Florida Senate - 2014                        COMMITTEE AMENDMENT
       Bill No. SB 944
       
       
       
       
       
       
                                Ì605394;Î605394                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/19/2014           .                                
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       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraph (a) of subsection (3) of section
    6  916.107, Florida Statutes, is amended to read:
    7         916.107 Rights of forensic clients.—
    8         (3) RIGHT TO EXPRESS AND INFORMED CONSENT.—
    9         (a) A forensic client shall be asked to give express and
   10  informed written consent for treatment. If a client refuses such
   11  treatment as is deemed necessary and essential by the client’s
   12  multidisciplinary treatment team for the appropriate care of the
   13  client, such treatment may be provided under the following
   14  circumstances:
   15         1. In an emergency situation in which there is immediate
   16  danger to the safety of the client or others, such treatment may
   17  be provided upon the written order of a physician for a period
   18  not to exceed 48 hours, excluding weekends and legal holidays.
   19  If, after the 48-hour period, the client has not given express
   20  and informed consent to the treatment initially refused, the
   21  administrator or designee of the civil or forensic facility
   22  shall, within 48 hours, excluding weekends and legal holidays,
   23  petition the committing court or the circuit court serving the
   24  county in which the facility is located, at the option of the
   25  facility administrator or designee, for an order authorizing the
   26  continued treatment of the client. In the interim, the need for
   27  treatment shall be reviewed every 48 hours and may be continued
   28  without the consent of the client upon the continued written
   29  order of a physician who has determined that the emergency
   30  situation continues to present a danger to the safety of the
   31  client or others.
   32         2. In a situation other than an emergency situation, the
   33  administrator or designee of the facility shall petition the
   34  court for an order authorizing necessary and essential treatment
   35  for the client.
   36         a. If the client has been receiving psychotherapeutic
   37  medications at the jail at the time of transfer to the forensic
   38  or civil facility and lacks the capacity to make an informed
   39  decision regarding mental health treatment at the time of
   40  admission, the admitting physician may order continued
   41  administration of psychotherapeutic medications if, in the
   42  clinical judgment of the physician, abrupt cessation of
   43  psychotherapeutic medications could pose a risk to the health or
   44  safety of the client during the time a court order to medicate
   45  is pursued. The administrator or designee of the civil or
   46  forensic facility shall, within 5 days after admission,
   47  excluding weekends and legal holidays, petition the committing
   48  court or the circuit court serving the county in which the
   49  facility is located, at the option of the facility administrator
   50  or designee, for an order authorizing the continued treatment of
   51  a client. The jail physician shall provide a current
   52  psychotherapeutic medication order at the time of transfer to
   53  the forensic or civil facility or upon request of the admitting
   54  physician after the client is evaluated.
   55         b. The court order shall allow such treatment for up to a
   56  period not to exceed 90 days after following the date of the
   57  entry of the order. Unless the court is notified in writing that
   58  the client has provided express and informed consent in writing
   59  or that the client has been discharged by the committing court,
   60  the administrator or designee shall, before the expiration of
   61  the initial 90-day order, petition the court for an order
   62  authorizing the continuation of treatment for another 90 days
   63  90-day period. This procedure shall be repeated until the client
   64  provides consent or is discharged by the committing court.
   65         3. At the hearing on the issue of whether the court should
   66  enter an order authorizing treatment for which a client was
   67  unable to or refused to give express and informed consent, the
   68  court shall determine by clear and convincing evidence that the
   69  client has mental illness, intellectual disability, or autism,
   70  that the treatment not consented to is essential to the care of
   71  the client, and that the treatment not consented to is not
   72  experimental and does not present an unreasonable risk of
   73  serious, hazardous, or irreversible side effects. In arriving at
   74  the substitute judgment decision, the court must consider at
   75  least the following factors:
   76         a. The client’s expressed preference regarding treatment;
   77         b. The probability of adverse side effects;
   78         c. The prognosis without treatment; and
   79         d. The prognosis with treatment.
   80  
   81  The hearing shall be as convenient to the client as may be
   82  consistent with orderly procedure and shall be conducted in
   83  physical settings not likely to be injurious to the client’s
   84  condition. The court may appoint a general or special magistrate
   85  to preside at the hearing. The client or the client’s guardian,
   86  and the representative, shall be provided with a copy of the
   87  petition and the date, time, and location of the hearing. The
   88  client has the right to have an attorney represent him or her at
   89  the hearing, and, if the client is indigent, the court shall
   90  appoint the office of the public defender to represent the
   91  client at the hearing. The client may testify or not, as he or
   92  she chooses, and has the right to cross-examine witnesses and
   93  may present his or her own witnesses.
   94         Section 2. Subsection (2) of section 916.13, Florida
   95  Statutes, is amended to read:
   96         916.13 Involuntary commitment of defendant adjudicated
   97  incompetent.—
   98         (2) A defendant who has been charged with a felony and who
   99  has been adjudicated incompetent to proceed due to mental
  100  illness, and who meets the criteria for involuntary commitment
  101  to the department under the provisions of this chapter, may be
  102  committed to the department, and the department shall retain and
  103  treat the defendant.
  104         (a) Within No later than 6 months after the date of
  105  admission and at the end of any period of extended commitment,
  106  or at any time the administrator or designee has shall have
  107  determined that the defendant has regained competency to proceed
  108  or no longer meets the criteria for continued commitment, the
  109  administrator or designee shall file a report with the court
  110  pursuant to the applicable Florida Rules of Criminal Procedure.
  111         (b) A competency hearing must be held within 30 days after
  112  the court receives notification that the defendant is competent
  113  to proceed or no longer meets the criteria for continued
  114  commitment.
  115         Section 3. Section 916.145, Florida Statutes, is amended to
  116  read:
  117         (Substantial rewording of section. See
  118         s. 916.145, F.S., for present text.)
  119         916.145 Dismissal of charges.—
  120         (1) The charges against a defendant adjudicated incompetent
  121  to proceed due to mental illness shall be dismissed without
  122  prejudice to the state if the defendant remains incompetent to
  123  proceed 5 years after such determination, unless the court in
  124  its order specifies its reasons for believing that the defendant
  125  will become competent to proceed within the foreseeable future
  126  and specifies the time within which the defendant is expected to
  127  become competent to proceed. The court may dismiss these charges
  128  between 3 and 5 years after such determination, unless the
  129  charge is:
  130         (a) Arson;
  131         (b) Sexual battery;
  132         (c) Robbery;
  133         (d) Kidnapping;
  134         (e) Aggravated child abuse;
  135         (f) Aggravated abuse of an elderly person or disabled
  136  adult;
  137         (g) Aggravated assault with a deadly weapon;
  138         (h) Murder;
  139         (i) Manslaughter;
  140         (j) Aggravated manslaughter of an elderly person or
  141  disabled adult;
  142         (k) Aggravated manslaughter of a child;
  143         (l) Unlawful throwing, projecting, placing, or discharging
  144  of a destructive device or bomb;
  145         (m) Armed burglary;
  146         (n) Aggravated battery; or
  147         (o) Aggravated stalking;
  148         (p) Any forcible felony as defined in s. 776.08, not listed
  149  in paragraphs (a)-(o);
  150         (q) Any offense involving the possession, use, or discharge
  151  of a firearm;
  152         (r) An attempt to commit any of the offenses listed in
  153  paragraphs (a)-(q);
  154         (s) Committed by a defendant who has had a forcible or
  155  violent felony conviction within the 5 years preceding the date
  156  of arrest for the nonviolent felony sought to be dismissed;
  157         (t) Committed by a defendant who, after having been found
  158  incompetent and under court supervision in a community based
  159  program, is formally charged by a state attorney with a new
  160  felony offense; or
  161         (u) Where there is an identifiable victim and such victim
  162  has not consented.
  163         (2) This section does not prohibit the state from refiling
  164  dismissed charges if the defendant is declared to be competent
  165  to proceed in the future.
  166         Section 4. Subsection (5) is added to section 916.15,
  167  Florida Statutes, to read:
  168         916.15 Involuntary commitment of defendant adjudicated not
  169  guilty by reason of insanity.—
  170         (5) The commitment hearing must be held within 30 days
  171  after the court receives notification that the defendant no
  172  longer meets the criteria for continued commitment.
  173         Section 5. Subsection (1) of section 985.19, Florida
  174  Statutes, is amended to read:
  175         985.19 Incompetency in juvenile delinquency cases.—
  176         (1) If, at any time prior to or during a delinquency case,
  177  the court has reason to believe that the child named in the
  178  petition may be incompetent to proceed with the hearing, the
  179  court on its own motion may, or on the motion of the child’s
  180  attorney or state attorney must, stay all proceedings and order
  181  an evaluation of the child’s mental condition.
  182         (a) Any motion questioning the child’s competency to
  183  proceed must be served upon the child’s attorney, the state
  184  attorney, the attorneys representing the Department of Juvenile
  185  Justice, and the attorneys representing the Department of
  186  Children and Families Family Services. Thereafter, any motion,
  187  notice of hearing, order, or other legal pleading relating to
  188  the child’s competency to proceed with the hearing must be
  189  served upon the child’s attorney, the state attorney, the
  190  attorneys representing the Department of Juvenile Justice, and
  191  the attorneys representing the Department of Children and
  192  Families Family Services.
  193         (b) All determinations of competency must shall be made at
  194  a hearing, with findings of fact based on an evaluation of the
  195  child’s mental condition made by at least not less than two but
  196  not nor more than three experts appointed by the court. The
  197  basis for the determination of incompetency must be specifically
  198  stated in the evaluation. In addition, a recommendation as to
  199  whether residential or nonresidential treatment or training is
  200  required must be included in the evaluation. Experts appointed
  201  by the court to determine the mental condition of a child shall
  202  be allowed reasonable fees for services rendered. State
  203  employees may be paid expenses pursuant to s. 112.061. The fees
  204  shall be taxed as costs in the case.
  205         (c) A child is competent to proceed if the child has
  206  sufficient present ability to consult with counsel with a
  207  reasonable degree of rational understanding and the child has a
  208  rational and factual understanding of the present proceedings.
  209  The expert’s competency evaluation report must specifically
  210  state the basis for the determination of the child’s mental
  211  condition and must include written findings that:
  212         1. Identify the specific matters referred for evaluation.
  213         2. Identify the sources of information used by the expert.
  214         3. Describe the procedures, techniques, and diagnostic
  215  tests used in the examination to determine the basis of the
  216  child’s mental condition.
  217         4. Address the child’s capacity to:
  218         a. Appreciate the charges or allegations against the child.
  219         b. Appreciate the range and nature of possible penalties
  220  that may be imposed in the proceedings against the child, if
  221  applicable.
  222         c. Understand the adversarial nature of the legal process.
  223         d. Disclose to counsel facts pertinent to the proceedings
  224  at issue.
  225         e. Display appropriate courtroom behavior.
  226         f. Testify relevantly.
  227         5. Present the factual basis for the expert’s clinical
  228  findings and opinions of the child’s mental condition. The
  229  expert’s factual basis of his or her clinical findings and
  230  opinions must be supported by the diagnostic criteria found in
  231  the most recent edition of the Diagnostic and Statistical Manual
  232  of Mental Disorders (DSM) published by the American Psychiatric
  233  Association and must be presented in a separate section of the
  234  report entitled “summary of findings.” This section must
  235  include:
  236         a. The day, month, year, and length of time of the face-to
  237  face diagnostic clinical interview to determine the child’s
  238  mental condition.
  239         b. A statement that identifies the DSM clinical name and
  240  associated diagnostic code for the specific mental disorder that
  241  forms the basis of the child’s incompetency.
  242         c. A statement of how the child would benefit from
  243  competency restoration services in the community or in a secure
  244  residential treatment facility.
  245         d. An assessment of the probable duration of the treatment
  246  to restore competence and the probability that the child will
  247  attain competence to proceed in the foreseeable future.
  248         e. A description of recommended treatment or education
  249  appropriate for the mental disorder.
  250         6. If the evaluator determines the child to be incompetent
  251  to proceed to trial, the evaluator must report on the mental
  252  disorder that forms the basis of the incompetency.
  253         (d)(c) All court orders determining incompetency must
  254  include specific written findings by the court as to the nature
  255  of the incompetency and whether the child requires secure or
  256  nonsecure treatment or training environment environments.
  257         (e)(d) For competency incompetency evaluations related to
  258  mental illness, the Department of Children and Families Family
  259  Services shall maintain and annually provide the courts with a
  260  list of available mental health professionals who have completed
  261  a training program approved by the Department of Children and
  262  Families Family Services to perform the evaluations.
  263         (f)(e) For competency incompetency evaluations related to
  264  intellectual disability or autism, the court shall order the
  265  Agency for Persons with Disabilities to examine the child to
  266  determine if the child meets the definition of “intellectual
  267  disability” or “autism” in s. 393.063 and, provide a clinical
  268  opinion as to if so, whether the child is competent to proceed
  269  with delinquency proceedings.
  270         (f) A child is competent to proceed if the child has
  271  sufficient present ability to consult with counsel with a
  272  reasonable degree of rational understanding and the child has a
  273  rational and factual understanding of the present proceedings.
  274  The report must address the child’s capacity to:
  275         1. Appreciate the charges or allegations against the child.
  276         2. Appreciate the range and nature of possible penalties
  277  that may be imposed in the proceedings against the child, if
  278  applicable.
  279         3. Understand the adversarial nature of the legal process.
  280         4. Disclose to counsel facts pertinent to the proceedings
  281  at issue.
  282         5. Display appropriate courtroom behavior.
  283         6. Testify relevantly.
  284         (g) Immediately upon the filing of the court order finding
  285  a child incompetent to proceed, the clerk of the court shall
  286  notify the Department of Children and Families Family Services
  287  and the Agency for Persons with Disabilities and fax or hand
  288  deliver to the department and to the agency a referral packet
  289  that includes, at a minimum, the court order, the charging
  290  documents, the petition, and the court-appointed evaluator’s
  291  reports.
  292         (h) After placement of the child in the appropriate
  293  setting, the Department of Children and Families Family Services
  294  in consultation with the Agency for Persons with Disabilities,
  295  as appropriate, must, within 30 days after placement of the
  296  child, prepare and submit to the court a treatment or training
  297  plan for the child’s restoration of competency. A copy of the
  298  plan must be served upon the child’s attorney, the state
  299  attorney, and the attorneys representing the Department of
  300  Juvenile Justice.
  301         Section 6. This act shall take effect July 1, 2014.
  302  
  303  ================= T I T L E  A M E N D M E N T ================
  304  And the title is amended as follows:
  305         Delete everything before the enacting clause
  306  and insert:
  307                        A bill to be entitled                      
  308         An act relating to mental health treatment; amending
  309         s. 916.107, F.S.; authorizing forensic and civil
  310         facilities to order the continuation of
  311         psychotherapeutics for individuals receiving such
  312         medications in the jail before admission; amending s.
  313         916.13, F.S.; providing timeframes within which
  314         competency hearings must be held; amending s. 916.145,
  315         F.S.; revising the time for dismissal of certain
  316         charges for defendants that remain incompetent to
  317         proceed to trial; providing exceptions; amending s.
  318         916.15, F.S.; providing a timeframe within which
  319         commitment hearings must be held; amending s. 985.19,
  320         F.S.; standardizing the protocols, procedures,
  321         diagnostic criteria, and information and findings that
  322         must be included in an expert’s competency evaluation
  323         report; providing an effective date.