Florida Senate - 2016                                    SB 1336
       
       
        
       By Senator Latvala
       
       20-01629B-16                                          20161336__
    1                        A bill to be entitled                      
    2         An act relating to behavioral health care services;
    3         amending s. 394.453, F.S.; revising legislative intent
    4         and providing legislative findings for the Florida
    5         Mental Health Act; amending ss. 394.66 and 397.305,
    6         F.S.; revising legislative intent with respect to
    7         mental health and substance abuse treatment services;
    8         amending s. 394.9082, F.S.; requiring behavioral
    9         health managing entities to coordinate service
   10         delivery plans with their respective counties or
   11         circuits; providing responsibilities of county
   12         governments for designation of receiving facilities
   13         for the examination and assessment of persons with
   14         mental health or substance use disorders; authorizing
   15         the Department of Children and Families to monitor and
   16         enforce compliance with ch. 394, F.S., relating to
   17         mental health; requiring managing entities to
   18         coordinate the development of a certain local plan;
   19         requiring managing entities to provide certain
   20         technical assistance; requiring managing entities to
   21         develop and implement transportation plans; requiring
   22         local law enforcement agencies, local governments, and
   23         certain providers to review and approve transportation
   24         plans; providing departmental authority for final
   25         approval of such plans; amending s. 397.675, F.S.;
   26         revising criteria for involuntary admission for
   27         assessment, stabilization, and treatment of persons
   28         with substance use or mental health disorders;
   29         amending s. 397.6793, F.S.; specifying professionals
   30         authorized to execute a certificate for emergency
   31         admission; providing criteria for emergency admission;
   32         amending s. 397.681, F.S.; prohibiting a court from
   33         charging a fee for the filing of a petition for
   34         involuntary assessment and stabilization; amending s.
   35         397.6811, F.S.; revising who may file a petition for
   36         involuntary assessment and stabilization; amending s.
   37         397.6818, F.S.; providing a time limitation on a court
   38         order authorizing involuntary assessment and
   39         stabilization; amending ss. 397.697, 397.6971, and
   40         397.6977, F.S.; revising the maximum duration of
   41         court-ordered involuntary treatment and conforming
   42         provisions; amending s. 397.6955, F.S.; revising
   43         requirements for scheduling a hearing on a petition
   44         for involuntary treatment; requiring the Louis de la
   45         Parte Florida Mental Health Institute within the
   46         University of South Florida to provide certain
   47         information to the department on a monthly basis;
   48         amending s. 397.6773, F.S.; conforming a cross
   49         reference; redesignating part V of ch. 765, F.S., as
   50         part VI of ch. 765, F.S.; creating a new part V of ch.
   51         765, F.S., entitled “Mental Health and Substance Abuse
   52         Treatment Advance Directives”; creating s. 765.501,
   53         F.S.; providing a short title; creating s. 765.502,
   54         F.S.; providing legislative findings; creating s.
   55         765.503, F.S.; defining terms; creating s. 765.504,
   56         F.S.; authorizing the execution of mental health or
   57         substance abuse treatment advance directives;
   58         authorizing directive provisions; creating s. 765.505,
   59         F.S.; providing requirements for the execution of a
   60         mental health or substance abuse treatment advance
   61         directive; creating s. 765.506, F.S.; providing
   62         requirements for the revocation or waiver of a mental
   63         health or substance abuse treatment advance directive;
   64         creating s. 765.507, F.S.; providing an immunity from
   65         liability; providing applicability; creating s.
   66         765.508, F.S.; providing for the recognition of a
   67         mental health or substance abuse treatment advance
   68         directive executed in another state; creating s.
   69         765.509, F.S.; requiring service providers to give
   70         patients information relating to mental health or
   71         substance abuse treatment advance directives;
   72         prohibiting a service provider from requiring a
   73         patient to execute a mental health or substance abuse
   74         treatment advance directive; requiring the Department
   75         of Children and Families to provide information and
   76         forms on its website relating to mental health or
   77         substance abuse treatment advance directives; amending
   78         ss. 406.11, 408.802, 408.820, 765.101, and 765.203,
   79         F.S.; conforming cross-references; providing an
   80         effective date.
   81          
   82  Be It Enacted by the Legislature of the State of Florida:
   83  
   84         Section 1. Section 394.453, Florida Statutes, is amended to
   85  read:
   86         394.453 Legislative findings and intent.—
   87         (1)The Legislature finds that mental health and substance
   88  use disorders are diseases of the brain; are complex medical
   89  conditions that encompass biological, genetic, psychological,
   90  cultural, and social factors; and are subspecialties within the
   91  field of medical practice. The Legislature recognizes that
   92  behavioral health disorders may temporarily or permanently
   93  affect a person’s ability to reason, exercise good judgment,
   94  recognize the need for services, or sufficiently provide self
   95  care; thus responsibility for such a person’s care must be
   96  delegated to a third party and may be vested in an authorized,
   97  licensed, qualified health professional who can provide
   98  behavioral health services.
   99         (2) It is the intent of the Legislature:
  100         (a)To authorize licensed, qualified health professionals
  101  to exercise the full authority of their respective scopes of
  102  practice in the performance of professional functions necessary
  103  to carry out the intent of this part.
  104         (b)To ensure that local systems of acute care services use
  105  a common protocol and apply consistent practice standards that
  106  provide for nondiscriminatory and equitable access to the level
  107  and duration of care based on the specific needs and preferences
  108  of the persons served.
  109         (c)That services provided to persons in this state use the
  110  coordination-of-care principles characteristic of recovery
  111  oriented services and include social support services, such as
  112  housing support, life skills and vocational training, and
  113  employment assistance, necessary for persons with mental health
  114  and substance use disorders to live successfully in their
  115  communities.
  116         (d) To authorize and direct the Department of Children and
  117  Families to evaluate, research, plan, and recommend to the
  118  Governor and the Legislature programs designed to reduce the
  119  occurrence, severity, duration, and disabling aspects of mental,
  120  emotional, and behavioral disorders.
  121         (e)That state policy and funding decisions be driven by
  122  data that is representative of the populations served and the
  123  effectiveness of services provided.
  124         (f)It is the intent of the Legislature That treatment
  125  programs for such disorders shall include, but not be limited
  126  to, comprehensive health, social, educational, and
  127  rehabilitative services to persons requiring intensive short
  128  term and continued treatment in order to encourage them to
  129  assume responsibility for their treatment and recovery. It is
  130  intended that:
  131         1. Such persons be provided with emergency service and
  132  temporary detention for evaluation when required;
  133         2.Such persons that they be admitted to treatment
  134  facilities on a voluntary basis when extended or continuing care
  135  is needed and unavailable in the community;
  136         3.that Involuntary placement be provided only when expert
  137  evaluation determines that it is necessary;
  138         4.that Any involuntary treatment or examination be
  139  accomplished in a setting that which is clinically appropriate
  140  and most likely to facilitate the person’s return to the
  141  community as soon as possible; and
  142         5.that Individual dignity and human rights be guaranteed
  143  to all persons who are admitted to mental health facilities or
  144  who are being held under s. 394.463. It is the further intent of
  145  the Legislature that the least restrictive means of intervention
  146  be employed based on the individual needs of each person, within
  147  the scope of available services.
  148         (3) It is the policy of this state that the use of
  149  restraint and seclusion on clients is justified only as an
  150  emergency safety measure to be used in response to imminent
  151  danger to the client or others. It is, therefore, the intent of
  152  the Legislature to achieve an ongoing reduction in the use of
  153  restraint and seclusion in programs and facilities serving
  154  persons with mental illness.
  155         Section 2. Subsection (2) of section 394.66, Florida
  156  Statutes, is amended to read:
  157         394.66 Legislative intent with respect to substance abuse
  158  and mental health services.—It is the intent of the Legislature
  159  to:
  160         (2) Recognize that mental health and substance use
  161  disorders are diseases of the brain; are complex medical
  162  conditions that encompass biological, genetic, psychological,
  163  cultural, and social factors; and are subspecialties within the
  164  field of medical practice. The Legislature recognizes that
  165  behavioral health disorders may temporarily or permanently
  166  affect a person’s ability to reason, exercise good judgment,
  167  recognize the need for services, or sufficiently provide self
  168  care, thus responsibility for such a person’s care must be
  169  delegated to a third party and may be vested in an authorized,
  170  licensed, qualified health professional who can provide
  171  behavioral health services mental illness and substance abuse
  172  impairment are diseases that are responsive to medical and
  173  psychological interventions and management that integrate
  174  treatment, rehabilitative, and support services to achieve
  175  recovery.
  176         Section 3. Subsections (4) through (12) of section
  177  394.9082, Florida Statutes, are renumbered as subsections (6)
  178  though (14), respectively, and new subsections (4) and (5) are
  179  added to that section, to read:
  180         394.9082 Behavioral health managing entities.—
  181         (4)COMMUNITY PLANNING.—Each managing entity shall develop
  182  a plan with each county or circuit in its geographic area to
  183  establish and maintain a behavioral health service system that
  184  has sufficient capacity to ensure that all persons with mental
  185  health or substance use disorders who are subject to involuntary
  186  admission under this chapter receive prompt assessment of the
  187  need for evaluation and treatment. At a minimum, the plan must
  188  include the following components:
  189         (a)Each county shall work with managing entities, the
  190  department, community-based treatment providers, private
  191  providers, local hospitals and health departments, law
  192  enforcement agencies, the courts, and other local governmental
  193  agencies to designate a receiving facility that shall be used by
  194  law enforcement officers, but may be used by other authorized
  195  persons, for voluntary and involuntary assessments or
  196  examinations.
  197         1.A county may have more than one facility or may use or
  198  share the resources of adjacent counties.
  199         2.The department shall suspend or withdraw such
  200  designation for failure to comply with this chapter and rules
  201  adopted under this chapter. Unless designated by the department,
  202  a facility may not hold or treat involuntary patients under this
  203  chapter.
  204         (b)A managing entity shall coordinate the development of a
  205  local plan that:
  206         1.Includes the county or circuit.
  207         2.Establishes the specifications and minimum standards for
  208  access to care available in each community and specifies the
  209  roles, processes, and responsibilities of community intervention
  210  programs for the diversion of persons from acute care
  211  placements.
  212         3.Specifies the method by which local hospitals,
  213  ambulatory centers, designated receiving facilities, and acute
  214  care inpatient and detoxification providers will coordinate
  215  activities to assess, examine, triage, intake, and process
  216  persons presented on an involuntary basis.
  217         4.Includes a local transportation plan as provided in s.
  218  394.462.
  219         5.Provides an option to procure nonmedical transportation
  220  contracts for the transportation of patients between facilities.
  221         (c)A managing entity shall provide technical assistance to
  222  counties or circuits for the development, receipt, and approval
  223  of such plans and incorporate the community resources designated
  224  in such plans when conducting the needs assessment and
  225  coordinating the resources within its assigned region.
  226         (5)TRANSPORTATION PLANS.—
  227         (a)Each managing entity shall develop, in consultation
  228  with local law enforcement agencies, county officials, and local
  229  acute care providers, a transportation plan for each county or
  230  circuit within its assigned region. At a minimum, the plan must
  231  address the following:
  232         1.The designated public or private substance abuse
  233  receiving facility or residential detoxification facility to be
  234  used by local law enforcement agencies as their primary
  235  receiving facility.
  236         2.The method of transporting a person after a law
  237  enforcement officer has relinquished physical custody of the
  238  person at a designated public or private substance abuse
  239  receiving facility or residential detoxification facility.
  240         3.Provide for consumer choice with respect to a receiving
  241  facility or other designated facility, or other acute care
  242  service provider capable of meeting the person’s needs, within
  243  reasonable parameters of funding, geography, and safety.
  244         4.Specify responsibility for and the means by which
  245  transportation to and between facilities of persons in need of
  246  behavioral health services will be implemented to support
  247  involuntary assessments or examinations, provision of emergency
  248  services, acute care placements, and attendance at involuntary
  249  court proceedings and resulting commitments.
  250         (b)The transportation plan shall be initiated by the local
  251  managing entity and must be reviewed and approved by local law
  252  enforcement agencies, county commissioners, and designated acute
  253  care providers in the county or circuit before submission to the
  254  managing entity. The department has final review and approval
  255  authority for the transportation plan.
  256         Section 4. Section 397.305, Florida Statutes, is amended to
  257  read:
  258         397.305 Legislative findings, intent, and purpose.—
  259         (1)The Legislature finds that mental health and substance
  260  use disorders are diseases of the brain; are complex medical
  261  conditions that encompass biological, genetic, psychological,
  262  cultural, and social factors; and are subspecialties within the
  263  field of medical practice. The Legislature recognizes that
  264  behavioral health disorders may temporarily or permanently
  265  affect a person’s ability to reason, exercise good judgment,
  266  recognize the need for services, or sufficiently provide self
  267  care, thus responsibility for such a person’s care must be
  268  delegated to a third party and may be vested in an authorized,
  269  licensed, qualified health professional who can provide
  270  behavioral health services.
  271         (2)(1) Substance abuse is a major health problem that
  272  affects multiple service systems and leads to such profoundly
  273  disturbing consequences as serious impairment, chronic
  274  addiction, criminal behavior, vehicular casualties, spiraling
  275  health care costs, AIDS, and business losses, and significantly
  276  affects the culture, socialization, and learning ability of
  277  children within our schools and educational systems. Substance
  278  abuse impairment is a disease which affects the whole family and
  279  the whole society and requires a system of care that includes
  280  prevention, intervention, clinical treatment, and recovery
  281  support services that support and strengthen the family unit.
  282  Further, it is the intent of the Legislature to require the
  283  collaboration of state agencies, service systems, and program
  284  offices to achieve the goals of this chapter and address the
  285  needs of the public; to establish a comprehensive system of care
  286  for substance abuse; and to reduce duplicative requirements
  287  across state agencies. This chapter is designed to provide for
  288  substance abuse services.
  289         (3)(2) It is the goal of the Legislature to discourage
  290  substance abuse by promoting healthy lifestyles; healthy
  291  families; and drug-free schools, workplaces, and communities.
  292         (4)(3) It is the purpose of this chapter to provide for a
  293  comprehensive continuum of accessible and quality substance
  294  abuse prevention, intervention, clinical treatment, and recovery
  295  support services in the least restrictive environment which
  296  promotes long-term recovery while protecting and respecting the
  297  rights of individuals, primarily through community-based private
  298  not-for-profit providers working with local governmental
  299  programs involving a wide range of agencies from both the public
  300  and private sectors.
  301         (5)It is the intent of the Legislature to authorize
  302  licensed, qualified health professionals to exercise the full
  303  authority of their respective scopes of practice in the
  304  performance of professional functions necessary to carry out the
  305  intent of this chapter.
  306         (6)It is the intent of the Legislature that state policy
  307  and funding decisions be driven by data that is representative
  308  of the populations served and the effectiveness of services
  309  provided.
  310         (7)It is the intent of the Legislature to establish
  311  expectations that services provided to persons in this state use
  312  the coordination-of-care principles characteristic of recovery
  313  oriented services and include social support services, such as
  314  housing support, life skills and vocational training, and
  315  employment assistance, necessary for persons with mental health
  316  and substance use disorders to live successfully in their
  317  communities.
  318         (8)(4) It is the intent of the Legislature to ensure within
  319  available resources a full system of care for substance abuse
  320  services based on identified needs, delivered without
  321  discrimination and with adequate provision for specialized
  322  needs.
  323         (9)(5) It is the intent of the Legislature to establish
  324  services for individuals with co-occurring substance abuse and
  325  mental disorders.
  326         (10)(6) It is the intent of the Legislature to provide an
  327  alternative to criminal imprisonment for substance abuse
  328  impaired adults and juvenile offenders by encouraging the
  329  referral of such offenders to service providers not generally
  330  available within the juvenile justice and correctional systems,
  331  instead of or in addition to criminal penalties.
  332         (11)(7) It is the intent of the Legislature to provide,
  333  within the limits of appropriations and safe management of the
  334  juvenile justice and correctional systems, substance abuse
  335  services to substance abuse impaired offenders who are placed by
  336  the Department of Juvenile Justice or who are incarcerated
  337  within the Department of Corrections, in order to better enable
  338  these offenders or inmates to adjust to the conditions of
  339  society presented to them when their terms of placement or
  340  incarceration end.
  341         (12)(8) It is the intent of the Legislature to provide for
  342  assisting substance abuse impaired persons primarily through
  343  health and other rehabilitative services in order to relieve the
  344  police, courts, correctional institutions, and other criminal
  345  justice agencies of a burden that interferes with their ability
  346  to protect people, apprehend offenders, and maintain safe and
  347  orderly communities.
  348         (13)(9) It is the intent of the Legislature that the
  349  freedom of religion of all citizens shall be inviolate. Nothing
  350  in This act does not shall give any governmental entity
  351  jurisdiction to regulate religious, spiritual, or ecclesiastical
  352  services.
  353         Section 5. Section 397.675, Florida Statutes, is amended to
  354  read:
  355         397.675 Criteria for involuntary admissions, including
  356  protective custody, emergency admission, and other involuntary
  357  assessment, involuntary treatment, and alternative involuntary
  358  assessment for minors, for purposes of assessment and
  359  stabilization, and for involuntary treatment.—A person meets the
  360  criteria for involuntary admission if there is good faith reason
  361  to believe the person has a substance use or co-occurring mental
  362  health disorder and, because of this condition, has refused or
  363  is unable to determine whether examination is necessary. The
  364  refusal of services is insufficient evidence of an inability to
  365  determine whether an examination is necessary unless, without
  366  care or treatment is substance abuse impaired and, because of
  367  such impairment:
  368         (1) The person is likely to neglect or refuse care for
  369  himself or herself to the extent that the neglect or refusal
  370  poses a real and present threat of substantial harm to his or
  371  her well-being;
  372         (2)The person is at risk of the deterioration of his or
  373  her physical or mental health and this condition may not be
  374  avoided despite assistance from willing family members, friends,
  375  or other services; or
  376         (3)There is a substantial likelihood that the person will
  377  cause serious bodily harm to himself or herself or others, as
  378  shown by the person’s recent behavior. Has lost the power of
  379  self-control with respect to substance use; and either
  380         (2)(a)Has inflicted, or threatened or attempted to
  381  inflict, or unless admitted is likely to inflict, physical harm
  382  on himself or herself or another; or
  383         (b)Is in need of substance abuse services and, by reason
  384  of substance abuse impairment, his or her judgment has been so
  385  impaired that the person is incapable of appreciating his or her
  386  need for such services and of making a rational decision in
  387  regard thereto; however, mere refusal to receive such services
  388  does not constitute evidence of lack of judgment with respect to
  389  his or her need for such services.
  390         Section 6. Section 397.6793, Florida Statutes, is amended
  391  to read:
  392         397.6793 Professional Physician’s certificate for emergency
  393  admission.—
  394         (1) A physician, clinical psychologist, physician’s
  395  assistant working under the scope of practice of the supervising
  396  physician, psychiatric nurse, advanced registered nurse
  397  practitioner, licensed mental health counselor, licensed
  398  marriage and family therapist, master’s level-certified
  399  addiction professional for substance abuse services, or licensed
  400  clinical social worker may execute a certificate stating that he
  401  or she has examined a person within the preceding 5 days and
  402  finds that the person appears to meet the criteria for emergency
  403  admission and stating the observations upon which that
  404  conclusion is based. The professional physician’s certificate
  405  must include the name of the person to be admitted, the
  406  relationship between the person and the professional executing
  407  the certificate physician, the relationship between the
  408  applicant and the professional executing the certificate
  409  physician, and any relationship between the professional
  410  executing the certificate physician and the licensed service
  411  provider, and a statement that the person has been examined and
  412  assessed within 5 days of the application date, and must include
  413  factual allegations with respect to the need for emergency
  414  admission, including:
  415         (a) The reason for the physician’s belief that the person
  416  is substance abuse impaired; and
  417         (b) The reason for the physician’s belief that because of
  418  such impairment the person has lost the power of self-control
  419  with respect to substance abuse; and either
  420         (c)1. The reason for the belief that, without care or
  421  treatment:
  422         1.The person is likely to neglect or refuse to care for
  423  himself or herself to the extent that the neglect or refusal
  424  poses a real and present threat of substantial harm to his or
  425  her well-being;
  426         2.The person is at risk of the deterioration of his or her
  427  physical or mental health and that this condition may not be
  428  avoided despite assistance from willing family members, friends,
  429  or other services; or
  430         3.There is a substantial likelihood that the person will
  431  cause serious bodily harm to himself or herself or others, as
  432  shown by the person’s recent behavior. the physician believes
  433  that the person has inflicted or is likely to inflict physical
  434  harm on himself or herself or others unless admitted; or
  435         2.The reason the physician believes that the person’s
  436  refusal to voluntarily receive care is based on judgment so
  437  impaired by reason of substance abuse that the person is
  438  incapable of appreciating his or her need for care and of making
  439  a rational decision regarding his or her need for care.
  440         (2) The professional physician’s certificate must recommend
  441  the least restrictive type of service that is appropriate for
  442  the person. The certificate must be signed by the professional
  443  physician. If other less restrictive means are not available,
  444  such as voluntary appearance for outpatient evaluation, a law
  445  enforcement officer shall take the person named in the
  446  certificate into custody and deliver him or her to the nearest
  447  facility selected by the county for emergency admission.
  448         (3) A signed copy of the professional physician’s
  449  certificate shall accompany the person, and shall be made a part
  450  of the person’s clinical record, together with a signed copy of
  451  the application. The application and professional physician’s
  452  certificate authorize the involuntary admission of the person
  453  pursuant to, and subject to the provisions of, ss. 397.679
  454  397.6797.
  455         (4) The professional physician’s certificate must indicate
  456  whether the person requires transportation assistance for
  457  delivery for emergency admission and specify, pursuant to s.
  458  397.6795, the type of transportation assistance necessary.
  459         Section 7. Subsection (1) of section 397.681, Florida
  460  Statutes, is amended to read:
  461         397.681 Involuntary petitions; general provisions; court
  462  jurisdiction and right to counsel.—
  463         (1) JURISDICTION.—The courts have jurisdiction of
  464  involuntary assessment and stabilization petitions and
  465  involuntary treatment petitions for substance abuse impaired
  466  persons, and such petitions must be filed with the clerk of the
  467  court in the county where the person is located. The court may
  468  not charge a fee for the filing of a petition under this
  469  section. The chief judge may appoint a general or special
  470  magistrate to preside over all or part of the proceedings. The
  471  alleged impaired person is named as the respondent.
  472         Section 8. Subsection (1) of section 397.6811, Florida
  473  Statutes, is amended to read:
  474         397.6811 Involuntary assessment and stabilization.—A person
  475  determined by the court to appear to meet the criteria for
  476  involuntary admission under s. 397.675 may be admitted for a
  477  period of 5 days to a hospital or to a licensed detoxification
  478  facility or addictions receiving facility, for involuntary
  479  assessment and stabilization or to a less restrictive component
  480  of a licensed service provider for assessment only upon entry of
  481  a court order or upon receipt by the licensed service provider
  482  of a petition. Involuntary assessment and stabilization may be
  483  initiated by the submission of a petition to the court.
  484         (1) If the person upon whose behalf the petition is being
  485  filed is an adult, a petition for involuntary assessment and
  486  stabilization may be filed by the respondent’s spouse or
  487  guardian, any relative, a private practitioner, the director of
  488  a licensed service provider or the director’s designee, or any
  489  adult willing to provide testimony that he or she has personally
  490  observed the actions of that person and believes that person to
  491  be a threat to himself or herself or others three adults who
  492  have personal knowledge of the respondent’s substance abuse
  493  impairment.
  494         Section 9. Subsection (4) is added to section 397.6818,
  495  Florida Statutes, to read:
  496         397.6818 Court determination.—At the hearing initiated in
  497  accordance with s. 397.6811(1), the court shall hear all
  498  relevant testimony. The respondent must be present unless the
  499  court has reason to believe that his or her presence is likely
  500  to be injurious to him or her, in which event the court shall
  501  appoint a guardian advocate to represent the respondent. The
  502  respondent has the right to examination by a court-appointed
  503  qualified professional. After hearing all the evidence, the
  504  court shall determine whether there is a reasonable basis to
  505  believe the respondent meets the involuntary admission criteria
  506  of s. 397.675.
  507         (4)The order is valid only until executed or, if not
  508  executed, for the period specified in the order. If no time
  509  limit is specified in the order, the order is valid for 7 days
  510  after the date the order is signed.
  511         Section 10. Subsection (1) of section 397.697, Florida
  512  Statutes, is amended to read:
  513         397.697 Court determination; effect of court order for
  514  involuntary substance abuse treatment.—
  515         (1) When the court finds that the conditions for
  516  involuntary substance abuse treatment have been proved by clear
  517  and convincing evidence, it may order the respondent to undergo
  518  involuntary treatment by a licensed service provider for a
  519  period not to exceed 90 60 days. If the court finds it
  520  necessary, it may direct the sheriff to take the respondent into
  521  custody and deliver him or her to the licensed service provider
  522  specified in the court order, or to the nearest appropriate
  523  licensed service provider, for involuntary treatment. When the
  524  conditions justifying involuntary treatment no longer exist, the
  525  individual must be released as provided in s. 397.6971. When the
  526  conditions justifying involuntary treatment are expected to
  527  exist after 90 60 days of treatment, a renewal of the
  528  involuntary treatment order may be requested pursuant to s.
  529  397.6975 before prior to the end of the 90-day 60-day period.
  530         Section 11. Section 397.6971, Florida Statutes, is amended
  531  to read:
  532         397.6971 Early release from involuntary substance abuse
  533  treatment.—
  534         (1) At any time before prior to the end of the 90-day 60
  535  day involuntary treatment period, or before prior to the end of
  536  any extension granted pursuant to s. 397.6975, an individual
  537  admitted for involuntary treatment may be determined eligible
  538  for discharge to the most appropriate referral or disposition
  539  for the individual when:
  540         (a) The individual no longer meets the criteria specified
  541  in s. 397.675 for involuntary admission and has given his or her
  542  informed consent to be transferred to voluntary treatment
  543  status;
  544         (b) If the individual was admitted on the grounds of
  545  likelihood of infliction of physical harm upon himself or
  546  herself or others, such likelihood no longer exists; or
  547         (c) If the individual was admitted on the grounds of need
  548  for assessment and stabilization or treatment, accompanied by
  549  inability to make a determination respecting such need, either:
  550         1. Such inability no longer exists; or
  551         2. It is evident that further treatment will not bring
  552  about further significant improvements in the individual’s
  553  condition;
  554         (d) The individual is no longer in need of services; or
  555         (e) The director of the service provider determines that
  556  the individual is beyond the safe management capabilities of the
  557  provider.
  558         (2) Whenever a qualified professional determines that an
  559  individual admitted for involuntary treatment is ready for early
  560  release for any of the reasons listed in subsection (1), the
  561  service provider shall immediately discharge the individual, and
  562  must notify all persons specified by the court in the original
  563  treatment order.
  564         Section 12. Section 397.6977, Florida Statutes, is amended
  565  to read:
  566         397.6977 Disposition of individual upon completion of
  567  involuntary substance abuse treatment.—At the conclusion of the
  568  90-day 60-day period of court-ordered involuntary treatment, the
  569  individual is automatically discharged unless a motion for
  570  renewal of the involuntary treatment order has been filed with
  571  the court pursuant to s. 397.6975.
  572         Section 13. Section 397.6955, Florida Statutes, is amended
  573  to read:
  574         397.6955 Duties of court upon filing of petition for
  575  involuntary treatment.—Upon the filing of a petition for the
  576  involuntary treatment of a substance abuse impaired person with
  577  the clerk of the court, the court shall immediately determine
  578  whether the respondent is represented by an attorney or whether
  579  the appointment of counsel for the respondent is appropriate.
  580  The court shall schedule a hearing to be held on the petition
  581  within 5 10 days, unless a continuance is granted. A copy of the
  582  petition and notice of the hearing must be provided to the
  583  respondent; the respondent’s parent, guardian, or legal
  584  custodian, in the case of a minor; the respondent’s attorney, if
  585  known; the petitioner; the respondent’s spouse or guardian, if
  586  applicable; and such other persons as the court may direct, and
  587  have such petition and order personally delivered to the
  588  respondent if he or she is a minor. The court shall also issue a
  589  summons to the person whose admission is sought.
  590         Section 14. In order to maximize efficiency, avoid
  591  duplication, and provide cost savings, the Louis de la Parte
  592  Florida Mental Health Institute within the University of South
  593  Florida shall provide monthly to the Department of Children and
  594  Families copies of each of the following:
  595         (1)Ex parte orders for involuntary examination.
  596         (2)Professional certificates for initiating involuntary
  597  examination.
  598         (3)Law enforcement reports on involuntary examination.
  599         (4)Involuntary outpatient placement orders.
  600         (5)Involuntary inpatient placement orders.
  601         Section 15. Subsection (1) of section 397.6773, Florida
  602  Statutes, is amended to read:
  603         397.6773 Dispositional alternatives after protective
  604  custody.—
  605         (1) An individual who is in protective custody must be
  606  released by a qualified professional when:
  607         (a) The individual no longer meets the involuntary
  608  admission criteria in s. 397.675 s. 397.675(1);
  609         (b) The 72-hour period has elapsed; or
  610         (c) The individual has consented to remain voluntarily at
  611  the licensed service provider.
  612         Section 16.  Part V of chapter 765, Florida Statutes, is
  613  redesignated as part VI, and a new part V of chapter 765,
  614  Florida Statutes, consisting of ss. 765.501-765.509, is created
  615  and entitled “Mental Health and Substance Abuse Treatment
  616  Advance Directives.”
  617         Section 17. Section 765.501, Florida Statutes, is created
  618  to read:
  619         765.501 Short title.—Sections 765.501-765.509 may be cited
  620  as the “Jennifer Act”.
  621         Section 18. Section 765.502, Florida Statutes, is created
  622  to read:
  623         765.502 Legislative findings.—
  624         (1) The Legislature recognizes that an individual with
  625  capacity has the ability to control decisions relating to his or
  626  her own mental health care or substance abuse treatment. The
  627  Legislature also makes the following findings:
  628         (a) Substance abuse and some mental illnesses cause
  629  individuals to fluctuate between capacity and incapacity.
  630         (b) During periods when an individual’s capacity is
  631  unclear, the individual may be unable to provide informed
  632  consent necessary to access needed treatment.
  633         (c) Early treatment may prevent an individual from becoming
  634  so ill that involuntary treatment is necessary.
  635         (d) Individuals with substance abuse impairment or mental
  636  illness need an established procedure to express their
  637  instructions and preferences for treatment and provide advance
  638  consent to or refusal of treatment. This procedure should be
  639  less expensive and less restrictive than guardianship.
  640         (2) The Legislature further recognizes the following:
  641         (a) A mental health or substance abuse treatment advance
  642  directive must provide the individual with a full range of
  643  choices.
  644         (b) For a mental health or substance abuse treatment
  645  advance directive to be an effective tool, individuals must be
  646  able to choose how they want their directives to be applied
  647  during periods when they are incompetent to consent to
  648  treatment.
  649         (c) There must be a clear process so that treatment
  650  providers can abide by an individual’s treatment choices.
  651         Section 19. Section 765.503, Florida Statutes, is created
  652  to read:
  653         765.503 Definitions.—As used in this part, the term:
  654         (1) “Adult” means any individual who has attained the age
  655  of majority or is an emancipated minor.
  656         (2) “Capacity” means that an adult has not been found to be
  657  incapacitated pursuant to s. 394.463.
  658         (3) “Health care facility” means a hospital, nursing home,
  659  hospice, home health agency, or health maintenance organization
  660  licensed in this state, or any facility subject to part I of
  661  chapter 394.
  662         (4) “Incapacity” or “incompetent” means one or more of the
  663  following conditions when present in an adult:
  664         (a) An inability to understand the nature, character, and
  665  anticipated results of proposed treatment or alternatives or the
  666  recognized serious possible risks, complications, and
  667  anticipated benefits of treatments and alternatives, including
  668  nontreatment.
  669         (b) An inability to physically or mentally communicate a
  670  willful and knowing decision about mental health care or
  671  substance abuse treatment.
  672         (c) An inability to communicate his or her understanding or
  673  treatment decisions.
  674         (d) Criteria exist for an involuntary examination pursuant
  675  to s. 394.463.
  676         (5) “Informed consent” means consent voluntarily given by a
  677  person after a sufficient explanation and disclosure of the
  678  subject matter involved to enable that person to have a general
  679  understanding of the treatment or procedure and the medically
  680  acceptable alternatives, including the substantial risks and
  681  hazards inherent in the proposed treatment or procedures or
  682  nontreatment, and to make knowing mental health care or
  683  substance abuse treatment decisions without coercion or undue
  684  influence.
  685         (6) “Interested person” means any person who may reasonably
  686  be expected to be affected by the outcome of the particular
  687  proceeding involved, including anyone interested in the welfare
  688  of an incapacitated person.
  689         (7) “Mental health or substance abuse treatment advance
  690  directive” means a written document in which the principal makes
  691  a declaration of instructions or preferences or appoints a
  692  surrogate to make decisions on behalf of the principal regarding
  693  the principal’s mental health or substance abuse treatment, or
  694  both.
  695         (8) “Mental health professional” means a psychiatrist,
  696  psychologist, psychiatric nurse, or social worker, and such
  697  other mental health professionals licensed pursuant to chapter
  698  458, chapter 459, chapter 464, chapter 490, or chapter 491.
  699         (9) “Principal” means a competent adult who executes a
  700  mental health or substance abuse treatment advance directive and
  701  on whose behalf mental health care or substance abuse treatment
  702  decisions are to be made.
  703         (10) “Service provider” means a mental health receiving
  704  facility, a facility licensed under chapter 397, a treatment
  705  facility, an entity under contract with the department to
  706  provide mental health or substance abuse services, a community
  707  mental health center or clinic, a psychologist, a clinical
  708  social worker, a marriage and family therapist, a mental health
  709  counselor, a physician, a psychiatrist, an advanced registered
  710  nurse practitioner, or a psychiatric nurse.
  711         (11) “Surrogate” means any competent adult expressly
  712  designated by a principal to make mental health care or
  713  substance abuse treatment decisions on behalf of the principal
  714  as set forth in the principal’s mental health or substance abuse
  715  treatment advance directive created pursuant to this part.
  716         Section 20. Section 765.504, Florida Statutes, is created
  717  to read:
  718         765.504 Mental health or substance abuse treatment advance
  719  directive; execution; allowable provisions.—
  720         (1) An adult with capacity may execute a mental health or
  721  substance abuse treatment advance directive.
  722         (2) A directive executed in accordance with this section is
  723  presumed to be valid. The inability to honor one or more
  724  provisions of a directive does not affect the validity of the
  725  remaining provisions.
  726         (3) A directive may include any provision relating to
  727  mental health or substance abuse treatment or the care of the
  728  principal for whom the directive is executed. Without
  729  limitation, a directive may include one or more of the
  730  following:
  731         (a) Preferences and instructions for mental health or
  732  substance abuse treatment.
  733         (b) Consent to specific types of mental health or substance
  734  abuse treatment.
  735         (c) Refusal of and direction not to administer specific
  736  types of mental health or substance abuse treatment.
  737         (d) Descriptions of situations that may cause the principal
  738  to experience a mental health or substance abuse crisis.
  739         (e) Suggested alternative responses that may supplement or
  740  be in lieu of direct mental health or substance abuse treatment,
  741  such as treatment approaches from other providers.
  742         (f) The principal’s nomination of a guardian, limited
  743  guardian, or guardian advocate as provided under chapter 744.
  744         (4) A directive may be combined with or be independent of a
  745  nomination of a guardian, a durable power of attorney, or other
  746  advance directive.
  747         Section 21. Section 765.505, Florida Statutes, is created
  748  to read:
  749         765.505 Execution of a mental health or substance abuse
  750  treatment advance directive.—
  751         (1) A directive must have all of the following
  752  characteristics:
  753         (a) Be in writing.
  754         (b) Contain language that clearly indicates that the
  755  principal intends to create a directive pursuant to this part.
  756         (c) Be dated and signed by the principal or, if the
  757  principal is unable to sign, at the principal’s direction in the
  758  principal’s presence.
  759         (d) Be witnessed by two adults, each of whom must declare
  760  that he or she personally knows the principal and was present
  761  when the principal dated and signed the directive, and that the
  762  principal did not appear to be incapacitated or acting under
  763  fraud, undue influence, or duress. The person designated as the
  764  surrogate may not act as a witness to the execution of a
  765  document designating the mental health care or substance abuse
  766  treatment surrogate. At least one person who acts as a witness
  767  may not be the principal’s spouse or his or her blood relative.
  768         (2) A directive is valid upon execution, but all or part of
  769  the directive may take effect at a later date as designated by
  770  the principal in the directive.
  771         (3) A directive may be revoked, in whole or in part,
  772  pursuant to s. 765.506 or expire under its own terms.
  773         (4) A directive does not or may not:
  774         (a) Create an entitlement to mental health, substance
  775  abuse, or medical treatment or supersede a determination of
  776  medical necessity.
  777         (b) Obligate any health care provider, professional person,
  778  or health care facility to pay the costs associated with the
  779  treatment requested.
  780         (c) Obligate a health care provider, professional person,
  781  or health care facility to be responsible for the nontreatment
  782  or personal care of the principal or the principal’s personal
  783  affairs outside the scope of services the facility normally
  784  provides.
  785         (d) Replace or supersede any will or testamentary document
  786  or supersede the application of intestate succession.
  787         Section 22. Section 765.506, Florida Statutes, is created
  788  to read:
  789         765.506 Revocation; waiver.—
  790         (1) A principal with capacity may, by written statement of
  791  the principal or at the principal’s direction in the principal’s
  792  presence, revoke a directive in whole or in part.
  793         (2) The principal shall provide a copy of his or her
  794  written statement of revocation to his or her agent, if any, and
  795  to each health care provider, professional person, or health
  796  care facility that received a copy of the directive from the
  797  principal.
  798         (3) The written statement of revocation is effective as to
  799  a health care provider, professional person, or health care
  800  facility upon the individual’s or entity’s receipt of the
  801  statement. The professional person, health care provider, or
  802  health care facility, or persons acting under their direction,
  803  shall make the statement of revocation part of the principal’s
  804  medical record.
  805         (4) A directive also may:
  806         (a) Be revoked, in whole or in part, expressly or to the
  807  extent of any inconsistency, by a subsequent directive; or
  808         (b) Be superseded or revoked by a court order, including
  809  any order entered in a criminal matter. The principal’s family,
  810  a health care facility, an attending physician, or any other
  811  interested person who may be directly affected by a surrogate’s
  812  decision relating to the principal’s health care may seek
  813  expedited judicial intervention pursuant to rule 5.900 of the
  814  Florida Probate Rules, if that person believes:
  815         1. The surrogate’s decision is not in accord with the
  816  principal’s known desires;
  817         2. The advance directive is ambiguous, or the principal has
  818  changed his or her mind after execution of the advance
  819  directive;
  820         3. The surrogate was improperly designated or appointed, or
  821  the designation of the surrogate is no longer effective or has
  822  been revoked;
  823         4. The surrogate has failed to discharge duties, or
  824  incapacity or illness renders the surrogate incapable of
  825  discharging duties;
  826         5. The surrogate has abused his or her power or authority;
  827  or
  828         6. The principal has sufficient capacity to make his or her
  829  own health care decisions.
  830         (5) A directive that would have otherwise expired but is
  831  effective because the principal is incapacitated remains
  832  effective until the principal is no longer incapacitated, unless
  833  the principal elected in the directive to be able to revoke
  834  while incapacitated and has revoked the directive.
  835         (6) When a principal with capacity consents to treatment
  836  that differs from, or refuses treatment consented to in, his or
  837  her directive, the consent or refusal constitutes a waiver of a
  838  particular provision of the directive and does not constitute a
  839  revocation of that provision or the directive unless the
  840  principal also expressly revokes the provision or directive.
  841         Section 23. Section 765.507, Florida Statutes, is created
  842  to read:
  843         765.507 Immunity from liability; weight of proof;
  844  presumption.—
  845         (1) A health care facility, provider, or other person who
  846  acts under the direction of a health care facility or provider
  847  is not subject to criminal prosecution or civil liability, and
  848  may not be deemed to have engaged in unprofessional conduct, as
  849  a result of carrying out a mental health care or substance abuse
  850  treatment decision made in accordance with this part. The
  851  surrogate who makes a mental health care or substance abuse
  852  treatment decision on a principal’s behalf, pursuant to this
  853  part, is not subject to criminal prosecution or civil liability
  854  for such action.
  855         (2) This section does not apply if it is shown by a
  856  preponderance of the evidence that the person authorizing or
  857  carrying out a mental health care or substance abuse treatment
  858  decision did not exercise reasonable care or, in good faith,
  859  comply with this part.
  860         Section 24. Section 765.508, Florida Statutes, is created
  861  to read:
  862         765.508 Recognition of mental health or substance abuse
  863  treatment advance directive executed in another state.—A mental
  864  health or substance abuse treatment advance directive executed
  865  in another state in compliance with the laws of that state is
  866  validly executed for the purposes of this part.
  867         Section 25. Section 765.509, Florida Statutes, is created
  868  to read:
  869         765.509 Dissemination of information.—
  870         (1) A service provider shall give information relating to
  871  mental health or substance abuse treatment advance directives to
  872  its patients and assist competent and willing patients in
  873  completing mental health or substance abuse treatment advance
  874  directives.
  875         (2) A service provider may not require a patient to execute
  876  a mental health or substance abuse treatment advance directive
  877  or to execute a new mental health or substance abuse treatment
  878  advance directive using the service provider’s forms. The
  879  principal’s mental health or substance abuse treatment advance
  880  directives shall travel with the principal as part of his or her
  881  medical record.
  882         (3) The Department of Children and Families shall develop,
  883  and publish on its website, information on the creation,
  884  execution, and purpose of mental health or substance abuse
  885  treatment advance directives and the distinction between mental
  886  health treatment advance directives created under this part and
  887  those created under part I of this chapter. The department shall
  888  also develop, and publish on its website, a mental health
  889  treatment advance directive form and a substance abuse treatment
  890  advance directive form that may be used by an individual to
  891  direct future care.
  892         Section 26. Paragraph (b) of subsection (2) of section
  893  406.11, Florida Statutes, is amended to read:
  894         406.11 Examinations, investigations, and autopsies.—
  895         (2)
  896         (b) The Medical Examiners Commission shall adopt rules,
  897  pursuant to chapter 120, providing for the notification of the
  898  next of kin that an investigation by the medical examiner’s
  899  office is being conducted. A medical examiner may not retain or
  900  furnish any body part of the deceased for research or any other
  901  purpose which is not in conjunction with a determination of the
  902  identification of or cause or manner of death of the deceased or
  903  the presence of disease or which is not otherwise authorized by
  904  this chapter, part VI part V of chapter 765, or chapter 873,
  905  without notification of and approval by the next of kin.
  906         Section 27. Subsection (29) of section 408.802, Florida
  907  Statutes, is amended to read:
  908         408.802 Applicability.—The provisions of this part apply to
  909  the provision of services that require licensure as defined in
  910  this part and to the following entities licensed, registered, or
  911  certified by the agency, as described in chapters 112, 383, 390,
  912  394, 395, 400, 429, 440, 483, and 765:
  913         (29) Organ, tissue, and eye procurement organizations, as
  914  provided under part VI part V of chapter 765.
  915         Section 28. Subsection (28) of section 408.820, Florida
  916  Statutes, is amended to read:
  917         408.820 Exemptions.—Except as prescribed in authorizing
  918  statutes, the following exemptions shall apply to specified
  919  requirements of this part:
  920         (28) Organ, tissue, and eye procurement organizations, as
  921  provided under part VI part V of chapter 765, are exempt from s.
  922  408.810(5)-(10).
  923         Section 29. Subsection (1) and paragraph (d) of subsection
  924  (6) of section 765.101, Florida Statutes, are amended to read:
  925         765.101 Definitions.—As used in this chapter:
  926         (1) “Advance directive” means a witnessed written document
  927  or oral statement in which instructions are given by a principal
  928  or in which the principal’s desires are expressed concerning any
  929  aspect of the principal’s health care or health information, and
  930  includes, but is not limited to, the designation of a health
  931  care surrogate, a living will, or an anatomical gift made
  932  pursuant to part VI part V of this chapter.
  933         (6) “Health care decision” means:
  934         (d) The decision to make an anatomical gift pursuant to
  935  part VI part V of this chapter.
  936         Section 30. Section 765.203, Florida Statutes, is amended
  937  to read:
  938         765.203 Suggested form of designation.—A written
  939  designation of a health care surrogate executed pursuant to this
  940  chapter may, but need not be, in the following form:
  941  
  942                DESIGNATION OF HEALTH CARE SURROGATE               
  943  
  944  I, ...(name)..., designate as my health care surrogate under s.
  945  765.202, Florida Statutes:
  946  
  947  Name: ...(name of health care surrogate)...
  948  Address: ...(address)...
  949  Phone: ...(telephone)...
  950  
  951  If my health care surrogate is not willing, able, or reasonably
  952  available to perform his or her duties, I designate as my
  953  alternate health care surrogate:
  954  
  955  Name: ...(name of alternate health care surrogate)...
  956  Address: ...(address)...
  957  Phone: ...(telephone)...
  958  
  959                    INSTRUCTIONS FOR HEALTH CARE                   
  960  
  961  I authorize my health care surrogate to:
  962         ...(Initial here)... Receive any of my health information,
  963  whether oral or recorded in any form or medium, that:
  964         1. Is created or received by a health care provider, health
  965  care facility, health plan, public health authority, employer,
  966  life insurer, school or university, or health care
  967  clearinghouse; and
  968         2. Relates to my past, present, or future physical or
  969  mental health or condition; the provision of health care to me;
  970  or the past, present, or future payment for the provision of
  971  health care to me.
  972  I further authorize my health care surrogate to:
  973         ...(Initial here)... Make all health care decisions for me,
  974  which means he or she has the authority to:
  975         1. Provide informed consent, refusal of consent, or
  976  withdrawal of consent to any and all of my health care,
  977  including life-prolonging procedures.
  978         2. Apply on my behalf for private, public, government, or
  979  veterans’ benefits to defray the cost of health care.
  980         3. Access my health information reasonably necessary for
  981  the health care surrogate to make decisions involving my health
  982  care and to apply for benefits for me.
  983         4. Decide to make an anatomical gift pursuant to part VI
  984  part V of chapter 765, Florida Statutes.
  985         ...(Initial here)... Specific instructions and
  986  restrictions: ..................................................
  987  ................................................................
  988  ................................................................
  989  
  990  While I have decisionmaking capacity, my wishes are controlling
  991  and my physicians and health care providers must clearly
  992  communicate to me the treatment plan or any change to the
  993  treatment plan prior to its implementation.
  994  
  995  To the extent I am capable of understanding, my health care
  996  surrogate shall keep me reasonably informed of all decisions
  997  that he or she has made on my behalf and matters concerning me.
  998  
  999  THIS HEALTH CARE SURROGATE DESIGNATION IS NOT AFFECTED BY MY
 1000  SUBSEQUENT INCAPACITY EXCEPT AS PROVIDED IN CHAPTER 765, FLORIDA
 1001  STATUTES.
 1002  
 1003  PURSUANT TO SECTION 765.104, FLORIDA STATUTES, I UNDERSTAND THAT
 1004  I MAY, AT ANY TIME WHILE I RETAIN MY CAPACITY, REVOKE OR AMEND
 1005  THIS DESIGNATION BY:
 1006         (1) SIGNING A WRITTEN AND DATED INSTRUMENT WHICH EXPRESSES
 1007  MY INTENT TO AMEND OR REVOKE THIS DESIGNATION;
 1008         (2) PHYSICALLY DESTROYING THIS DESIGNATION THROUGH MY OWN
 1009  ACTION OR BY THAT OF ANOTHER PERSON IN MY PRESENCE AND UNDER MY
 1010  DIRECTION;
 1011         (3) VERBALLY EXPRESSING MY INTENTION TO AMEND OR REVOKE
 1012  THIS DESIGNATION; OR
 1013         (4) SIGNING A NEW DESIGNATION THAT IS MATERIALLY DIFFERENT
 1014  FROM THIS DESIGNATION.
 1015  
 1016  MY HEALTH CARE SURROGATE’S AUTHORITY BECOMES EFFECTIVE WHEN MY
 1017  PRIMARY PHYSICIAN DETERMINES THAT I AM UNABLE TO MAKE MY OWN
 1018  HEALTH CARE DECISIONS UNLESS I INITIAL EITHER OR BOTH OF THE
 1019  FOLLOWING BOXES:
 1020  
 1021  IF I INITIAL THIS BOX [....], MY HEALTH CARE SURROGATE’S
 1022  AUTHORITY TO RECEIVE MY HEALTH INFORMATION TAKES EFFECT
 1023  IMMEDIATELY.
 1024  
 1025  IF I INITIAL THIS BOX [....], MY HEALTH CARE SURROGATE’S
 1026  AUTHORITY TO MAKE HEALTH CARE DECISIONS FOR ME TAKES EFFECT
 1027  IMMEDIATELY. PURSUANT TO SECTION 765.204(3), FLORIDA STATUTES,
 1028  ANY INSTRUCTIONS OR HEALTH CARE DECISIONS I MAKE, EITHER
 1029  VERBALLY OR IN WRITING, WHILE I POSSESS CAPACITY SHALL SUPERSEDE
 1030  ANY INSTRUCTIONS OR HEALTH CARE DECISIONS MADE BY MY SURROGATE
 1031  THAT ARE IN MATERIAL CONFLICT WITH THOSE MADE BY ME.
 1032  
 1033  SIGNATURES: Sign and date the form here:
 1034  ...(date)...                              ...(sign your name)...
 1035  ...(address)...                          ...(print your name)...
 1036  ...(city)... ...(state)...
 1037  
 1038  SIGNATURES OF WITNESSES:
 1039  First witness                                     Second witness
 1040  ...(print name)...                            ...(print name)...
 1041  ...(address)...                                  ...(address)...
 1042  ...(city)... ...(state)...            ...(city)... ...(state)...
 1043  ...(signature of witness)...        ...(signature of witness)...
 1044  ...(date)...                                        ...(date)...
 1045         Section 31. This act shall take effect July 1, 2016.