.
1713 (i)(h) If the appropriate law enforcement officer believes
1714 that an individual a person has an emergency medical condition
1715 as defined in s. 395.002, the individual person may be first
1716 transported to a hospital for emergency medical treatment,
1717 regardless of whether the hospital is a designated receiving
1718 facility.
1719 (j)(i) The costs of transportation, evaluation,
1720 hospitalization, and treatment incurred under this subsection by
1721 individuals persons who have been arrested for violations of any
1722 state law or county or municipal ordinance may be recovered as
1723 provided in s. 901.35.
1724 (k)(j) The nearest receiving facility must accept
1725 individuals persons brought by law enforcement officers for
1726 involuntary examination.
1727 (l)(k) Each law enforcement agency shall develop a
1728 memorandum of understanding with each receiving facility within
1729 the law enforcement agency’s jurisdiction which reflects a
1730 single set of protocols for the safe and secure transportation
1731 of the person and transfer of custody of the person. These
1732 protocols must also address crisis intervention measures.
1733 (m)(l) If When a jurisdiction has entered into a contract
1734 with an emergency medical transport service or a private
1735 transport company for transportation of individuals persons to
1736 receiving facilities, such service or company shall be given
1737 preference for transportation of individuals persons from
1738 nursing homes, assisted living facilities, adult day care
1739 centers, or adult family-care homes, unless the behavior of the
1740 individual person being transported is such that transportation
1741 by a law enforcement officer is necessary.
1742 (n)(m) Nothing in This section does not shall be construed
1743 to limit emergency examination and treatment of incapacitated
1744 individuals persons provided in accordance with the provisions
1745 of s. 401.445.
1746 (2) TRANSPORTATION TO A TREATMENT FACILITY.—
1747 (a) If neither the individual held for examination or
1748 admitted for mental health treatment or patient nor any person
1749 legally obligated or responsible for the individual patient is
1750 not able to pay for the expense of transporting an individual a
1751 voluntary or involuntary patient to a treatment facility, the
1752 governing board of the county in which the individual patient is
1753 hospitalized shall arrange for the such required transportation
1754 and shall ensure the safe and dignified transportation of the
1755 individual patient. The governing board of each county may is
1756 authorized to contract with private transport companies for such
1757 the transportation of such patients to and from a treatment
1758 facility.
1759 (b) Any company that transports an individual a patient
1760 pursuant to this subsection is considered an independent
1761 contractor and is solely liable for the safe and dignified
1762 transportation of the individual patient. Such company must be
1763 insured and provide at least no less than $100,000 in liability
1764 insurance for such with respect to the transportation of
1765 patients.
1766 (c) Any company that contracts with the governing board of
1767 a county to transport individuals must patients shall comply
1768 with the applicable rules of the department to ensure the safety
1769 and dignity of the individuals transported patients.
1770 (d) County or municipal law enforcement and correctional
1771 personnel and equipment may shall not be used to transport
1772 individuals patients adjudicated incapacitated or found by the
1773 court to meet the criteria for involuntary placement under
1774 pursuant to s. 394.467, except in small rural counties where
1775 there are no cost-efficient alternatives.
1776 (3) TRANSFER OF CUSTODY.—Custody of a person who is
1777 transported pursuant to this part, along with related
1778 documentation, shall be relinquished to a responsible individual
1779 at the appropriate receiving or treatment facility.
1780 (4) EXCEPTIONS.—
1781 (a) An exception to the requirements of this section may be
1782 granted by the secretary of the department for the purposes of
1783 improving service coordination or better meeting the special
1784 needs of individuals. A proposal for an exception shall must be
1785 submitted to the secretary by the circuit district administrator
1786 after being approved by the governing board of each affected
1787 county boards of any affected counties, prior to submission to
1788 the secretary.
1789 1.(a) A proposal for an exception must identify the
1790 specific provision from which an exception is requested,;
1791 describe how the proposal will be implemented by participating
1792 law enforcement agencies and transportation authorities,; and
1793 provide a plan for the coordination of services such as case
1794 management.
1795 2.(b) An The exception may be granted only for:
1796 a.1. An arrangement centralizing and improving the
1797 provision of services within a circuit district, which may
1798 include an exception to the requirement for transportation to
1799 the nearest receiving facility;
1800 b.2. An arrangement whereby by which a facility may
1801 provide, in addition to required psychiatric services, an
1802 environment and services that which are uniquely tailored to the
1803 needs of an identified group of individuals who have persons
1804 with special needs, such as persons who have with hearing
1805 impairments or visual impairments, or elderly persons who have
1806 with physical frailties; or
1807 c.3. A specialized transportation system that provides an
1808 efficient and humane method of transporting individuals patients
1809 to receiving facilities, among receiving facilities, and to
1810 treatment facilities.
1811 2.(c) Any exception approved pursuant to this subsection
1812 must shall be reviewed and approved every 5 years by the
1813 secretary.
1814 (b) The Department of Corrections may transport an
1815 individual who is being released from its custody to a receiving
1816 or treatment facility for involuntary examination or placement.
1817 Such transport shall be to a facility, specified by the
1818 department, which is able to meet the specific needs of the
1819 individual, or, if such specification cannot be made due to
1820 exigent circumstances, transport may be to the nearest receiving
1821 facility.
1822 Section 18. Section 394.4625, Florida Statutes, is amended
1823 to read:
1824 394.4625 Voluntary admissions.—
1825 (1) EXAMINATION AND TREATMENT AUTHORITY TO RECEIVE
1826 PATIENTS.—
1827 (a) A facility may receive for observation, diagnosis, or
1828 treatment an adult who makes any person 18 years of age or older
1829 making application by express and informed consent for admission
1830 or any minor person age 17 or under for whom such application is
1831 made by his or her guardian.
1832 1. If found to show evidence of mental illness, to be
1833 competent to provide express and informed consent, and to be
1834 suitable for treatment, an adult such person 18 years of age or
1835 older may be admitted to the facility.
1836 2. A minor person age 17 or under may be admitted only with
1837 the minor’s assent, which must be obtained in conjunction with
1838 consent from the minor’s guardian. The minor’s assent means that
1839 the minor has affirmatively agreed to stay at the facility for
1840 examination or mental health treatment. Mere failure to object,
1841 absent affirmative agreement, is not assent. The minor’s assent
1842 must be verified through a clinical assessment that is
1843 documented in the clinical record and conducted within 12 hours
1844 after admission by a licensed professional authorized to
1845 initiate an involuntary examination pursuant to s. 394.463. In
1846 verifying the minor’s assent, the examining professional must
1847 first provide the minor with an explanation of why the minor
1848 will be examined and treated, what the minor can expect while in
1849 the facility, and when the minor may expect to be released,
1850 using language that is appropriate to the minor’s age,
1851 experience, maturity, and condition. Unless the minor’s assent
1852 is verified pursuant to this section, a petition for involuntary
1853 inpatient placement must be filed with the court within 1
1854 working day after admission or the minor must be released to his
1855 or her guardian within 24 hours after admission only after a
1856 hearing to verify the voluntariness of the consent.
1857 (b) A mental health overlay program, or a mobile crisis
1858 response service, or a licensed professional who is authorized
1859 to initiate an involuntary examination pursuant to s. 394.463
1860 and is employed by a community mental health center or clinic
1861 must, pursuant to circuit district procedure approved by the
1862 respective circuit district administrator, conduct an initial
1863 assessment of the ability of the following individuals persons
1864 to give express and informed consent to treatment before such
1865 individuals persons may be admitted voluntarily:
1866 1. An individual A person 60 years of age or older for whom
1867 transfer is being sought from a nursing home, assisted living
1868 facility, adult day care center, or adult family-care home, if
1869 when such person has been diagnosed as suffering from dementia.
1870 2. An individual A person 60 years of age or older for whom
1871 transfer is being sought from a nursing home pursuant to s.
1872 400.0255(11) 400.0255(12).
1873 3. An individual A person for whom all decisions concerning
1874 medical treatment are currently being lawfully made by a the
1875 health care surrogate or proxy designated under chapter 765.
1876 (c) If When an initial assessment of the ability of an
1877 individual a person to give express and informed consent to
1878 treatment is required under this section, and a mobile crisis
1879 response service does not respond to a the request for an
1880 assessment within 2 hours after the request is made or informs
1881 the requesting facility that it will not be able to respond
1882 within 2 hours after the request is made, the requesting
1883 facility may arrange for assessment by a any licensed
1884 professional authorized to initiate an involuntary examination
1885 under pursuant to s. 394.463. The professional may not be who is
1886 not employed by or under contract with, or and does not have a
1887 financial interest in, either the facility initiating the
1888 transfer or the receiving facility to which the transfer may be
1889 made, and may not have a financial interest in the outcome of
1890 the assessment.
1891 (d) A facility may not admit an individual on as a
1892 voluntary status patient a person who has been adjudicated
1893 incapacitated, unless the condition of incapacity has been
1894 judicially removed. If a facility admits an individual on
1895 voluntary status as a voluntary patient a person who is later
1896 determined to have been adjudicated incapacitated, and the
1897 condition of incapacity had not been removed by the time of the
1898 admission, the facility must either discharge the patient or
1899 transfer the individual patient to involuntary status.
1900 (e) The health care surrogate or proxy of an individual on
1901 a voluntary status patient may not consent to the provision of
1902 mental health treatment for that individual the patient. An
1903 individual on voluntary status A voluntary patient who is
1904 unwilling or unable to provide express and informed consent to
1905 mental health treatment must either be discharged or transferred
1906 to involuntary status.
1907 (f) Within 24 hours after an individual’s voluntary
1908 admission of a voluntary patient, the admitting physician shall
1909 document in the patient’s clinical record that the individual
1910 patient is able to give express and informed consent for
1911 admission. If the individual patient is not able to give express
1912 and informed consent for admission, the facility must shall
1913 either discharge the patient or transfer the individual patient
1914 to involuntary status pursuant to subsection (5).
1915 (2) RELEASE OR DISCHARGE OF VOLUNTARY PATIENTS.—
1916 (a) A facility shall discharge an individual admitted on a
1917 voluntary status who patient:
1918 1. Who Has sufficiently improved so that retention in the
1919 facility is no longer desirable. The individual A patient may
1920 also be discharged to the care of a community facility.
1921 2. Who Has revoked revokes consent to admission or requests
1922 discharge. The individual A voluntary patient or his or her a
1923 relative, friend, or attorney of the patient may request
1924 discharge either orally or in writing at any time following
1925 admission to the facility. The individual patient must be
1926 discharged within 24 hours after of the request, unless the
1927 request is rescinded or the individual patient is transferred to
1928 involuntary status pursuant to this section. The 24-hour time
1929 period may be extended by a treatment facility if when necessary
1930 for adequate discharge planning, but may shall not exceed 3 days
1931 exclusive of weekends and holidays. If the individual patient,
1932 or another on his or her the patient’s behalf, makes an oral
1933 request for discharge to a staff member, such request must shall
1934 be immediately entered in the patient’s clinical record. If the
1935 request for discharge is made by a person other than the
1936 individual patient, the discharge may be conditioned upon the
1937 individual’s express and informed consent of the patient.
1938 (b) An individual on A voluntary status patient who has
1939 been admitted to a facility and who refuses to consent to or
1940 revokes consent to treatment must shall be discharged within 24
1941 hours after such refusal or revocation, unless transferred to
1942 involuntary status pursuant to this section or unless the
1943 refusal or revocation is freely and voluntarily rescinded by the
1944 individual patient.
1945 (c) An individual on voluntary status who has been charged
1946 with a crime shall be returned to the custody of a law
1947 enforcement officer upon release or discharge from a facility.
1948 (3) NOTICE OF RIGHT TO DISCHARGE.—At the time of admission
1949 and at least every 6 months thereafter, an individual on a
1950 voluntary status patient shall be notified in writing of his or
1951 her right to apply for a discharge.
1952 (4) TRANSFER TO VOLUNTARY STATUS.—An individual on
1953 involuntary status patient who has been certified by a physician
1954 or psychologist as competent to provide express and informed
1955 consent and who applies to be transferred to voluntary status
1956 shall be transferred to voluntary status immediately, unless the
1957 individual patient has been charged with a crime, or has been
1958 involuntarily placed for treatment by a court pursuant to s.
1959 394.467 and continues to meet the criteria for involuntary
1960 placement. When transfer to voluntary status occurs, notice
1961 shall be given as provided in s. 394.4599.
1962 (5) TRANSFER TO INVOLUNTARY STATUS.—If an individual on
1963 When a voluntary status patient, or an authorized person on the
1964 individual’s the patient’s behalf, makes a request for
1965 discharge, the request for discharge, unless freely and
1966 voluntarily rescinded, must be communicated to a physician,
1967 clinical psychologist, or psychiatrist as quickly as possible,
1968 but within not later than 12 hours after the request is made. If
1969 the individual patient meets the criteria for involuntary
1970 placement, the administrator of the facility must file with the
1971 court a petition for involuntary placement, within 2 court
1972 working days after the request for discharge is made. If the
1973 petition is not filed within 2 court working days, the
1974 individual must patient shall be discharged. Pending the filing
1975 of the petition, the individual patient may be held and
1976 emergency treatment rendered in the least restrictive manner,
1977 upon the written order of a physician, if it is determined that
1978 such treatment is necessary for the safety of the individual
1979 patient or others.
1980 Section 19. Section 394.463, Florida Statutes, is amended
1981 to read:
1982 394.463 Involuntary examination.—
1983 (1) CRITERIA.—An individual A person may be taken to a
1984 receiving facility for involuntary examination if there is
1985 reason to believe that he or she the person has a mental illness
1986 and because of this his or her mental illness:
1987 (a)1. The individual person has refused voluntary
1988 examination after conscientious explanation and disclosure of
1989 the purpose of the examination; or
1990 2. The individual person is unable to determine for himself
1991 or herself whether examination is necessary; and
1992 (b)1. Without care or treatment:, the person
1993 1. The individual is likely to suffer from neglect or
1994 refuse to care for himself or herself; such neglect or refusal
1995 poses a real and present threat of substantial harm to his or
1996 her well-being; and it is not apparent that such harm may be
1997 avoided through the help of willing family members or friends or
1998 the provision of other services; or
1999 2. There is a substantial likelihood that without care or
2000 treatment the individual person will cause serious bodily harm
2001 to self himself or herself or others in the near future, as
2002 evidenced by recent behavior.
2003 (2) INVOLUNTARY EXAMINATION.—
2004 (a) An involuntary examination may be initiated by any one
2005 of the following means:
2006 1. A court may enter an ex parte order stating that an
2007 individual a person appears to meet the criteria for involuntary
2008 examination, giving the findings on which that conclusion is
2009 based. The ex parte order for involuntary examination must be
2010 based on sworn testimony, written or oral, which includes
2011 specific facts that support the finding that the criteria have
2012 been met. Any behavior relied on for the issuance of the ex
2013 parte order must have occurred within the preceding 14 days. If
2014 other less restrictive means are not available, such as
2015 voluntary appearance for outpatient evaluation, A law
2016 enforcement officer, or other designated agent of the court,
2017 shall take the individual person into custody and deliver him or
2018 her to the nearest receiving facility for involuntary
2019 examination. The order of the court order must shall be made a
2020 part of the patient’s clinical record. A No fee may not shall be
2021 charged for the filing of an order under this subsection. Any
2022 receiving facility accepting the individual patient based on the
2023 this order must send a copy of the order to the Agency for
2024 Health Care Administration on the next working day. The order is
2025 shall be valid only until the individual is delivered to the
2026 receiving facility until executed or, if not executed, for the
2027 period specified in the order itself, whichever occurs first. If
2028 a no time limit is not specified in the order, the order is
2029 shall be valid for 7 days after the date it that the order was
2030 signed.
2031 2. A law enforcement officer shall take an individual a
2032 person who appears to meet the criteria for involuntary
2033 examination into custody and deliver or arrange for the delivery
2034 of the individual the person or have him or her delivered to the
2035 nearest receiving facility for examination. The officer shall
2036 complete execute a written report detailing the circumstances
2037 under which the individual person was taken into custody., and
2038 The report must shall be made a part of the patient’s clinical
2039 record. Any receiving facility accepting the individual patient
2040 based on the this report must send a copy of the report to the
2041 Agency for Health Care Administration on the next working day.
2042 3. A physician, clinical psychologist, psychiatric nurse,
2043 mental health counselor, marriage and family therapist, or
2044 clinical social worker, or physician assistant may execute a
2045 certificate stating that he or she has examined the individual a
2046 person within the preceding 48 hours and finds that the
2047 individual person appears to meet the criteria for involuntary
2048 examination and stating the observations upon which that
2049 conclusion is based. If other less restrictive means are not
2050 available, such as voluntary appearance for outpatient
2051 evaluation, A law enforcement officer shall take the individual
2052 person named in the certificate into custody and deliver him or
2053 her to the nearest receiving facility for involuntary
2054 examination. The law enforcement officer shall complete execute
2055 a written report detailing the circumstances under which the
2056 individual person was taken into custody. The report and
2057 certificate shall be made a part of the patient’s clinical
2058 record. Any receiving facility accepting the individual patient
2059 based on the this certificate must send a copy of the
2060 certificate to the Agency for Health Care Administration on the
2061 next working day. The certificate is valid only until the
2062 individual is delivered to the receiving facility or until 7
2063 calendar days after the certificate was executed, whichever
2064 occurs first.
2065 (b) A person who initiates an involuntary examination of a
2066 minor shall make and document immediate attempts to notify the
2067 minor’s guardian of such examination. A receiving facility
2068 accepting a minor for involuntary examination must immediately
2069 notify the minor’s guardian upon the minor’s arrival.
2070 (c)(b) An individual may A person shall not be removed from
2071 a any program or residential placement licensed under chapter
2072 400 or chapter 429 and transported to a receiving facility for
2073 involuntary examination unless an ex parte order, a professional
2074 certificate, or a law enforcement officer’s report is first
2075 prepared. If the condition of the individual person is such that
2076 preparation of a law enforcement officer’s report is not
2077 practicable before removal, the report must shall be completed
2078 as soon as possible after removal, but in any case before the
2079 individual person is transported to a receiving facility. A
2080 receiving facility admitting an individual a person for
2081 involuntary examination who is not accompanied by the required
2082 ex parte order, professional certificate, or law enforcement
2083 officer’s report must shall notify the Agency for Health Care
2084 Administration of such admission by certified mail by no later
2085 than the next working day. The provisions of this paragraph do
2086 not apply when transportation is provided by the patient’s
2087 family or guardian.
2088 (d)(c) A law enforcement officer acting in accordance with
2089 an ex parte order issued pursuant to this subsection may serve
2090 and execute such order on any day of the week, at any time of
2091 the day or night.
2092 (e)(d) A law enforcement officer acting in accordance with
2093 an ex parte order issued pursuant to this subsection may use
2094 such reasonable physical force if as is necessary to gain entry
2095 to the premises, and any dwellings, buildings, or other
2096 structures located on the premises, and to take custody of the
2097 individual person who is the subject of the ex parte order.
2098 (f)(e) The Agency for Health Care Administration shall
2099 receive and maintain the copies of ex parte orders, involuntary
2100 outpatient placement orders issued pursuant to s. 394.4655,
2101 involuntary inpatient placement orders issued pursuant to s.
2102 394.467, professional certificates, and law enforcement
2103 officers’ reports. These documents shall be considered part of
2104 the clinical record, governed by the provisions of s. 394.4615.
2105 The agency shall prepare annual reports analyzing the data
2106 obtained from these documents, without information identifying
2107 individuals held for examination or admitted for mental health
2108 treatment patients, and shall provide copies of reports to the
2109 department, the President of the Senate, the Speaker of the
2110 House of Representatives, and the minority leaders of the Senate
2111 and the House of Representatives.
2112 (g)(f) An individual A patient shall be examined by a
2113 physician or clinical psychologist at a receiving facility
2114 without unnecessary delay to determine if the criteria for
2115 involuntary inpatient placement is met. Emergency treatment may
2116 be provided and may, upon the order of a physician, be given
2117 emergency treatment if it is determined that such treatment is
2118 necessary for the safety of the patient or others. The patient
2119 may not be released by the receiving facility or its contractor
2120 without the documented approval of a psychiatrist, a clinical
2121 psychologist, or, if the receiving facility is a hospital, the
2122 release may also be approved by an attending emergency
2123 department physician with experience in the diagnosis and
2124 treatment of mental and nervous disorders and after completion
2125 of an involuntary examination pursuant to this subsection.
2126 However, a patient may not be held in a receiving facility for
2127 involuntary examination longer than 72 hours.
2128 (h) An individual may not be held for involuntary
2129 examination for more than 72 hours. Based on the individual’s
2130 needs, one of the following actions must be taken within the 72
2131 hour period:
2132 1. The individual shall be released after the completion of
2133 the involuntary examination and with the documented approval of
2134 a psychiatrist or a clinical psychologist or, if the facility is
2135 a hospital, the release may be approved by an attending
2136 emergency department physician;
2137 2. The individual shall be asked to give express and
2138 informed consent for voluntary admission if a physician or
2139 clinical psychologist has determined that the individual is
2140 competent to consent to treatment; or
2141 3. A petition for involuntary placement shall be completed
2142 and filed in the circuit court if involuntary outpatient or
2143 inpatient treatment is deemed necessary. If the 72-hour period
2144 ends on a weekend or holiday, the petition must be filed by the
2145 next working day. If inpatient treatment is deemed necessary,
2146 the least restrictive treatment consistent with the optimum
2147 improvement of the individual’s condition must be made
2148 available.
2149 (i) An individual released from a receiving or treatment
2150 facility on a voluntary or involuntary basis who is charged with
2151 a crime shall be returned to the custody of a law enforcement
2152 officer.
2153 (j)(g) If an individual A person for whom an involuntary
2154 examination has been initiated who is also being evaluated or
2155 treated at a hospital for an emergency medical condition
2156 specified in s. 395.002, must be examined by a receiving
2157 facility within 72 hours. the 72-hour period begins when the
2158 individual patient arrives at the hospital and ceases when the
2159 attending physician documents that the individual patient has an
2160 emergency medical condition. The 72-hour period resumes when the
2161 physician documents that the emergency medical condition has
2162 stabilized or does not exist. If the patient is examined at a
2163 hospital providing emergency medical services by a professional
2164 qualified to perform an involuntary examination and is found as
2165 a result of that examination not to meet the criteria for
2166 involuntary outpatient placement pursuant to s. 394.4655(1) or
2167 involuntary inpatient placement pursuant to s. 394.467(1), the
2168 patient may be offered voluntary placement, if appropriate, or
2169 released directly from the hospital providing emergency medical
2170 services. The finding by the professional that the patient has
2171 been examined and does not meet the criteria for involuntary
2172 inpatient placement or involuntary outpatient placement must be
2173 entered into the patient’s clinical record. Nothing in this
2174 paragraph is intended to prevent A hospital providing emergency
2175 medical services may transfer an individual from appropriately
2176 transferring a patient to another hospital before prior to
2177 stabilization if, provided the requirements of s. 395.1041(3)(c)
2178 are have been met.
2179 (h) One of the following must occur within 12 hours after
2180 the patient’s attending physician documents that the
2181 individual’s patient’s medical condition has stabilized or that
2182 an emergency medical condition does not exist:
2183 1. The individual shall be examined by a physician or
2184 clinical psychologist and, if found not to meet the criteria for
2185 involuntary examination pursuant to s. 394.463, shall be
2186 released directly from the hospital providing the emergency
2187 medical services. The results of the examination, including the
2188 final disposition, shall be entered into the clinical record; or
2189 2. The individual shall be transferred to a receiving
2190 facility for examination if appropriate medical and mental
2191 health treatment are available. However, the receiving facility
2192 must be notified of the transfer within 2 hours after the
2193 individual’s condition has been stabilized or after
2194 determination that an emergency medical condition does not
2195 exist.
2196 1. The patient must be examined by a designated receiving
2197 facility and released; or
2198 2. The patient must be transferred to a designated
2199 receiving facility in which appropriate medical treatment is
2200 available. However, the receiving facility must be notified of
2201 the transfer within 2 hours after the patient’s condition has
2202 been stabilized or after determination that an emergency medical
2203 condition does not exist.
2204 (i) Within the 72-hour examination period or, if the 72
2205 hours ends on a weekend or holiday, no later than the next
2206 working day thereafter, one of the following actions must be
2207 taken, based on the individual needs of the patient:
2208 1. The patient shall be released, unless he or she is
2209 charged with a crime, in which case the patient shall be
2210 returned to the custody of a law enforcement officer;
2211 2. The patient shall be released, subject to the provisions
2212 of subparagraph 1., for voluntary outpatient treatment;
2213 3. The patient, unless he or she is charged with a crime,
2214 shall be asked to give express and informed consent to placement
2215 as a voluntary patient, and, if such consent is given, the
2216 patient shall be admitted as a voluntary patient; or
2217 4. A petition for involuntary placement shall be filed in
2218 the circuit court when outpatient or inpatient treatment is
2219 deemed necessary. When inpatient treatment is deemed necessary,
2220 the least restrictive treatment consistent with the optimum
2221 improvement of the patient’s condition shall be made available.
2222 When a petition is to be filed for involuntary outpatient
2223 placement, it shall be filed by one of the petitioners specified
2224 in s. 394.4655(3)(a). A petition for involuntary inpatient
2225 placement shall be filed by the facility administrator.
2226 (3) NOTICE OF RELEASE.—Notice of the release shall be given
2227 to the individual’s patient’s guardian or representative, to any
2228 person who executed a certificate admitting the individual
2229 patient to the receiving facility, and to any court that which
2230 ordered the individual’s patient’s evaluation.
2231 Section 20. Section 394.4655, Florida Statutes, is amended
2232 to read:
2233 394.4655 Involuntary outpatient placement.—
2234 (1) CRITERIA FOR INVOLUNTARY OUTPATIENT PLACEMENT.—An
2235 individual A person may be ordered to involuntary outpatient
2236 placement upon a finding of the court that by clear and
2237 convincing evidence that:
2238 (a) The individual is an adult person is 18 years of age or
2239 older;
2240 (b) The individual person has a mental illness;
2241 (c) The individual person is unlikely to survive safely in
2242 the community without supervision, based on a clinical
2243 determination;
2244 (d) The individual person has a history of lack of
2245 compliance with treatment for mental illness;
2246 (e) The individual person has:
2247 1. At least twice within the immediately preceding 36
2248 months been involuntarily admitted to a receiving or treatment
2249 facility as defined in s. 394.455, or has received mental health
2250 services in a forensic or correctional facility. The 36-month
2251 period does not include any period during which the individual
2252 person was admitted or incarcerated; or
2253 2. Engaged in one or more acts of serious violent behavior
2254 toward self or others, or attempts at serious bodily harm to
2255 self himself or herself or others, within the preceding 36
2256 months;
2257 (f) Due to The person is, as a result of his or her mental
2258 illness, the individual is unlikely to voluntarily participate
2259 in the recommended treatment plan and either he or she has
2260 refused voluntary placement for treatment after sufficient and
2261 conscientious explanation and disclosure of the purpose of
2262 placement for treatment or he or she is unable to determine for
2263 himself or herself whether placement is necessary;
2264 (g) In view of the individual’s person’s treatment history
2265 and current behavior, the individual person is in need of
2266 involuntary outpatient placement in order to prevent a relapse
2267 or deterioration that would be likely to result in serious
2268 bodily harm to self himself or herself or others, or a
2269 substantial harm to his or her well-being as set forth in s.
2270 394.463(1);
2271 (h) It is likely that the individual person will benefit
2272 from involuntary outpatient placement; and
2273 (i) All available, less restrictive alternatives that would
2274 offer an opportunity for improvement of his or her condition
2275 have been judged to be inappropriate or unavailable.
2276 (2) INVOLUNTARY OUTPATIENT PLACEMENT.—
2277 (a)1. An individual A patient who is being recommended for
2278 involuntary outpatient placement by the administrator of the
2279 receiving facility where the patient has been examined may be
2280 retained by the facility after adherence to the notice
2281 procedures provided in s. 394.4599.
2282 1. The recommendation must be supported by the opinion of a
2283 psychiatrist and the second opinion of a clinical psychologist
2284 or another psychiatrist, both of whom have personally examined
2285 the individual patient within the preceding 72 hours, that the
2286 criteria for involuntary outpatient placement are met. However,
2287 in a county having a population of fewer than 50,000, if the
2288 administrator certifies that a psychiatrist or clinical
2289 psychologist is not available to provide the second opinion, the
2290 second opinion may be provided by a licensed physician who has
2291 postgraduate training and experience in diagnosis and treatment
2292 of mental and nervous disorders or by a psychiatric nurse. Any
2293 second opinion authorized in this subparagraph may be conducted
2294 through a face-to-face examination, in person or by electronic
2295 means. Such recommendation must be entered on an involuntary
2296 outpatient placement certificate that authorizes the receiving
2297 facility to retain the individual patient pending completion of
2298 a hearing. The certificate shall be made a part of the patient’s
2299 clinical record.
2300 2. If the individual patient has been stabilized and no
2301 longer meets the criteria for involuntary examination pursuant
2302 to s. 394.463(1), he or she the patient must be released from
2303 the receiving facility while awaiting the hearing for
2304 involuntary outpatient placement.
2305 3. Before filing a petition for involuntary outpatient
2306 treatment, the administrator of the a receiving facility or a
2307 designated department representative must identify the service
2308 provider that will have primary responsibility for service
2309 provision under an order for involuntary outpatient placement,
2310 unless the individual person is otherwise participating in
2311 outpatient psychiatric treatment and is not in need of public
2312 financing for that treatment, in which case the individual, if
2313 eligible, may be ordered to involuntary treatment pursuant to
2314 the existing psychiatric treatment relationship.
2315 4.3. The service provider shall prepare a written proposed
2316 treatment plan in consultation with the individual being held
2317 patient or his or her the patient’s guardian advocate, if
2318 appointed, for the court’s consideration for inclusion in the
2319 involuntary outpatient placement order. The service provider
2320 shall also provide a copy of the proposed treatment plan to the
2321 individual patient and the administrator of the receiving
2322 facility. The treatment plan must specify the nature and extent
2323 of the individual’s patient’s mental illness, address the
2324 reduction of symptoms that necessitate involuntary outpatient
2325 placement, and include measurable goals and objectives for the
2326 services and treatment that are provided to treat the
2327 individual’s person’s mental illness and assist the individual
2328 person in living and functioning in the community or to prevent
2329 a relapse or deterioration. Service providers may select and
2330 supervise other providers individuals to implement specific
2331 aspects of the treatment plan. The services in the treatment
2332 plan must be deemed clinically appropriate by a physician,
2333 clinical psychologist, psychiatric nurse, mental health
2334 counselor, marriage and family therapist, or clinical social
2335 worker who consults with, or is employed or contracted by, the
2336 service provider. The service provider must certify to the court
2337 in the proposed treatment plan whether sufficient services for
2338 improvement and stabilization are currently available and
2339 whether the service provider agrees to provide those services.
2340 If the service provider certifies that the services in the
2341 proposed treatment plan are not available, the petitioner may
2342 not file the petition.
2343 (b) If an individual a patient in involuntary inpatient
2344 placement meets the criteria for involuntary outpatient
2345 placement, the administrator of the treatment facility may,
2346 before the expiration of the period during which the treatment
2347 facility is authorized to retain the individual patient,
2348 recommend involuntary outpatient placement.
2349 1. The recommendation must be supported by the opinion of a
2350 psychiatrist and the second opinion of a clinical psychologist
2351 or another psychiatrist, both of whom have personally examined
2352 the individual patient within the preceding 72 hours, that the
2353 criteria for involuntary outpatient placement are met. However,
2354 in a county having a population of fewer than 50,000, if the
2355 administrator certifies that a psychiatrist or clinical
2356 psychologist is not available to provide the second opinion, the
2357 second opinion may be provided by a licensed physician who has
2358 postgraduate training and experience in diagnosis and treatment
2359 of mental and nervous disorders or by a psychiatric nurse. Any
2360 second opinion authorized in this subparagraph may be conducted
2361 through a face-to-face examination, in person or by electronic
2362 means. Such recommendation must be entered on an involuntary
2363 outpatient placement certificate, and the certificate must be
2364 made a part of the patient’s clinical record.
2365 (c)1. The administrator of the treatment facility shall
2366 provide a copy of the involuntary outpatient placement
2367 certificate and a copy of the state mental health discharge form
2368 to a department representative in the county where the
2369 individual patient will be residing. For persons who are leaving
2370 a state mental health treatment facility, the petition for
2371 involuntary outpatient placement must be filed in the county
2372 where the patient will be residing.
2373 2. The service provider that will have primary
2374 responsibility for service provision shall be identified by the
2375 designated department representative prior to the order for
2376 involuntary outpatient placement and shall must, before prior to
2377 filing a petition for involuntary outpatient placement, certify
2378 to the court whether the services recommended in the
2379 individual’s patient’s discharge plan are available in the local
2380 community and whether the service provider agrees to provide
2381 those services. The service provider shall must develop with the
2382 individual patient, or the individual’s patient’s guardian
2383 advocate, if one is appointed, a treatment or service plan that
2384 addresses the needs identified in the discharge plan. The plan
2385 must be deemed to be clinically appropriate by a physician,
2386 clinical psychologist, psychiatric nurse, mental health
2387 counselor, marriage and family therapist, or clinical social
2388 worker, as defined in this chapter, who consults with, or is
2389 employed or contracted by, the service provider.
2390 3. If the service provider certifies that the services in
2391 the proposed treatment or service plan are not available, the
2392 petitioner may not file the petition.
2393 (3) PETITION FOR INVOLUNTARY OUTPATIENT PLACEMENT.—
2394 (a) A petition for involuntary outpatient placement may be
2395 filed by:
2396 1. The administrator of a receiving facility; or
2397 2. The administrator of a treatment facility.
2398 (b) Each required criterion for involuntary outpatient
2399 placement must be alleged and substantiated in the petition for
2400 involuntary outpatient placement. A copy of the certificate
2401 recommending involuntary outpatient placement completed by a
2402 qualified professional specified in subsection (2) must be
2403 attached to the petition. A copy of the proposed treatment plan
2404 must be attached to the petition. Before the petition is filed,
2405 the service provider shall certify that the services in the
2406 proposed treatment plan are available. If the necessary services
2407 are not available in the patient’s local community where the
2408 individual will reside to respond to the person’s individual
2409 needs, the petition may not be filed.
2410 (c) A The petition for involuntary outpatient placement
2411 must be filed in the county where the individual who is the
2412 subject of the petition patient is located, unless the
2413 individual the patient is being placed from a state treatment
2414 facility, in which case the petition must be filed in the county
2415 where the individual patient will reside. When the petition is
2416 has been filed, the clerk of the court shall provide copies of
2417 the petition and the proposed treatment plan to the department,
2418 the individual patient, the individual’s patient’s guardian or
2419 representative, the state attorney, and the public defender or
2420 the patient’s private counsel representing the individual. A fee
2421 may not be charged for filing a petition under this subsection.
2422 (4) APPOINTMENT OF COUNSEL.—Within 1 court working day
2423 after the filing of a petition for involuntary outpatient
2424 placement, the court shall appoint a the public defender to
2425 represent the individual person who is the subject of the
2426 petition, unless the individual person is otherwise represented
2427 by counsel. The clerk of the court shall immediately notify the
2428 public defender of the appointment. The public defender shall
2429 represent the individual person until the petition is dismissed,
2430 the court order expires, or the individual patient is discharged
2431 from involuntary outpatient placement. An attorney who
2432 represents the individual patient shall have access to the
2433 individual patient, witnesses, and records relevant to the
2434 presentation of the individual’s patient’s case and shall
2435 represent the interests of the individual patient, regardless of
2436 the source of payment to the attorney.
2437 (5) CONTINUANCE OF HEARING.—The patient is entitled, with
2438 the concurrence of the patient’s counsel, to at least one
2439 continuance of the hearing. The continuance shall be for a
2440 period of up to 4 weeks.
2441 (5)(6) HEARING ON INVOLUNTARY OUTPATIENT PLACEMENT.—
2442 (a)1. The court shall hold the hearing on involuntary
2443 outpatient placement within 5 working days after the filing of
2444 the petition, unless a continuance is granted. The hearing shall
2445 be held in the county where the petition is filed, shall be as
2446 convenient to the individual who is the subject of the petition
2447 patient as is consistent with orderly procedure, and shall be
2448 conducted in physical settings not likely to be injurious to the
2449 individual’s patient’s condition. If the court finds that the
2450 individual’s patient’s attendance at the hearing is not
2451 consistent with the individual’s best interests, of the patient
2452 and if the individual’s patient’s counsel does not object, the
2453 court may waive the presence of the individual patient from all
2454 or any portion of the hearing. The state attorney for the
2455 circuit in which the individual patient is located shall
2456 represent the state, rather than the petitioner, as the real
2457 party in interest in the proceeding.
2458 (b)2. The court may appoint a magistrate master to preside
2459 at the hearing. One of the professionals who executed the
2460 involuntary outpatient placement certificate shall be a witness.
2461 The individual who is the subject of the petition patient and
2462 his or her the patient’s guardian or representative shall be
2463 informed by the court of the right to an independent expert
2464 examination. If the individual patient cannot afford such an
2465 examination, the court shall provide for one. The independent
2466 expert’s report is shall be confidential and not discoverable,
2467 unless the expert is to be called as a witness for the
2468 individual patient at the hearing. The court shall allow
2469 testimony from persons individuals, including family members,
2470 deemed by the court to be relevant under state law, regarding
2471 the individual’s person’s prior history and how that prior
2472 history relates to the individual’s person’s current condition.
2473 The testimony in the hearing must be given under oath, and the
2474 proceedings must be recorded. The individual patient may refuse
2475 to testify at the hearing.
2476 (c) At the hearing on involuntary outpatient placement, the
2477 court shall consider testimony and evidence regarding the
2478 competence of the individual being held to consent to treatment.
2479 If the court finds that the individual is incompetent to
2480 consent, it shall appoint a guardian advocate as provided in s.
2481 394.4598.
2482 (d) The individual who is the subject of the petition is
2483 entitled to at least one continuance of the hearing for up to 4
2484 weeks, at the individual's request.
2485 (e) The attorney representing the individual may not
2486 request a continuance of the hearing unless this is the
2487 individual's expressed desire.
2488 (6) COURT ORDER.—
2489 (a)(b)1. If the court concludes that the individual who is
2490 the subject of the petition patient meets the criteria for
2491 involuntary outpatient placement under pursuant to subsection
2492 (1), the court shall issue an order for involuntary outpatient
2493 placement. The court order may shall be for a period of up to 6
2494 months. The order must specify the nature and extent of the
2495 individual’s patient’s mental illness. The court order of the
2496 court and the treatment plan must shall be made part of the
2497 patient’s clinical record. The service provider shall discharge
2498 an individual a patient from involuntary outpatient placement
2499 when the order expires or any time the individual patient no
2500 longer meets the criteria for involuntary placement. Upon
2501 discharge, the service provider shall send a certificate of
2502 discharge to the court.
2503 (b)2. The court may not order the department or the service
2504 provider to provide services if the program or service is not
2505 available in the patient’s local community of the individual
2506 being served, if there is no space available in the program or
2507 service for the individual patient, or if funding is not
2508 available for the program or service. A copy of the order must
2509 be sent to the Agency for Health Care Administration by the
2510 service provider within 1 working day after it is received from
2511 the court. After the placement order is issued, the service
2512 provider and the individual patient may modify provisions of the
2513 treatment plan. For any material modification of the treatment
2514 plan to which the individual patient or the individual’s
2515 patient’s guardian advocate, if appointed, agrees does agree,
2516 the service provider shall send notice of the modification to
2517 the court. Any material modifications of the treatment plan
2518 which are contested by the individual patient or the
2519 individual’s patient’s guardian advocate, if appointed, must be
2520 approved or disapproved by the court consistent with the
2521 requirements of subsection (2).
2522 (c)3. If, in the clinical judgment of a physician, the
2523 individual being served patient has failed or has refused to
2524 comply with the treatment ordered by the court, and, in the
2525 clinical judgment of the physician, efforts were made to solicit
2526 compliance and the individual patient may meet the criteria for
2527 involuntary examination, the individual a person may be brought
2528 to a receiving facility pursuant to s. 394.463 for involuntary
2529 examination. If, after examination, the individual patient does
2530 not meet the criteria for involuntary inpatient placement under
2531 pursuant to s. 394.467, the individual patient must be
2532 discharged from the receiving facility. The involuntary
2533 outpatient placement order remains shall remain in effect unless
2534 the service provider determines that the individual patient no
2535 longer meets the criteria for involuntary outpatient placement
2536 or until the order expires. The service provider shall must
2537 determine whether modifications should be made to the existing
2538 treatment plan and must continue to attempt to continue to
2539 engage the individual patient in treatment. For any material
2540 modification of the treatment plan to which the individual
2541 patient or the individual’s patient’s guardian advocate, if
2542 appointed, agrees does agree, the service provider shall send
2543 notice of the modification to the court. Any material
2544 modifications of the treatment plan which are contested by the
2545 individual patient or the individual’s patient’s guardian
2546 advocate, if appointed, must be approved or disapproved by the
2547 court consistent with the requirements of subsection (2).
2548 (d)(c) If, at any time before the conclusion of the initial
2549 hearing on involuntary outpatient placement, it appears to the
2550 court that the individual person does not meet the criteria for
2551 involuntary outpatient placement under this section but,
2552 instead, meets the criteria for involuntary inpatient placement,
2553 the court may order the individual person admitted for
2554 involuntary inpatient examination under s. 394.463. If the
2555 individual person instead meets the criteria for involuntary
2556 assessment, protective custody, or involuntary admission under
2557 pursuant to s. 397.675, the court may order the individual
2558 person to be admitted for involuntary assessment for a period of
2559 5 days pursuant to s. 397.6811. Thereafter, all proceedings are
2560 shall be governed by chapter 397.
2561 (d) At the hearing on involuntary outpatient placement, the
2562 court shall consider testimony and evidence regarding the
2563 patient’s competence to consent to treatment. If the court finds
2564 that the patient is incompetent to consent to treatment, it
2565 shall appoint a guardian advocate as provided in s. 394.4598.
2566 The guardian advocate shall be appointed or discharged in
2567 accordance with s. 394.4598.
2568 (e) The administrator of the receiving facility or the
2569 designated department representative shall provide a copy of the
2570 court order and adequate documentation of an individual’s a
2571 patient’s mental illness to the service provider for involuntary
2572 outpatient placement. Such documentation must include any
2573 advance directives made by the individual patient, a psychiatric
2574 evaluation of the individual patient, and any evaluations of the
2575 individual patient performed by a clinical psychologist or a
2576 clinical social worker.
2577 (7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
2578 PLACEMENT.—
2579 (a)1. If an individual the person continues to meet the
2580 criteria for involuntary outpatient placement, the service
2581 provider shall, before the expiration of the period during which
2582 the placement treatment is ordered for the person, file in the
2583 circuit court a petition for continued involuntary outpatient
2584 placement.
2585 1.2. The existing involuntary outpatient placement order
2586 remains in effect until disposition of on the petition for
2587 continued involuntary outpatient placement.
2588 2.3. A certificate must shall be attached to the petition
2589 which includes a statement from the individual’s person’s
2590 physician or clinical psychologist justifying the request, a
2591 brief description of the individual’s patient’s treatment during
2592 the time he or she was involuntarily placed, and a personalized
2593 an individualized plan of continued treatment.
2594 3.4. The service provider shall develop the individualized
2595 plan of continued treatment in consultation with the individual
2596 patient or his or her the patient’s guardian advocate, if
2597 appointed. When the petition has been filed, the clerk of the
2598 court shall provide copies of the certificate and the
2599 individualized plan of continued treatment to the department,
2600 the individual patient, the individual’s patient’s guardian
2601 advocate, the state attorney, and the individual’s patient’s
2602 private counsel or the public defender.
2603 (b) Within 1 court working day after the filing of a
2604 petition for continued involuntary outpatient placement, the
2605 court shall appoint the public defender to represent the
2606 individual person who is the subject of the petition, unless the
2607 individual person is otherwise represented by counsel. The clerk
2608 of the court shall immediately notify the public defender of
2609 such appointment. The public defender shall represent the
2610 individual person until the petition is dismissed, or the court
2611 order expires, or the individual patient is discharged from
2612 involuntary outpatient placement. An Any attorney representing
2613 the individual must patient shall have access to the individual
2614 patient, witnesses, and records relevant to the presentation of
2615 the individual’s patient’s case and shall represent the
2616 interests of the individual patient, regardless of the source of
2617 payment to the attorney.
2618 (c) The court shall inform the individual who is the
2619 subject of the petition and his or her guardian, guardian
2620 advocate, or representative of the individual’s right to an
2621 independent expert examination. If the individual cannot afford
2622 such an examination, the court shall provide one.
2623 (d)(c) Hearings on petitions for continued involuntary
2624 outpatient placement are shall be before the circuit court. The
2625 court may appoint a magistrate master to preside at the hearing.
2626 The procedures for obtaining an order pursuant to this paragraph
2627 must shall be in accordance with subsection (5) (6), except that
2628 the time period included in paragraph (1)(e) is not applicable
2629 for in determining the appropriateness of additional periods of
2630 involuntary outpatient placement.
2631 (e)(d) Notice of the hearing shall be provided in
2632 accordance with as set forth in s. 394.4599. The individual
2633 being served patient and the individual’s patient’s attorney may
2634 agree to a period of continued outpatient placement without a
2635 court hearing.
2636 (f)(e) The same procedure must shall be repeated before the
2637 expiration of each additional period the individual being served
2638 patient is placed in treatment.
2639 (g)(f) If the individual in involuntary outpatient
2640 placement patient has previously been found incompetent to
2641 consent to treatment, the court shall consider testimony and
2642 evidence regarding the individual’s patient’s competence.
2643 Section 394.4598 governs the discharge of the guardian advocate
2644 if the individual’s patient’s competency to consent to treatment
2645 has been restored.
2646 Section 21. Section 394.467, Florida Statutes, is amended
2647 to read:
2648 394.467 Involuntary inpatient placement.—
2649 (1) CRITERIA.—An individual A person may be placed in
2650 involuntary inpatient placement for treatment upon a finding of
2651 the court by clear and convincing evidence that:
2652 (a) He or she has a mental illness is mentally ill and
2653 because of his or her mental illness:
2654 1.a. He or she has refused voluntary placement for
2655 treatment after sufficient and conscientious explanation and
2656 disclosure of the purpose of placement for treatment; or
2657 b. He or she is unable to determine for himself or herself
2658 whether placement is necessary; and
2659 2.a. He or she is manifestly incapable of surviving alone
2660 or with the help of willing and responsible family or friends,
2661 including available alternative services, and, without
2662 treatment, is likely to suffer from neglect or refuse to care
2663 for himself or herself, and such neglect or refusal poses a real
2664 and present threat of substantial harm to his or her well-being;
2665 or
2666 b. There is substantial likelihood that in the near future
2667 he or she will inflict serious bodily harm on self or others
2668 himself or herself or another person, as evidenced by recent
2669 behavior causing, attempting, or threatening such harm; and
2670 (b) All available less restrictive treatment alternatives
2671 that which would offer an opportunity for improvement of his or
2672 her condition have been judged to be inappropriate.
2673 (2) ADMISSION TO A TREATMENT FACILITY.—An individual A
2674 patient may be retained by a receiving facility or involuntarily
2675 placed in a treatment facility upon the recommendation of the
2676 administrator of the receiving facility where the individual
2677 patient has been examined and after adherence to the notice and
2678 hearing procedures provided in s. 394.4599. The recommendation
2679 must be supported by the opinion of a psychiatrist and the
2680 second opinion of a clinical psychologist or another
2681 psychiatrist, both of whom have personally examined the
2682 individual patient within the preceding 72 hours, that the
2683 criteria for involuntary inpatient placement are met. However,
2684 in a county that has a population of fewer than 50,000, if the
2685 administrator certifies that a psychiatrist or clinical
2686 psychologist is not available to provide the second opinion, the
2687 second opinion may be provided by a licensed physician who has
2688 postgraduate training and experience in diagnosis and treatment
2689 of mental and nervous disorders or by a psychiatric nurse. Any
2690 second opinion authorized in this subsection may be conducted
2691 through a face-to-face examination, in person or by electronic
2692 means. Such recommendation must shall be entered on an
2693 involuntary inpatient placement certificate that authorizes the
2694 receiving facility to retain the individual being held patient
2695 pending transfer to a treatment facility or completion of a
2696 hearing.
2697 (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.—
2698 (a) The administrator of the facility shall file a petition
2699 for involuntary inpatient placement in the court in the county
2700 where the individual patient is located. Upon filing, the clerk
2701 of the court shall provide copies to the department, the
2702 individual patient, the individual’s patient’s guardian or
2703 representative, and the state attorney and public defender of
2704 the judicial circuit in which the individual patient is located.
2705 A No fee may not shall be charged for the filing of a petition
2706 under this subsection.
2707 (b) A receiving or treatment facility filing a petition for
2708 involuntary inpatient placement shall send a copy of the
2709 petition to the Agency for Health Care Administration by the
2710 next working day.
2711 (4) APPOINTMENT OF COUNSEL.—
2712 (a) Within 1 court working day after the filing of a
2713 petition for involuntary inpatient placement, the court shall
2714 appoint the public defender to represent the individual person
2715 who is the subject of the petition, unless the individual person
2716 is otherwise represented by counsel. The clerk of the court
2717 shall immediately notify the public defender of such
2718 appointment. Any attorney representing the individual patient
2719 shall have access to the individual patient, witnesses, and
2720 records relevant to the presentation of the individual’s
2721 patient’s case and shall represent the interests of the
2722 individual patient, regardless of the source of payment to the
2723 attorney. An attorney representing an individual in involuntary
2724 placement proceedings shall represent the individual’s expressed
2725 desires and must be present and actively participate in all
2726 hearings on involuntary placement.
2727 (b) The state attorney for the circuit in which the
2728 individual is located shall represent the state rather than the
2729 petitioning facility administrator as the real party in interest
2730 in the proceeding. The state attorney shall have access to the
2731 individual’s clinical record and witnesses and shall
2732 independently evaluate and confirm the allegations set forth in
2733 the petition for involuntary placement. If the allegations are
2734 substantiated, the state attorney shall vigorously prosecute the
2735 petition. If the allegations are not substantiated, the state
2736 attorney shall withdraw the petition. The state attorney shall
2737 be present and actively participate in all hearings on
2738 involuntary placement.
2739 (5) CONTINUANCE OF HEARING.—The individual patient is
2740 entitled, with the concurrence of the individual’s patient’s
2741 counsel, to at least one continuance of the hearing. Requests
2742 for a continuance from parties other than the individual or his
2743 or her counsel may not be granted. The continuance shall be for
2744 a period of up to 4 weeks. At the time the court is considering
2745 a motion for continuance, the court shall also conduct a hearing
2746 to consider the capacity of the individual to consent to
2747 treatment if there is a pending petition for adjudication of
2748 incompetence to consent to treatment. If the court finds that
2749 the individual is not competent to consent to treatment, a
2750 guardian advocate shall be appointed at the time the involuntary
2751 placement hearing is continued to make mental health decisions
2752 for the individual.
2753 (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.—
2754 (a)1. The court shall hold the hearing on involuntary
2755 inpatient placement within 5 working days after the petition is
2756 filed, unless a continuance is granted.
2757 1. Except for good cause documented in the court file, the
2758 hearing shall be held in the receiving or treatment facility
2759 county where the individual patient is located. If the hearing
2760 cannot be held in the receiving or treatment facility, it must
2761 held in a location and shall be as convenient to the individual
2762 patient as is may be consistent with orderly procedure and which
2763 is shall be conducted in physical settings not likely to be
2764 injurious to the individual’s patient’s condition. If the
2765 individual wishes to waive his or her court finds that the
2766 patient’s attendance at the hearing, the court must determine
2767 that the waiver is knowing, intelligent, and voluntary before
2768 waiving is not consistent with the best interests of the
2769 patient, and the patient’s counsel does not object, the court
2770 may waive the presence of the individual patient from all or any
2771 portion of the hearing. The state attorney for the circuit in
2772 which the patient is located shall represent the state, rather
2773 than the petitioning facility administrator, as the real party
2774 in interest in the proceeding.
2775 2. The court may appoint a general or special magistrate to
2776 preside at the hearing. One of the two professionals who
2777 executed the involuntary inpatient placement certificate shall
2778 be a witness. The individual patient and the individual’s
2779 patient’s guardian or representative shall be informed by the
2780 court of the right to an independent expert examination. If the
2781 individual patient cannot afford such an examination, the court
2782 shall provide for one. The independent expert’s report is shall
2783 be confidential and not discoverable, unless the expert is to be
2784 called as a witness for the individual patient at the hearing.
2785 The testimony in the hearing must be given under oath, and the
2786 proceedings must be recorded. The individual patient may refuse
2787 to testify at the hearing.
2788 3. The court shall allow testimony from persons, including
2789 family members, deemed by the court to be relevant regarding the
2790 individual’s prior history and how that prior history relates to
2791 the individual’s current condition.
2792 (b) If the court concludes that the individual patient
2793 meets the criteria for involuntary inpatient placement, it shall
2794 order that the individual patient be transferred to a treatment
2795 facility or, if the individual patient is at a treatment
2796 facility, that the individual patient be retained there or be
2797 treated at any other appropriate receiving or treatment
2798 facility, or that the individual patient receive services from a
2799 receiving or treatment facility, on an involuntary basis, for a
2800 period of up to 6 months. The order must shall specify the
2801 nature and extent of the individual’s patient’s mental illness.
2802 The facility shall discharge the individual a patient any time
2803 the individual patient no longer meets the criteria for
2804 involuntary inpatient placement, unless the individual patient
2805 has transferred to voluntary status.
2806 (c) If at any time before prior to the conclusion of the
2807 hearing on involuntary inpatient placement it appears to the
2808 court that the individual person does not meet the criteria for
2809 involuntary inpatient placement under this section, but instead
2810 meets the criteria for involuntary outpatient placement, the
2811 court may order the individual person evaluated for involuntary
2812 outpatient placement pursuant to s. 394.4655. The petition and
2813 hearing procedures set forth in s. 394.4655 shall apply. If the
2814 individual person instead meets the criteria for involuntary
2815 assessment, protective custody, or involuntary admission
2816 pursuant to s. 397.675, then the court may order the individual
2817 person to be admitted for involuntary assessment for up to a
2818 period of 5 days pursuant to s. 397.6811. Thereafter, all
2819 proceedings are shall be governed by chapter 397.
2820 (d) At the hearing on involuntary inpatient placement, the
2821 court shall consider testimony and evidence regarding the
2822 individual’s patient’s competence to consent to treatment. If
2823 the court finds that the individual patient is incompetent to
2824 consent to treatment, it shall appoint a guardian advocate as
2825 provided in s. 394.4598.
2826 (e) The administrator of the receiving facility shall
2827 provide a copy of the court order and adequate documentation of
2828 an individual’s a patient’s mental illness to the administrator
2829 of a treatment facility if the individual whenever a patient is
2830 ordered for involuntary inpatient placement, whether by civil or
2831 criminal court. The documentation must shall include any advance
2832 directives made by the individual patient, a psychiatric
2833 evaluation of the individual patient, and any evaluations of the
2834 individual patient performed by a clinical psychologist, a
2835 marriage and family therapist, a mental health counselor, or a
2836 clinical social worker. The administrator of a treatment
2837 facility may refuse admission to an individual any patient
2838 directed to its facilities on an involuntary basis, whether by
2839 civil or criminal court order, who is not accompanied at the
2840 same time by adequate orders and documentation.
2841 (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT
2842 PLACEMENT.—
2843 (a) Hearings on petitions for continued involuntary
2844 inpatient placement shall be administrative hearings and shall
2845 be conducted in accordance with the provisions of s. 120.57(1),
2846 except that an any order entered by an the administrative law
2847 judge is shall be final and subject to judicial review in
2848 accordance with s. 120.68. Orders concerning an individual
2849 patients committed after successfully pleading not guilty by
2850 reason of insanity are shall be governed by the provisions of s.
2851 916.15.
2852 (b) If the individual patient continues to meet the
2853 criteria for involuntary inpatient placement, the administrator
2854 shall, before prior to the expiration of the period during which
2855 the treatment facility is authorized to retain the individual
2856 patient, file a petition requesting authorization for continued
2857 involuntary inpatient placement. The request must shall be
2858 accompanied by a statement from the individual’s patient’s
2859 physician or clinical psychologist justifying the request, a
2860 brief description of the individual’s patient’s treatment during
2861 the time he or she was involuntarily placed, and a personalized
2862 an individualized plan of continued treatment. Notice of the
2863 hearing must shall be provided in accordance with as set forth
2864 in s. 394.4599. If at the hearing the administrative law judge
2865 finds that attendance at the hearing is not consistent with the
2866 individual’s best interests of the patient, the administrative
2867 law judge may waive the presence of the individual patient from
2868 all or any portion of the hearing, unless the individual
2869 patient, through counsel, objects to the waiver of presence. The
2870 testimony in the hearing must be under oath, and the proceedings
2871 must be recorded.
2872 (c) Unless the individual patient is otherwise represented
2873 or is ineligible, he or she shall be represented at the hearing
2874 on the petition for continued involuntary inpatient placement by
2875 the public defender of the circuit in which the facility is
2876 located.
2877 (d) The Division of Administrative Hearings shall inform
2878 the individual and his or her guardian, guardian advocate, or
2879 representative of the right to an independent expert
2880 examination. If the individual cannot afford such an
2881 examination, the administrative law judge shall appoint one and
2882 the county of the individual’s residence shall be billed for the
2883 cost of the examination.
2884 (e)(d) If at a hearing it is shown that the individual
2885 patient continues to meet the criteria for involuntary inpatient
2886 placement, the administrative law judge shall sign the order for
2887 continued involuntary inpatient placement for a period of up to
2888 not to exceed 6 months. The same procedure must shall be
2889 repeated before prior to the expiration of each additional
2890 period the individual patient is retained.
2891 (f)(e) If continued involuntary inpatient placement is
2892 necessary for an individual a patient admitted while serving a
2893 criminal sentence, but whose sentence is about to expire, or for
2894 a minor patient involuntarily placed while a minor but who is
2895 about to reach the age of 18, the administrator shall petition
2896 the administrative law judge for an order authorizing continued
2897 involuntary inpatient placement.
2898 (g)(f) If the individual patient has been previously found
2899 incompetent to consent to treatment, the administrative law
2900 judge shall consider testimony and evidence regarding the
2901 individual’s patient’s competence. If the administrative law
2902 judge finds evidence that the individual patient is now
2903 competent to consent to treatment, the administrative law judge
2904 may issue a recommended order to the court that found the
2905 individual patient incompetent to consent to treatment that the
2906 individual’s patient’s competence be restored and that any
2907 guardian advocate previously appointed be discharged.
2908 (8) RETURN TO FACILITY OF PATIENTS.—If an individual held
2909 When a patient at a treatment facility leaves the facility
2910 without authorization, the administrator may authorize a search
2911 for, the patient and the return of, the individual patient to
2912 the facility. The administrator may request the assistance of a
2913 law enforcement agency in the search for and return of the
2914 patient.
2915 Section 22. Section 394.46715, Florida Statutes, is amended
2916 to read:
2917 394.46715 Rulemaking authority.—The department may adopt
2918 rules to administer of Children and Family Services shall have
2919 rulemaking authority to implement the provisions of ss. 394.455,
2920 394.4598, 394.4615, 394.463, 394.4655, and 394.467 as amended or
2921 created by this act. These rules are shall be for the purpose of
2922 protecting the health, safety, and well-being of individuals
2923 persons examined, treated, or placed under this part act.
2924 Section 23. Section 394.4672, Florida Statutes, is amended
2925 to read:
2926 394.4672 Procedure for placement of veteran with federal
2927 agency.—
2928 (1) If a Whenever it is determined by the court determines
2929 that an individual a person meets the criteria for involuntary
2930 placement and he or she it appears that such person is eligible
2931 for care or treatment by the United States Department of
2932 Veterans Affairs or other agency of the United States
2933 Government, the court, upon receipt of a certificate from the
2934 United States Department of Veterans Affairs or such other
2935 agency showing that facilities are available and that the
2936 individual person is eligible for care or treatment therein, may
2937 place that individual person with the United States Department
2938 of Veterans Affairs or other federal agency. The individual
2939 person whose placement is sought shall be personally served with
2940 notice of the pending placement proceeding in the manner as
2941 provided in this part., and nothing in This section does not
2942 shall affect the individual’s his or her right to appear and be
2943 heard in the proceeding. Upon placement, the individual is
2944 person shall be subject to the rules and regulations of the
2945 United States Department of Veterans Affairs or other federal
2946 agency.
2947 (2) The judgment or order of placement issued by a court of
2948 competent jurisdiction of another state or of the District of
2949 Columbia which places an individual, placing a person with the
2950 United States Department of Veterans Affairs or other federal
2951 agency for care or treatment has, shall have the same force and
2952 effect in this state as in the jurisdiction of the court
2953 entering the judgment or making the order.; and The courts of
2954 the placing state or of the District of Columbia shall retain be
2955 deemed to have retained jurisdiction over of the individual
2956 person so placed. Consent is hereby given to the application of
2957 the law of the placing state or district with respect to the
2958 authority of the chief officer of any facility of the United
2959 States Department of Veterans Affairs or other federal agency
2960 operated in this state to retain custody or to transfer, parole,
2961 or discharge the individual person.
2962 (3) Upon receipt of a certificate of the United States
2963 Department of Veterans Affairs or another such other federal
2964 agency that facilities are available for the care or treatment
2965 individuals who have mental illness of mentally ill persons and
2966 that the individual person is eligible for that care or
2967 treatment, the administrator of the receiving or treatment
2968 facility may cause the transfer of that individual person to the
2969 United States Department of Veterans Affairs or other federal
2970 agency. Upon effecting such transfer, the committing court shall
2971 be notified by the transferring agency. An individual may not No
2972 person shall be transferred to the United States Department of
2973 Veterans Affairs or other federal agency if he or she is
2974 confined pursuant to the conviction of any felony or misdemeanor
2975 or if he or she has been acquitted of the charge solely on the
2976 ground of insanity, unless prior to transfer the court placing
2977 the individual such person enters an order for the transfer
2978 after appropriate motion and hearing and without objection by
2979 the United States Department of Veterans Affairs.
2980 (4) An individual Any person transferred as provided in
2981 this section shall be deemed to be placed with the United States
2982 Department of Veterans Affairs or other federal agency pursuant
2983 to the original placement.
2984 Section 24. Section 394.4674, Florida Statutes, is
2985 repealed.
2986 Section 25. Section 394.4685, Florida Statutes, is amended
2987 to read:
2988 394.4685 Transfer between of patients among facilities.—
2989 (1) TRANSFER BETWEEN PUBLIC FACILITIES.—
2990 (a) An individual A patient who has been admitted to a
2991 public receiving facility, or his or her the family member,
2992 guardian, or guardian advocate of such patient, may request the
2993 transfer of the individual patient to another public receiving
2994 facility. An individual A patient who has been admitted to a
2995 public treatment facility, or his or her the family member,
2996 guardian, or guardian advocate of such patient, may request the
2997 transfer of the individual patient to another public treatment
2998 facility. Depending on the medical treatment or mental health
2999 treatment needs of the individual patient and the availability
3000 of appropriate facility resources, the individual patient may be
3001 transferred at the discretion of the department. If the
3002 department approves the transfer of an individual on involuntary
3003 status patient, notice in accordance with according to the
3004 provisions of s. 394.4599 must shall be given before prior to
3005 the transfer by the transferring facility. The department shall
3006 respond to the request for transfer within 2 working days after
3007 receipt of the request by the facility administrator.
3008 (b) If When required by the medical treatment or mental
3009 health treatment needs of the individual patient or the
3010 efficient use utilization of a public receiving or public
3011 treatment facility, an individual a patient may be transferred
3012 from one receiving facility to another, or one treatment
3013 facility to another, at the department’s discretion, or, with
3014 the express and informed consent of the individual patient or
3015 the individual’s patient’s guardian or guardian advocate, to a
3016 facility in another state. Notice in accordance with according
3017 to the provisions of s. 394.4599 must shall be given before
3018 prior to the transfer by the transferring facility. If prior
3019 notice is not possible, notice of the transfer must shall be
3020 provided as soon as practicable after the transfer.
3021 (2) TRANSFER FROM PUBLIC TO PRIVATE FACILITIES.—
3022 (a) An individual A patient who has been admitted to a
3023 public receiving or public treatment facility and has requested,
3024 either personally or through his or her guardian or guardian
3025 advocate, and is able to pay for treatment in a private facility
3026 shall be transferred at the individual’s patient’s expense to a
3027 private facility upon acceptance of the individual patient by
3028 the private facility.
3029 (b) A public facility may request the transfer of an
3030 individual from the facility to a private facility, and the
3031 individual may be transferred upon acceptance of the individual
3032 by the private facility.
3033 (3) TRANSFER FROM PRIVATE TO PUBLIC FACILITIES.—
3034 (a) An individual A patient or his or her the patient’s
3035 guardian or guardian advocate may request the transfer of the
3036 individual patient from a private to a public facility, and the
3037 individual patient may be so transferred upon acceptance of the
3038 individual patient by the public facility.
3039 (b) A private facility may request the transfer of an
3040 individual a patient from the facility to a public facility, and
3041 the individual patient may be so transferred upon acceptance of
3042 the individual patient by the public facility. The cost of such
3043 transfer is shall be the responsibility of the transferring
3044 facility.
3045 (c) A public facility must respond to a request for the
3046 transfer of an individual a patient within 2 working days after
3047 receipt of the request.
3048 (4) TRANSFER BETWEEN PRIVATE FACILITIES.—An individual
3049 being held A patient in a private facility or his or her the
3050 patient’s guardian or guardian advocate may request the transfer
3051 of the individual patient to another private facility at any
3052 time, and the individual patient shall be transferred upon
3053 acceptance of the individual patient by the facility to which
3054 transfer is sought.
3055 Section 26. Section 394.469, Florida Statutes, is amended
3056 to read:
3057 394.469 Discharge of involuntary placements patients.—
3058 (1) POWER TO DISCHARGE.—At any time an individual a patient
3059 is found to no longer meet the criteria for involuntary
3060 placement, the administrator shall:
3061 (a) Discharge the individual patient, unless the patient is
3062 under a criminal charge, in which case the patient shall be
3063 transferred to the custody of the appropriate law enforcement
3064 officer;
3065 (b) Transfer the individual patient to voluntary status on
3066 his or her own authority or at the individual’s patient’s
3067 request, unless the individual patient is under criminal charge
3068 or adjudicated incapacitated; or
3069 (c) Return an individual released from a receiving or
3070 treatment facility on voluntary or involuntary status who is
3071 charged with a crime to the custody of a law enforcement officer
3072 Place an improved patient, except a patient under a criminal
3073 charge, on convalescent status in the care of a community
3074 facility.
3075 (2) NOTICE.—Notice of discharge or transfer of an
3076 individual must be provided in accordance with a patient shall
3077 be given as provided in s. 394.4599.
3078 Section 27. Section 394.473, Florida Statutes, is amended
3079 to read:
3080 394.473 Attorney’s fee; expert witness fee.—
3081 (1) In the case of an indigent person for whom An attorney
3082 is appointed to represent an indigent individual pursuant to the
3083 provisions of this part, the attorney shall be compensated by
3084 the state pursuant to s. 27.5304. In the case of an indigent
3085 person, the court may appoint a public defender. A The public
3086 defender appointed to represent an indigent person may shall
3087 receive no additional compensation other than that usually paid
3088 his or her office.
3089 (2) An In the case of an indigent person for whom expert
3090 whose testimony is required for an indigent individual in a
3091 court hearing pursuant to the provisions of this part act, the
3092 expert, except one who is classified as a full-time employee of
3093 the state or who is receiving remuneration from the state for
3094 his or her time in attendance at the hearing, shall be
3095 compensated by the state pursuant to s. 27.5304.
3096 Section 28. Section 394.475, Florida Statutes, is amended
3097 to read:
3098 394.475 Acceptance, examination, and involuntary placement
3099 of Florida residents from out-of-state mental health
3100 authorities.—
3101 (1) Upon the request of the state mental health authority
3102 of another state, the department may is authorized to accept an
3103 individual as a patient, for up to a period of not more than 15
3104 days, a person who is and has been a bona fide resident of this
3105 state for at least a period of not less than 1 year.
3106 (2) An individual Any person received pursuant to
3107 subsection (1) shall be examined by the staff of the state
3108 facility where the individual such patient has been admitted
3109 accepted, which examination shall be completed during the 15-day
3110 period.
3111 (3) If, upon examination, the individual such a person
3112 requires continued involuntary placement, a petition for a
3113 hearing regarding involuntary placement shall be filed with the
3114 court of the county where wherein the treatment facility
3115 receiving the individual patient is located or the county where
3116 the individual patient is a resident.
3117 (4) During the pendency of the examination period and the
3118 pendency of the involuntary placement proceedings, an individual
3119 such person may continue to be held in the treatment facility
3120 unless the court having jurisdiction enters an order to the
3121 contrary.
3122 Section 29. Section 394.4785, Florida Statutes, is amended
3123 to read:
3124 394.4785 Children and adolescents; admission and placement
3125 in mental health facilities.—
3126 (1) A child or adolescent as defined in s. 394.492 may not
3127 be admitted to a state-owned or state-operated mental health
3128 treatment facility. A child may be admitted pursuant to s.
3129 394.4625 or s. 394.467 to a crisis stabilization unit or a
3130 residential treatment center licensed under this chapter or a
3131 hospital licensed under chapter 395. The treatment center, unit,
3132 or hospital must provide the least restrictive available
3133 treatment that is appropriate to the individual needs of the
3134 child or adolescent and must adhere to the guiding principles,
3135 system of care, and service planning provisions of contained in
3136 part III of this chapter.
3137 (2) A child or adolescent, as defined in s. 394.492, who is
3138 younger than person under the age of 14 years of age and who is
3139 admitted to a any hospital licensed pursuant to chapter 395 may
3140 not be admitted to a bed in a room or ward with an adult patient
3141 in a mental health unit or share common areas with an adult
3142 patient in a mental health unit. However, an adolescent a person
3143 14 years of age or older may be admitted to a bed in a room or
3144 ward in the mental health unit with an adult if the admitting
3145 physician documents in the case record that such placement is
3146 medically indicated or for reasons of safety. Such placement
3147 shall be reviewed by the attending physician or a designee or
3148 on-call physician each day and documented in the clinical case
3149 record.
3150 Section 30. Subsection (2) of section 394.4786, Florida
3151 Statutes, is amended to read:
3152 394.4786 Intent.—
3153 (2) Further, the Legislature intends that a specialty
3154 psychiatric hospital that provides health care to specified
3155 indigent individuals patients be eligible for reimbursement up
3156 to the amount that hospital contributed to the Public Medical
3157 Assistance Trust Fund in the previous fiscal year.
3158 Section 31. Subsection (2) of section 394.47865, Florida
3159 Statutes, is amended to read:
3160 394.47865 South Florida State Hospital; privatization.—
3161 (2) The contractor shall operate South Florida State
3162 Hospital as a mental health treatment facility that serves
3163 voluntarily and involuntarily committed indigent adult
3164 individuals adults who meet the criteria of this part I of this
3165 chapter and who reside in the South Florida State Hospital
3166 service area.
3167 (a) South Florida State Hospital shall remain a participant
3168 in the mental health disproportionate share program so long as
3169 such individuals the residents receive eligible services.
3170 (b) The department and the contractor shall ensure that the
3171 treatment facility is operated as a part of a total continuum of
3172 care for individuals persons who are mentally ill. The
3173 contractor shall have as its primary goal for the treatment
3174 facility to effectively treat and assist individuals held at the
3175 facility residents to return to the community as quickly as
3176 possible.
3177 Section 32. Section 394.4787, Florida Statutes, is amended
3178 to read:
3179 394.4787 Definitions; ss. 394.4786, 394.4787, 394.4788, and
3180 394.4789.—As used in sections 394.4786-394.4789, the term this
3181 section and ss. 394.4786, 394.4788, and 394.4789:
3182 (1) “Acute mental health services” means mental health
3183 services provided through inpatient hospitalization.
3184 (2) “Agency” means the Agency for Health Care
3185 Administration.
3186 (3) “Charity care” means that portion of hospital charges
3187 for care provided to an individual a patient whose family income
3188 for the 12 months preceding the determination is equal to or
3189 below 150 percent of the current federal nonfarm poverty
3190 guideline or the amount of hospital charges due from the
3191 individual patient which exceeds 25 percent of the annual family
3192 income and for which there is no compensation. Charity care does
3193 shall not include administrative or courtesy discounts,
3194 contractual allowances to third party payors, or failure of a
3195 hospital to collect full charges due to partial payment by
3196 governmental programs.
3197 (4) “Indigent” means an individual whose financial status
3198 would qualify him or her for charity care.
3199 (5) “Operating expense” means all common and accepted costs
3200 appropriate in developing and maintaining the operating of the
3201 patient care facility and its activities.
3202 (6) “PMATF” means the Public Medical Assistance Trust Fund.
3203 (7) “Specialty psychiatric hospital” has the same meaning
3204 as in means a hospital licensed by the agency pursuant to s.
3205 395.002(28), and includes facilities licensed under and part II
3206 of chapter 408 as a specialty psychiatric hospital.
3207 Section 33. Subsections (1), (2), and (6) of section
3208 394.4788, Florida Statutes, are amended to read:
3209 394.4788 Use of certain PMATF funds for the purchase of
3210 acute care mental health services.—
3211 (1) A hospital may be eligible to be reimbursed an amount
3212 no greater than the hospital’s previous year contribution to the
3213 PMATF for acute mental health services provided to indigent
3214 mentally ill individuals persons who have been determined by the
3215 agency or its agent to require such treatment and who:
3216 (a) Do not meet Medicaid eligibility criteria, unless the
3217 agency makes a referral for a Medicaid eligible individual
3218 patient pursuant to s. 394.4789;
3219 (b) Meet the criteria for mental illness under this part;
3220 and
3221 (c) Meet the definition of charity care.
3222 (2) The agency shall annually calculate a per diem
3223 reimbursement rate for each specialty psychiatric hospital to be
3224 paid to the specialty psychiatric hospitals for the provision of
3225 acute mental health services provided to indigent mentally ill
3226 individuals patients who meet the criteria in subsection (1).
3227 After the first rate period, providers shall be notified of new
3228 reimbursement rates for each new state fiscal year by June 1.
3229 The new reimbursement rates shall commence on July 1.
3230 (6) Hospitals that agree to participate in the program set
3231 forth in this section and ss. 394.4786, 394.4787, and 394.4789
3232 shall agree that payment from the PMATF is payment in full for
3233 all individuals patients for which reimbursement is received
3234 under this section and ss. 394.4786, 394.4787, and 394.4789,
3235 until the funds for this program are no longer available.
3236 Section 34. Section 394.4789, Florida Statutes, is amended
3237 to read:
3238 394.4789 Establishment of referral process and eligibility
3239 determination.—
3240 (1) The department shall adopt by rule a referral process
3241 that provides which shall provide each participating specialty
3242 psychiatric hospital with a system for accepting into the
3243 hospital’s care indigent mentally ill individuals persons
3244 referred by the department. It is the intent of the Legislature
3245 that a hospital that which seeks payment under s. 394.4788 shall
3246 accept referrals from the department. However, a hospital may
3247 shall have the right to refuse the admission of an individual a
3248 patient due to lack of functional bed space or lack of services
3249 appropriate to a patient’s specific treatment and is not no
3250 hospital shall be required to accept referrals if the costs for
3251 treating the referred patient are no longer reimbursable because
3252 the hospital has reached the level of contribution made to the
3253 PMATF in the previous fiscal year. Furthermore, a hospital that
3254 does not seek compensation for indigent mentally ill patients
3255 under the provisions of this part is act shall not be obliged to
3256 accept department referrals, notwithstanding any agreements it
3257 may have entered into with the department. The right of refusal
3258 in this subsection does shall not affect a hospital’s
3259 requirement to provide emergency care pursuant to s. 395.1041 or
3260 other state or federal law statutory requirements related to the
3261 provision of emergency care.
3262 (2) The department shall adopt by rule a patient
3263 eligibility form and is shall be responsible for eligibility
3264 determination. However, the department may contract with
3265 participating psychiatric hospitals for eligibility
3266 determination. The eligibility form must shall provide the
3267 mechanism for determining a patient’s eligibility according to
3268 the requirements of s. 394.4788(1).
3269 (a) A specialty psychiatric hospital is shall be eligible
3270 for reimbursement only if when an eligibility form has been
3271 completed for each indigent mentally ill individual person for
3272 whom reimbursement is sought.
3273 (b) As part of eligibility determination, every effort
3274 shall be made by the hospital to determine if any third party
3275 insurance coverage is available.
3276 Section 35. Paragraph (a) of subsection (3) of section
3277 39.407, Florida Statutes, is amended to read:
3278 39.407 Medical, psychiatric, and psychological examination
3279 and treatment of child; physical, mental, or substance abuse
3280 examination of person with or requesting child custody.—
3281 (3)(a)1. Except as otherwise provided in subparagraph (b)1.
3282 or paragraph (e), before the department provides psychotropic
3283 medications to a child in its custody, the prescribing physician
3284 shall attempt to obtain express and informed consent, as defined
3285 in s. 394.455 394.455(9) and as described in s. 394.459(3)
3286 394.459(3)(a), from the child’s parent or legal guardian. The
3287 department shall must take steps necessary to facilitate the
3288 inclusion of the parent in the child’s consultation with the
3289 physician. However, if the parental rights of the parent have
3290 been terminated, the parent’s location or identity is unknown or
3291 cannot reasonably be ascertained, or the parent declines to give
3292 express and informed consent, the department may, after
3293 consultation with the prescribing physician, seek court
3294 authorization to provide the psychotropic medications to the
3295 child. Unless parental rights have been terminated and if it is
3296 possible to do so, the department shall continue to involve the
3297 parent in the decisionmaking process regarding the provision of
3298 psychotropic medications. If, at any time, a parent whose
3299 parental rights have not been terminated provides express and
3300 informed consent to the provision of a psychotropic medication,
3301 the requirements of this section that the department seek court
3302 authorization do not apply to that medication until such time as
3303 the parent no longer consents.
3304 2. If Any time the department seeks a medical evaluation to
3305 determine the need to initiate or continue a psychotropic
3306 medication for a child, the department must provide to the
3307 evaluating physician all pertinent medical information known to
3308 the department concerning that child.
3309 Section 36. Subsection (3) of section 394.495, Florida
3310 Statutes, is amended to read:
3311 394.495 Child and adolescent mental health system of care;
3312 programs and services.—
3313 (3) Assessments shall must be performed by:
3314 (a) A clinical psychologist, clinical social worker,
3315 physician, psychiatric nurse, or psychiatrist professional as
3316 defined in s. 394.455 394.455(2), (4), (21), (23), or (24);
3317 (b) A professional licensed under chapter 491; or
3318 (c) A person who is under the direct supervision of a
3319 professional listed in paragraph (a) or paragraph (b) as defined
3320 in s. 394.455(2), (4), (21), (23), or (24) or a professional
3321 licensed under chapter 491.
3322
3323 The department shall adopt by rule statewide standards for
3324 mental health assessments, which are must be based on current
3325 relevant professional and accreditation standards.
3326 Section 37. Subsection (6) of section 394.496, Florida
3327 Statutes, is amended to read:
3328 394.496 Service planning.—
3329 (6) A clinical psychologist, clinical social worker,
3330 physician, psychiatric nurse, or psychiatrist professional as
3331 defined in s. 394.455, 394.455(2), (4), (21), (23), or (24) or a
3332 professional licensed under chapter 491, must be included among
3333 those persons developing the services plan.
3334 Section 38. Subsection (6) of section 394.9085, Florida
3335 Statutes, is amended to read:
3336 394.9085 Behavioral provider liability.—
3337 (6) For purposes of this section, the terms “detoxification
3338 services,” “addictions receiving facility,” and “receiving
3339 facility” have the same meanings as those provided in ss.
3340 397.311(18)(a)4., 397.311(18)(a)1., and 394.455 394.455(26),
3341 respectively.
3342 Section 39. Paragraph (d) of subsection (1) of section
3343 419.001, Florida Statutes, is amended to read:
3344 419.001 Site selection of community residential homes.—
3345 (1) For the purposes of this section, the following
3346 definitions shall apply:
3347 (d) “Resident” means any of the following: a frail elder as
3348 defined in s. 429.65; a physically disabled or handicapped
3349 person as defined in s. 760.22(7)(a); a developmentally disabled
3350 person as defined in s. 393.063; a nondangerous individual who
3351 has a mental illness as defined in s. 394.455 mentally ill
3352 person as defined in s. 394.455(18); or a child who is found to
3353 be dependent as defined in s. 39.01 or s. 984.03, or a child in
3354 need of services as defined in s. 984.03 or s. 985.03.
3355 Section 40. Subsection (7) of section 744.704, Florida
3356 Statutes, is amended to read:
3357 744.704 Powers and duties.—
3358 (7) A public guardian may shall not commit a ward to a
3359 mental health treatment facility, as defined in s. 394.455
3360 394.455(32), without an involuntary placement proceeding as
3361 provided by law.
3362 Section 41. This act shall take effect July 1, 2010.