Florida Senate - 2019                        COMMITTEE AMENDMENT
       Bill No. SB 1418
       
       
       
       
       
       
                                Ì178120qÎ178120                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/02/2019           .                                
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       The Committee on Children, Families, and Elder Affairs (Powell)
       recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Present subsections (4) through (11) of section
    6  394.4615, Florida Statutes, are redesignated as subsections (5)
    7  through (12), respectively, a new subsection (4) is added to
    8  that section, and subsection (3) of that section is amended, to
    9  read:
   10         394.4615 Clinical records; confidentiality.—
   11         (3) Information from the clinical record must may be
   12  released in the following circumstances:
   13         (a) when a patient has communicated to a service provider a
   14  specific threat to cause serious bodily injury or death to an
   15  identified or a readily available person, if the service
   16  provider reasonably believes, or should reasonably believe
   17  according to the standards of his or her profession, that the
   18  patient has the apparent intent and ability to imminently or
   19  immediately carry out such threat declared an intention to harm
   20  other persons. When such communication declaration has been
   21  made, the administrator must may authorize the release of
   22  sufficient information to provide adequate warning to the person
   23  threatened with harm by the patient and communicate the threat
   24  to law enforcement.
   25         (4)(a)(b)Information from the clinical record may be
   26  released when the administrator of the facility or secretary of
   27  the department deems release to a qualified researcher as
   28  defined in administrative rule, an aftercare treatment provider,
   29  or an employee or agent of the department is necessary for
   30  treatment of the patient, maintenance of adequate records,
   31  compilation of treatment data, aftercare planning, or evaluation
   32  of programs.
   33         (b) For the purpose of determining whether a person meets
   34  the criteria for involuntary outpatient placement or for
   35  preparing the proposed treatment plan pursuant to s. 394.4655,
   36  the clinical record may be released to the state attorney, the
   37  public defender or the patient’s private legal counsel, the
   38  court, and to the appropriate mental health professionals,
   39  including the service provider identified in s.
   40  394.4655(7)(b)2., in accordance with state and federal law.
   41         Section 2. Paragraph (a) of subsection (2) of section
   42  394.463, Florida Statutes, is amended to read:
   43         394.463 Involuntary examination.—
   44         (2) INVOLUNTARY EXAMINATION.—
   45         (a) An involuntary examination may be initiated by any one
   46  of the following means:
   47         1. A circuit or county court may enter an ex parte order
   48  stating that a person appears to meet the criteria for
   49  involuntary examination and specifying the findings on which
   50  that conclusion is based. The ex parte order for involuntary
   51  examination must be based on written or oral sworn testimony
   52  that includes specific facts that support the findings. If other
   53  less restrictive means are not available, such as voluntary
   54  appearance for outpatient evaluation, a law enforcement officer,
   55  or other designated agent of the court, shall take the person
   56  into custody and deliver him or her to an appropriate, or the
   57  nearest, facility within the designated receiving system
   58  pursuant to s. 394.462 for involuntary examination. The order of
   59  the court shall be made a part of the patient’s clinical record.
   60  A fee may not be charged for the filing of an order under this
   61  subsection. A facility accepting the patient based on this order
   62  must send a copy of the order to the department within 5 the
   63  next working days day. The order may be submitted electronically
   64  through existing data systems, if available. The order shall be
   65  valid only until the person is delivered to the facility or for
   66  the period specified in the order itself, whichever comes first.
   67  If no time limit is specified in the order, the order shall be
   68  valid for 7 days after the date that the order was signed.
   69         2. A law enforcement officer shall take a person who
   70  appears to meet the criteria for involuntary examination into
   71  custody and deliver the person or have him or her delivered to
   72  an appropriate, or the nearest, facility within the designated
   73  receiving system pursuant to s. 394.462 for examination. The
   74  officer shall execute a written report detailing the
   75  circumstances under which the person was taken into custody,
   76  which must be made a part of the patient’s clinical record. Any
   77  facility accepting the patient based on this report must send a
   78  copy of the report to the department within 5 the next working
   79  days day.
   80         3. A physician, clinical psychologist, psychiatric nurse,
   81  mental health counselor, marriage and family therapist, or
   82  clinical social worker may execute a certificate stating that he
   83  or she has examined a person within the preceding 48 hours and
   84  finds that the person appears to meet the criteria for
   85  involuntary examination and stating the observations upon which
   86  that conclusion is based. If other less restrictive means, such
   87  as voluntary appearance for outpatient evaluation, are not
   88  available, a law enforcement officer shall take into custody the
   89  person named in the certificate and deliver him or her to the
   90  appropriate, or nearest, facility within the designated
   91  receiving system pursuant to s. 394.462 for involuntary
   92  examination. The law enforcement officer shall execute a written
   93  report detailing the circumstances under which the person was
   94  taken into custody. The report and certificate shall be made a
   95  part of the patient’s clinical record. Any facility accepting
   96  the patient based on this certificate must send a copy of the
   97  certificate to the department within 5 the next working days
   98  day. The document may be submitted electronically through
   99  existing data systems, if applicable.
  100         Section 3. Section 456.059, Florida Statutes, is amended to
  101  read:
  102         456.059 Communications confidential; exceptions.
  103  Communications between a patient and a psychiatrist, as defined
  104  in s. 394.455, shall be held confidential and may shall not be
  105  disclosed except upon the request of the patient or the
  106  patient’s legal representative. Provision of psychiatric records
  107  and reports are shall be governed by s. 456.057. Notwithstanding
  108  any other provision of this section or s. 90.503, when where:
  109         (1) A patient is engaged in a treatment relationship with a
  110  psychiatrist;
  111         (2) Such patient has communicated to the psychiatrist a
  112  specific threat to cause serious bodily injury or death to an
  113  identified or a readily available person made an actual threat
  114  to physically harm an identifiable victim or victims; and
  115         (3) The treating psychiatrist makes a clinical judgment
  116  that the patient has the apparent intent and ability to
  117  imminently or immediately carry out such threat capability to
  118  commit such an act and that it is more likely than not that in
  119  the near future the patient will carry out that threat,
  120  
  121  the psychiatrist shall may disclose patient communications to
  122  the extent necessary to warn any potential victim or to
  123  communicate the threat to a law enforcement agency. A
  124  psychiatrist’s disclosure of confidential communications when
  125  communicating a threat pursuant to this section may not be the
  126  basis of any legal action or criminal or civil liability against
  127  the psychiatrist No civil or criminal action shall be
  128  instituted, and there shall be no liability on account of
  129  disclosure of otherwise confidential communications by a
  130  psychiatrist in disclosing a threat pursuant to this section.
  131         Section 4. Section 490.0147, Florida Statutes, is amended
  132  to read:
  133         490.0147 Confidentiality and privileged communications.—
  134         (1) Any communication between a psychologist any person
  135  licensed under this chapter and her or his patient or client is
  136  shall be confidential. This privilege may be waived under the
  137  following conditions:
  138         (a)(1) When the psychologist person licensed under this
  139  chapter is a party defendant to a civil, criminal, or
  140  disciplinary action arising from a complaint filed by the
  141  patient or client, in which case the waiver shall be limited to
  142  that action; or.
  143         (b)(2) When the patient or client agrees to the waiver, in
  144  writing, or when more than one person in a family is receiving
  145  therapy, when each family member agrees to the waiver, in
  146  writing.
  147         (2) Such privilege must be waived, and the psychologist
  148  shall disclose patient and client communications to the extent
  149  necessary to warn any potential victim and to communicate the
  150  threat to a law enforcement agency, if a patient or client has
  151  communicated to the psychologist a specific threat to cause
  152  serious bodily injury or death to an identified or readily
  153  available person, and the psychologist makes a clinical judgment
  154  that the patient or client has the apparent intent and ability
  155  to imminently or immediately carry out such threat. A
  156  psychologist’s disclosure of confidential communications when
  157  communicating a threat pursuant to this subsection may not be
  158  the basis of any legal action or criminal or civil liability
  159  against the psychologist
  160         (3) When there is a clear and immediate probability of
  161  physical harm to the patient or client, to other individuals, or
  162  to society and the person licensed under this chapter
  163  communicates the information only to the potential victim,
  164  appropriate family member, or law enforcement or other
  165  appropriate authorities.
  166         Section 5. Section 491.0147, Florida Statutes, is amended
  167  to read:
  168         491.0147 Confidentiality and privileged communications.—Any
  169  communication between any person licensed or certified under
  170  this chapter and her or his patient or client is shall be
  171  confidential.
  172         (1) This privilege secrecy may be waived under the
  173  following conditions:
  174         (a)(1) When the person licensed or certified under this
  175  chapter is a party defendant to a civil, criminal, or
  176  disciplinary action arising from a complaint filed by the
  177  patient or client, in which case the waiver shall be limited to
  178  that action.
  179         (b)(2) When the patient or client agrees to the waiver, in
  180  writing, or, when more than one person in a family is receiving
  181  therapy, when each family member agrees to the waiver, in
  182  writing.
  183         (2) This privilege must be waived, and the person licensed
  184  or certified under this chapter shall disclose patient and
  185  client communications to the extent necessary to warn any
  186  potential victim and to communicate the threat to a law
  187  enforcement agency, if a patient or client has communicated to
  188  such person a specific threat to cause serious bodily injury or
  189  death to an identified or readily available person, and the
  190  person licensed or certified under this chapter makes a clinical
  191  judgment that the patient or client has the apparent intent and
  192  ability to imminently or immediately carry out such threat. A
  193  disclosure of confidential communications by a person licensed
  194  or certified under this chapter when communicating a threat
  195  pursuant to this subsection may not be the basis of any legal
  196  action or criminal or civil liability against such person
  197         (3) When, in the clinical judgment of the person licensed
  198  or certified under this chapter, there is a clear and immediate
  199  probability of physical harm to the patient or client, to other
  200  individuals, or to society and the person licensed or certified
  201  under this chapter communicates the information only to the
  202  potential victim, appropriate family member, or law enforcement
  203  or other appropriate authorities. There shall be no liability on
  204  the part of, and no cause of action of any nature shall arise
  205  against, a person licensed or certified under this chapter for
  206  the disclosure of otherwise confidential communications under
  207  this subsection.
  208         Section 6. Section 1012.583, Florida Statutes, is amended
  209  to read:
  210         1012.583 Continuing education and inservice training for
  211  youth suicide awareness and prevention.—
  212         (1) By July 1, 2019 Beginning with the 2016-2017 school
  213  year, the Department of Education, in consultation with the
  214  Statewide Office for Suicide Prevention and suicide prevention
  215  experts, shall develop a list of approved youth suicide
  216  awareness and prevention training materials and suicide
  217  screening instruments that may be used for training in youth
  218  suicide awareness, suicide and prevention, and suicide screening
  219  for instructional personnel in elementary school, middle school,
  220  and high school. The approved list of materials:
  221         (a)Must identify available standardized suicide screening
  222  instruments appropriate for use with a school-age population and
  223  which have validity and reliability and include information
  224  about obtaining instruction in the administration and use of
  225  such instruments.
  226         (b)(a) Must include training on how to identify appropriate
  227  mental health services and how to refer youth and their families
  228  to those services.
  229         (c)(b) May include materials currently being used by a
  230  school district if such materials meet any criteria established
  231  by the department.
  232         (d)(c) May include programs that instructional personnel
  233  can complete through a self-review of approved youth suicide
  234  awareness and prevention materials.
  235         (2) A school that chooses to incorporate 2 hours of
  236  training offered pursuant to this section shall be considered a
  237  “Suicide Prevention Certified School.if it:
  238         (a)Incorporates 2 hours of training offered pursuant to
  239  this section. The training must be included in the existing
  240  continuing education or inservice training requirements for
  241  instructional personnel and may not add to the total hours
  242  currently required by the department. A school that chooses to
  243  participate in the training must require all instructional
  244  personnel to participate.
  245         (b)Has at least two school-based staff members certified
  246  or otherwise deemed competent in the use of a suicide screening
  247  instrument approved under subsection (1) and has a policy to use
  248  such suicide risk screening instrument to evaluate a student’s
  249  suicide risk before requesting the initiation of, or initiating,
  250  an involuntary examination due to concerns about that student’s
  251  suicide risk.
  252         (3) A school that meets the criteria in subsection (2)
  253  participates in the suicide awareness and prevention training
  254  pursuant to this section must report its compliance
  255  participation to the department. The department shall keep an
  256  updated record of all Suicide Prevention Certified Schools and
  257  shall post the list of these schools on the department’s
  258  website. Each school shall also post on its own website whether
  259  it is a Suicide Prevention Certified School, and each school
  260  district shall post on its district website a list of the
  261  Suicide Prevention Certified Schools in that district.
  262         (4) A person has no cause of action for any loss or damage
  263  caused by an act or omission resulting from the implementation
  264  of this section or resulting from any training required by this
  265  section unless the loss or damage was caused by willful or
  266  wanton misconduct. This section does not create any new duty of
  267  care or basis of liability.
  268         (5) The State Board of Education may adopt rules to
  269  implement this section.
  270         Section 7. For the purpose of incorporating the amendment
  271  made by this act to section 490.0147, Florida Statutes, in a
  272  reference thereto, paragraph (u) of subsection (1) of section
  273  490.009, Florida Statutes, is reenacted to read:
  274         490.009 Discipline.—
  275         (1) The following acts constitute grounds for denial of a
  276  license or disciplinary action, as specified in s. 456.072(2):
  277         (u) Failing to maintain in confidence a communication made
  278  by a patient or client in the context of such services, except
  279  as provided in s. 490.0147.
  280         Section 8. For the purpose of incorporating the amendment
  281  made by this act to section 491.0147, Florida Statutes, in a
  282  reference thereto, paragraph (u) of subsection (1) of section
  283  491.009, Florida Statutes, is reenacted to read:
  284         491.009 Discipline.—
  285         (1) The following acts constitute grounds for denial of a
  286  license or disciplinary action, as specified in s. 456.072(2):
  287         (u) Failure of the licensee, registered intern, or
  288  certificateholder to maintain in confidence a communication made
  289  by a patient or client in the context of such services, except
  290  as provided in s. 491.0147.
  291         Section 9. This act shall take effect upon becoming a law.
  292  
  293  ================= T I T L E  A M E N D M E N T ================
  294  And the title is amended as follows:
  295         Delete everything before the enacting clause
  296  and insert:
  297                        A bill to be entitled                      
  298         An act relating to mental health; amending s.
  299         394.4615, F.S.; requiring service providers to
  300         disclose information from a clinical record under
  301         certain circumstances relating to threats to cause
  302         seriously bodily injury or death; amending s. 394.463,
  303         F.S.; revising deadlines for submission of
  304         documentation regarding involuntary examinations;
  305         amending s. 456.059, F.S.; requiring, rather than
  306         authorizing, psychiatrists to disclose certain patient
  307         communications for purposes of notifying potential
  308         victims and law enforcement agencies of certain
  309         threats; amending s. 490.0147, F.S.; requiring, rather
  310         than authorizing, psychologists to disclose certain
  311         patient and client communications for purposes of
  312         notifying potential victims and law enforcement
  313         agencies of certain threats; providing psychologists
  314         with immunity from specified liability and actions
  315         under certain circumstances; amending s. 491.0147,
  316         F.S.; requiring, rather than authorizing, certain
  317         license holders and certificate holders to disclose
  318         certain patient and client communications for purposes
  319         of notifying potential victims and law enforcement
  320         agencies of certain threats; providing such persons
  321         with immunity from specified liability and actions;
  322         amending s. 1012.583, F.S.; revising responsibilities
  323         of the Department of Education and the Statewide
  324         Office for Suicide Prevention; revising criteria for
  325         designation as a Suicide Prevention Certified School;
  326         requiring that the department, schools, and school
  327         districts post certain information regarding such
  328         schools be posted on their respective websites;
  329         reenacting s. 490.009, F.S., relating to discipline of
  330         psychiatrists; reenacting s. 491.009, F.S., relating
  331         to discipline of psychologists; providing an effective
  332         date.