Florida Senate - 2019                        COMMITTEE AMENDMENT
       Bill No. CS for SB 1418
       
       
       
       
       
       
                                Ì923424ÈÎ923424                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/18/2019           .                                
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       The Committee on Rules (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 renumbered as subsections (5)
    7  through (12), respectively, paragraph (a) of subsection (3) is
    8  amended, and a new subsection (4) is added to that section, to
    9  read:
   10         394.4615 Clinical records; confidentiality.—
   11         (3) Information from the clinical record may be released in
   12  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 may authorize the release of sufficient
   22  information to provide adequate warning to the person threatened
   23  with harm by the patient.
   24  
   25  For the purpose of determining whether a person meets the
   26  criteria for involuntary outpatient placement or for preparing
   27  the proposed treatment plan pursuant to s. 394.4655, the
   28  clinical record may be released to the state attorney, the
   29  public defender or the patient’s private legal counsel, the
   30  court, and to the appropriate mental health professionals,
   31  including the service provider identified in s.
   32  394.4655(7)(b)2., in accordance with state and federal law.
   33         (4)Information from the clinical record must be released
   34  when a patient has communicated to a service provider a specific
   35  threat to cause serious bodily injury or death to an identified
   36  or a readily available person, if the service provider
   37  reasonably believes, or should reasonably believe according to
   38  the standards of his or her profession, that the patient has the
   39  apparent intent and ability to imminently or immediately carry
   40  out such threat. When such communication has been made, the
   41  administrator must authorize the release of sufficient
   42  information to communicate the threat to law enforcement. A law
   43  enforcement agency that receives notification of a specific
   44  threat under this subsection must take appropriate action to
   45  prevent the risk of harm, including, but not limited to,
   46  notifying the intended victim of such threat or initiating a
   47  risk protection order. A service provider’s authorization to
   48  release information from a clinical record when communicating a
   49  threat pursuant to this section may not be the basis of any
   50  legal action or criminal or civil liability against the service
   51  provider.
   52         Section 2. Paragraph (a) of subsection (2) of section
   53  394.463, Florida Statutes, is amended, and subsection (4) is
   54  added to that section, to read:
   55         394.463 Involuntary examination.—
   56         (2) INVOLUNTARY EXAMINATION.—
   57         (a) An involuntary examination may be initiated by any one
   58  of the following means:
   59         1. A circuit or county court may enter an ex parte order
   60  stating that a person appears to meet the criteria for
   61  involuntary examination and specifying the findings on which
   62  that conclusion is based. The ex parte order for involuntary
   63  examination must be based on written or oral sworn testimony
   64  that includes specific facts that support the findings. If other
   65  less restrictive means are not available, such as voluntary
   66  appearance for outpatient evaluation, a law enforcement officer,
   67  or other designated agent of the court, shall take the person
   68  into custody and deliver him or her to an appropriate, or the
   69  nearest, facility within the designated receiving system
   70  pursuant to s. 394.462 for involuntary examination. The order of
   71  the court shall be made a part of the patient’s clinical record.
   72  A fee may not be charged for the filing of an order under this
   73  subsection. A facility accepting the patient based on this order
   74  must send a copy of the order to the department within 5 the
   75  next working days day. The order may be submitted electronically
   76  through existing data systems, if available. The order shall be
   77  valid only until the person is delivered to the facility or for
   78  the period specified in the order itself, whichever comes first.
   79  If no time limit is specified in the order, the order shall be
   80  valid for 7 days after the date that the order was signed.
   81         2. A law enforcement officer shall take a person who
   82  appears to meet the criteria for involuntary examination into
   83  custody and deliver the person or have him or her delivered to
   84  an appropriate, or the nearest, facility within the designated
   85  receiving system pursuant to s. 394.462 for examination. The
   86  officer shall execute a written report detailing the
   87  circumstances under which the person was taken into custody,
   88  which must be made a part of the patient’s clinical record. Any
   89  facility accepting the patient based on this report must send a
   90  copy of the report to the department within 5 the next working
   91  days day.
   92         3. A physician, clinical psychologist, psychiatric nurse,
   93  mental health counselor, marriage and family therapist, or
   94  clinical social worker may execute a certificate stating that he
   95  or she has examined a person within the preceding 48 hours and
   96  finds that the person appears to meet the criteria for
   97  involuntary examination and stating the observations upon which
   98  that conclusion is based. If other less restrictive means, such
   99  as voluntary appearance for outpatient evaluation, are not
  100  available, a law enforcement officer shall take into custody the
  101  person named in the certificate and deliver him or her to the
  102  appropriate, or nearest, facility within the designated
  103  receiving system pursuant to s. 394.462 for involuntary
  104  examination. The law enforcement officer shall execute a written
  105  report detailing the circumstances under which the person was
  106  taken into custody. The report and certificate shall be made a
  107  part of the patient’s clinical record. Any facility accepting
  108  the patient based on this certificate must send a copy of the
  109  certificate to the department within 5 the next working days
  110  day. The document may be submitted electronically through
  111  existing data systems, if applicable.
  112  
  113  When sending the order, report, or certificate to the
  114  department, a facility shall at a minimum provide information
  115  about which action was taken regarding the patient under
  116  paragraph (g), which information shall also be made a part of
  117  the patient’s clinical record.
  118         (4)DATA ANALYSIS.—Using data collected under paragraph
  119  (2)(a), the department shall, at a minimum, analyze data on the
  120  initiation of involuntary examinations of children, identify any
  121  patterns or trends and cases in which involuntary examinations
  122  are repeatedly initiated on the same child, study root causes
  123  for such patterns, trends, or repeated involuntary examinations,
  124  and make recommendations for encouraging alternatives to and
  125  eliminating inappropriate initiations of such examinations. The
  126  department shall submit a report on its findings and
  127  recommendations to the Governor, the President of the Senate,
  128  and the Speaker of the House of Representatives by November 1 of
  129  each odd numbered year.
  130         Section 3. Subsection (2) of section 394.917, Florida
  131  Statutes, is amended to read:
  132         394.917 Determination; commitment procedure; mistrials;
  133  housing; counsel and costs in indigent appellate cases.—
  134         (2) If the court or jury determines that the person is a
  135  sexually violent predator, upon the expiration of the
  136  incarcerative portion of all criminal sentences and disposition
  137  of any detainers, the person shall be committed to the custody
  138  of the Department of Children and Families for control, care,
  139  and treatment, and rehabilitation of criminal offenders, until
  140  such time as the person’s mental abnormality or personality
  141  disorder has so changed that it is safe for the person to be at
  142  large. At all times, persons who are detained or committed under
  143  this part shall be kept in a secure facility segregated from
  144  patients of the department who are not detained or committed
  145  under this part.
  146         Section 4. Section 456.059, Florida Statutes, is amended to
  147  read:
  148         456.059 Communications confidential; exceptions.
  149  Communications between a patient and a psychiatrist, as defined
  150  in s. 394.455, shall be held confidential and may shall not be
  151  disclosed except upon the request of the patient or the
  152  patient’s legal representative. Provision of psychiatric records
  153  and reports are shall be governed by s. 456.057. Notwithstanding
  154  any other provision of this section or s. 90.503, when where:
  155         (1) A patient is engaged in a treatment relationship with a
  156  psychiatrist;
  157         (2) Such patient has communicated to the psychiatrist a
  158  specific threat to cause serious bodily injury or death to an
  159  identified or a readily available person made an actual threat
  160  to physically harm an identifiable victim or victims; and
  161         (3) The treating psychiatrist makes a clinical judgment
  162  that the patient has the apparent intent and ability to
  163  imminently or immediately carry out such threat capability to
  164  commit such an act and that it is more likely than not that in
  165  the near future the patient will carry out that threat,
  166  
  167  the psychiatrist may disclose patient communications to the
  168  extent necessary to warn any potential victim or and must
  169  disclose patient communications to the extent necessary to
  170  communicate the threat to a law enforcement agency. A law
  171  enforcement agency that receives notification of a specific
  172  threat under this subsection must take appropriate action to
  173  prevent the risk of harm, including, but not limited to,
  174  notifying the intended victim of such threat or initiating a
  175  risk protection order. A psychiatrist’s disclosure of
  176  confidential communications when communicating a threat pursuant
  177  to this section may not be the basis of any legal action or
  178  criminal or civil liability against the psychiatrist No civil or
  179  criminal action shall be instituted, and there shall be no
  180  liability on account of disclosure of otherwise confidential
  181  communications by a psychiatrist in disclosing a threat pursuant
  182  to this section.
  183         Section 5. Section 490.0147, Florida Statutes, is amended
  184  to read:
  185         490.0147 Confidentiality and privileged communications.—
  186         (1) Any communication between a psychologist any person
  187  licensed under this chapter and her or his patient or client is
  188  shall be confidential. This privilege may be waived under the
  189  following conditions:
  190         (a)(1) When the psychologist person licensed under this
  191  chapter is a party defendant to a civil, criminal, or
  192  disciplinary action arising from a complaint filed by the
  193  patient or client, in which case the waiver shall be limited to
  194  that action.;
  195         (b)(2) When the patient or client agrees to the waiver, in
  196  writing, or when more than one person in a family is receiving
  197  therapy, when each family member agrees to the waiver, in
  198  writing.; or
  199         (c)(3) When a patient or client has communicated to the
  200  psychologist a specific threat to cause serious bodily injury or
  201  death to an identified or readily available person, and the
  202  psychologist makes a clinical judgment that the patient or
  203  client has the apparent intent and ability to imminently or
  204  immediately carry out such threat and the psychologist there is
  205  a clear and immediate probability of physical harm to the
  206  patient or client, to other individuals, or to society and the
  207  person licensed under this chapter communicates the information
  208  only to the potential victim, appropriate family member, or law
  209  enforcement or other appropriate authorities. A disclosure of
  210  confidential communications by a psychologist when communicating
  211  a threat pursuant to this subsection may not be the basis of any
  212  legal action or criminal or civil liability against the
  213  psychologist.
  214         (2)Such privilege must be waived, and the psychologist
  215  shall disclose patient or client communications to the extent
  216  necessary to communicate the threat to a law enforcement agency,
  217  if a patient or client has communicated to the psychologist a
  218  specific threat to cause serious bodily injury or death to an
  219  identified or readily available person, and the psychologist
  220  makes a clinical judgment that the patient or client has the
  221  apparent intent and ability to imminently or immediately carry
  222  out such threat. A law enforcement agency that receives
  223  notification of a specific threat under this subsection must
  224  take appropriate action to prevent the risk of harm, including,
  225  but not limited to, notifying the intended victim of such threat
  226  or initiating a risk protection order. A psychologist’s
  227  disclosure of confidential communications when communicating a
  228  threat pursuant to this subsection may not be the basis of any
  229  legal action or criminal or civil liability against the
  230  psychologist.
  231         Section 6. Section 491.0147, Florida Statutes, is amended
  232  to read:
  233         491.0147 Confidentiality and privileged communications.—Any
  234  communication between any person licensed or certified under
  235  this chapter and her or his patient or client is shall be
  236  confidential.
  237         (1) This privilege secrecy may be waived under the
  238  following conditions:
  239         (a)(1) When the person licensed or certified under this
  240  chapter is a party defendant to a civil, criminal, or
  241  disciplinary action arising from a complaint filed by the
  242  patient or client, in which case the waiver shall be limited to
  243  that action.
  244         (b)(2) When the patient or client agrees to the waiver, in
  245  writing, or, when more than one person in a family is receiving
  246  therapy, when each family member agrees to the waiver, in
  247  writing.
  248         (c)(3) When a patient or client has communicated to the
  249  person licensed or certified under this chapter a specific
  250  threat to cause serious bodily injury or death to an identified
  251  or readily available person, and the person licensed or
  252  certified under this chapter makes a clinical judgment that the
  253  patient or client has the apparent intent and ability to
  254  imminently or immediately carry out such threat, in the clinical
  255  judgment of the person licensed or certified under this chapter,
  256  there is a clear and immediate probability of physical harm to
  257  the patient or client, to other individuals, or to society and
  258  the person licensed or certified under this chapter communicates
  259  the information only to the potential victim, appropriate family
  260  member, or law enforcement or other appropriate authorities.
  261  There shall be no liability on the part of, and no cause of
  262  action of any nature shall arise against, a person licensed or
  263  certified under this chapter for the disclosure of otherwise
  264  confidential communications under this subsection. A disclosure
  265  of confidential communications by a person licensed or certified
  266  under this chapter when communicating a threat pursuant to this
  267  subsection may not be the basis of any legal action or criminal
  268  or civil liability against such person.
  269         (2)This privilege must be waived, and the person licensed
  270  or certified under this chapter shall disclose patient or client
  271  communications to the extent necessary to communicate the threat
  272  to a law enforcement agency, if a patient or client has
  273  communicated to such person a specific threat to cause serious
  274  bodily injury or death to an identified or readily available
  275  person, and the person licensed or certified under this chapter
  276  makes a clinical judgment that the patient or client has the
  277  apparent intent and ability to imminently or immediately carry
  278  out such threat. A law enforcement agency that receives
  279  notification of a specific threat under this subsection must
  280  take appropriate action to prevent the risk of harm, including,
  281  but not limited to, notifying the intended victim of such threat
  282  or initiating a risk protection order. A disclosure of
  283  confidential communications by a person licensed or certified
  284  under this chapter when communicating a threat pursuant to this
  285  subsection may not be the basis of any legal action or criminal
  286  or civil liability against such person.
  287         Section 7. Section 1012.583, Florida Statutes, is amended
  288  to read:
  289         1012.583 Continuing education and inservice training for
  290  youth suicide awareness and prevention.—
  291         (1) By July 1, 2019 Beginning with the 2016-2017 school
  292  year, the Department of Education, in consultation with the
  293  Statewide Office for Suicide Prevention and suicide prevention
  294  experts, shall develop a list of approved youth suicide
  295  awareness and prevention training materials and suicide
  296  screening instruments that may be used for training in youth
  297  suicide awareness, suicide and prevention, and suicide screening
  298  for instructional personnel in elementary school, middle school,
  299  and high school. The approved list of materials:
  300         (a)Must identify available standardized suicide screening
  301  instruments appropriate for use with a school-age population and
  302  which have validity and reliability and include information
  303  about obtaining instruction in the administration and use of
  304  such instruments.
  305         (b)(a) Must include training on how to identify appropriate
  306  mental health services and how to refer youth and their families
  307  to those services.
  308         (c)(b) May include materials currently being used by a
  309  school district if such materials meet any criteria established
  310  by the department.
  311         (d)(c) May include programs that instructional personnel
  312  can complete through a self-review of approved youth suicide
  313  awareness and prevention materials.
  314         (2) A school that chooses to incorporate 2 hours of
  315  training offered pursuant to this section shall be considered a
  316  “Suicide Prevention Certified School.if it:
  317         (a)Incorporates 2 hours of training offered pursuant to
  318  this section. The training must be included in the existing
  319  continuing education or inservice training requirements for
  320  instructional personnel and may not add to the total hours
  321  currently required by the department. A school that chooses to
  322  participate in the training must require all instructional
  323  personnel to participate.
  324         (b)Has at least two school-based staff members certified
  325  or otherwise deemed competent in the use of a suicide screening
  326  instrument approved under subsection (1) and has a policy to use
  327  such suicide risk screening instrument to evaluate a student’s
  328  suicide risk before requesting the initiation of, or initiating,
  329  an involuntary examination due to concerns about that student’s
  330  suicide risk.
  331         (3) A school that meets the criteria in subsection (2)
  332  participates in the suicide awareness and prevention training
  333  pursuant to this section must report its compliance
  334  participation to the department. The department shall keep an
  335  updated record of all Suicide Prevention Certified Schools and
  336  shall post the list of these schools on the department’s
  337  website. Each school shall also post on its own website whether
  338  it is a Suicide Prevention Certified School, and each school
  339  district shall post on its district website a list of the
  340  Suicide Prevention Certified Schools in that district.
  341         (4) A person has no cause of action for any loss or damage
  342  caused by an act or omission resulting from the implementation
  343  of this section or resulting from any training required by this
  344  section unless the loss or damage was caused by willful or
  345  wanton misconduct. This section does not create any new duty of
  346  care or basis of liability.
  347         (5) The State Board of Education may adopt rules to
  348  implement this section.
  349         Section 8. For the purpose of incorporating the amendment
  350  made by this act to section 490.0147, Florida Statutes, in a
  351  reference thereto, paragraph (u) of subsection (1) of section
  352  490.009, Florida Statutes, is reenacted to read:
  353         490.009 Discipline.—
  354         (1) The following acts constitute grounds for denial of a
  355  license or disciplinary action, as specified in s. 456.072(2):
  356         (u) Failing to maintain in confidence a communication made
  357  by a patient or client in the context of such services, except
  358  as provided in s. 490.0147.
  359         Section 9. For the purpose of incorporating the amendment
  360  made by this act to section 491.0147, Florida Statutes, in a
  361  reference thereto, paragraph (u) of subsection (1) of section
  362  491.009, Florida Statutes, is reenacted to read:
  363         491.009 Discipline.—
  364         (1) The following acts constitute grounds for denial of a
  365  license or disciplinary action, as specified in s. 456.072(2):
  366         (u) Failure of the licensee, registered intern, or
  367  certificateholder to maintain in confidence a communication made
  368  by a patient or client in the context of such services, except
  369  as provided in s. 491.0147.
  370         Section 10. This act shall take effect July 1, 2019.
  371  
  372  ================= T I T L E  A M E N D M E N T ================
  373  And the title is amended as follows:
  374         Delete everything before the enacting clause
  375  and insert:
  376                        A bill to be entitled                      
  377         An act relating to mental health; amending s.
  378         394.4615, F.S.; requiring service providers to
  379         disclose information from a clinical record under
  380         certain circumstances relating to threats to cause
  381         seriously bodily injury or death; requiring a law
  382         enforcement agency that receives notification of a
  383         specific threat to take appropriate action; providing
  384         immunity for service providers for certain actions;
  385         amending s. 394.463, F.S.; revising deadlines for
  386         submission of documentation regarding involuntary
  387         examinations; requiring additional information be
  388         included in reports to the department; requiring the
  389         department to report to the Governor and Legislature
  390         on data collected from such reports; amending s.
  391         394.917, F.S.; revising the purpose of civil
  392         commitment of sexually violent predators to the
  393         department after completion of their criminal
  394         incarceration sentences; amending s. 456.059, F.S.;
  395         requiring psychiatrists to disclose certain patient
  396         communications for purposes of notifying law
  397         enforcement agencies of certain threats; requiring the
  398         notified law enforcement agency to take appropriate
  399         action to prevent the risk of harm to the victim;
  400         providing psychiatrists with immunity from specified
  401         liability and actions under certain circumstances;
  402         amending s. 490.0147, F.S.; requiring psychologists to
  403         disclose certain patient or client communications for
  404         purposes of notifying law enforcement agencies of
  405         certain threats; requiring the notified law
  406         enforcement agency to take appropriate action to
  407         prevent the risk of harm to the victim; providing
  408         psychologists with immunity from specified liability
  409         and actions under certain circumstances; amending s.
  410         491.0147, F.S.; requiring certain license holders and
  411         certificate holders to disclose certain patient or
  412         client communications for purposes of notifying law
  413         enforcement agencies of certain threats; requiring the
  414         notified law enforcement agency to take appropriate
  415         action to prevent the risk of harm to the victim;
  416         providing such persons with immunity from specified
  417         liability and actions; amending s. 1012.583, F.S.;
  418         revising responsibilities of the Department of
  419         Education and the Statewide Office for Suicide
  420         Prevention; revising criteria for designation as a
  421         Suicide Prevention Certified School; requiring that
  422         the department, schools, and school districts post
  423         certain information regarding such schools be posted
  424         on their respective websites; reenacting ss. 490.009
  425         and 491.009, F.S., relating to discipline of
  426         psychologists and other licensed therapists, to
  427         incorporate amendments made by the act; providing an
  428         effective date.