Florida Senate - 2019 CS for SB 1418
By the Committee on Children, Families, and Elder Affairs; and
Senator Powell
586-03728-19 20191418c1
1 A bill to be entitled
2 An act relating to mental health; amending s.
3 394.4615, F.S.; requiring service providers to
4 disclose information from a clinical record under
5 certain circumstances relating to threats to cause
6 seriously bodily injury or death; amending s. 394.463,
7 F.S.; revising deadlines for submission of
8 documentation regarding involuntary examinations;
9 amending s. 456.059, F.S.; requiring, rather than
10 authorizing, psychiatrists to disclose certain patient
11 communications for purposes of notifying potential
12 victims and law enforcement agencies of certain
13 threats; amending s. 490.0147, F.S.; requiring, rather
14 than authorizing, psychologists to disclose certain
15 patient and client communications for purposes of
16 notifying potential victims and law enforcement
17 agencies of certain threats; providing psychologists
18 with immunity from specified liability and actions
19 under certain circumstances; amending s. 491.0147,
20 F.S.; requiring, rather than authorizing, certain
21 license holders and certificate holders to disclose
22 certain patient and client communications for purposes
23 of notifying potential victims and law enforcement
24 agencies of certain threats; providing such persons
25 with immunity from specified liability and actions;
26 amending s. 1012.583, F.S.; revising responsibilities
27 of the Department of Education and the Statewide
28 Office for Suicide Prevention; revising criteria for
29 designation as a Suicide Prevention Certified School;
30 requiring that the department, schools, and school
31 districts post certain information regarding such
32 schools be posted on their respective websites;
33 reenacting s. 490.009, F.S., relating to discipline of
34 psychiatrists; reenacting s. 491.009, F.S., relating
35 to discipline of psychologists; providing an effective
36 date.
37
38 Be It Enacted by the Legislature of the State of Florida:
39
40 Section 1. Present subsections (4) through (11) of section
41 394.4615, Florida Statutes, are redesignated as subsections (5)
42 through (12), respectively, a new subsection (4) is added to
43 that section, and subsection (3) of that section is amended, to
44 read:
45 394.4615 Clinical records; confidentiality.—
46 (3) Information from the clinical record must may be
47 released in the following circumstances:
48 (a) when a patient has communicated to a service provider a
49 specific threat to cause serious bodily injury or death to an
50 identified or a readily available person, if the service
51 provider reasonably believes, or should reasonably believe
52 according to the standards of his or her profession, that the
53 patient has the apparent intent and ability to imminently or
54 immediately carry out such threat declared an intention to harm
55 other persons. When such communication declaration has been
56 made, the administrator must may authorize the release of
57 sufficient information to provide adequate warning to the person
58 threatened with harm by the patient and communicate the threat
59 to law enforcement.
60 (4)(a)(b) Information from the clinical record may be
61 released when the administrator of the facility or secretary of
62 the department deems release to a qualified researcher as
63 defined in administrative rule, an aftercare treatment provider,
64 or an employee or agent of the department is necessary for
65 treatment of the patient, maintenance of adequate records,
66 compilation of treatment data, aftercare planning, or evaluation
67 of programs.
68 (b) For the purpose of determining whether a person meets
69 the criteria for involuntary outpatient placement or for
70 preparing the proposed treatment plan pursuant to s. 394.4655,
71 the clinical record may be released to the state attorney, the
72 public defender or the patient’s private legal counsel, the
73 court, and to the appropriate mental health professionals,
74 including the service provider identified in s.
75 394.4655(7)(b)2., in accordance with state and federal law.
76 Section 2. Paragraph (a) of subsection (2) of section
77 394.463, Florida Statutes, is amended to read:
78 394.463 Involuntary examination.—
79 (2) INVOLUNTARY EXAMINATION.—
80 (a) An involuntary examination may be initiated by any one
81 of the following means:
82 1. A circuit or county court may enter an ex parte order
83 stating that a person appears to meet the criteria for
84 involuntary examination and specifying the findings on which
85 that conclusion is based. The ex parte order for involuntary
86 examination must be based on written or oral sworn testimony
87 that includes specific facts that support the findings. If other
88 less restrictive means are not available, such as voluntary
89 appearance for outpatient evaluation, a law enforcement officer,
90 or other designated agent of the court, shall take the person
91 into custody and deliver him or her to an appropriate, or the
92 nearest, facility within the designated receiving system
93 pursuant to s. 394.462 for involuntary examination. The order of
94 the court shall be made a part of the patient’s clinical record.
95 A fee may not be charged for the filing of an order under this
96 subsection. A facility accepting the patient based on this order
97 must send a copy of the order to the department within 5 the
98 next working days day. The order may be submitted electronically
99 through existing data systems, if available. The order shall be
100 valid only until the person is delivered to the facility or for
101 the period specified in the order itself, whichever comes first.
102 If no time limit is specified in the order, the order shall be
103 valid for 7 days after the date that the order was signed.
104 2. A law enforcement officer shall take a person who
105 appears to meet the criteria for involuntary examination into
106 custody and deliver the person or have him or her delivered to
107 an appropriate, or the nearest, facility within the designated
108 receiving system pursuant to s. 394.462 for examination. The
109 officer shall execute a written report detailing the
110 circumstances under which the person was taken into custody,
111 which must be made a part of the patient’s clinical record. Any
112 facility accepting the patient based on this report must send a
113 copy of the report to the department within 5 the next working
114 days day.
115 3. A physician, clinical psychologist, psychiatric nurse,
116 mental health counselor, marriage and family therapist, or
117 clinical social worker may execute a certificate stating that he
118 or she has examined a person within the preceding 48 hours and
119 finds that the person appears to meet the criteria for
120 involuntary examination and stating the observations upon which
121 that conclusion is based. If other less restrictive means, such
122 as voluntary appearance for outpatient evaluation, are not
123 available, a law enforcement officer shall take into custody the
124 person named in the certificate and deliver him or her to the
125 appropriate, or nearest, facility within the designated
126 receiving system pursuant to s. 394.462 for involuntary
127 examination. The law enforcement officer shall execute a written
128 report detailing the circumstances under which the person was
129 taken into custody. The report and certificate shall be made a
130 part of the patient’s clinical record. Any facility accepting
131 the patient based on this certificate must send a copy of the
132 certificate to the department within 5 the next working days
133 day. The document may be submitted electronically through
134 existing data systems, if applicable.
135 Section 3. Section 456.059, Florida Statutes, is amended to
136 read:
137 456.059 Communications confidential; exceptions.
138 Communications between a patient and a psychiatrist, as defined
139 in s. 394.455, shall be held confidential and may shall not be
140 disclosed except upon the request of the patient or the
141 patient’s legal representative. Provision of psychiatric records
142 and reports are shall be governed by s. 456.057. Notwithstanding
143 any other provision of this section or s. 90.503, when where:
144 (1) A patient is engaged in a treatment relationship with a
145 psychiatrist;
146 (2) Such patient has communicated to the psychiatrist a
147 specific threat to cause serious bodily injury or death to an
148 identified or a readily available person made an actual threat
149 to physically harm an identifiable victim or victims; and
150 (3) The treating psychiatrist makes a clinical judgment
151 that the patient has the apparent intent and ability to
152 imminently or immediately carry out such threat capability to
153 commit such an act and that it is more likely than not that in
154 the near future the patient will carry out that threat,
155
156 the psychiatrist shall may disclose patient communications to
157 the extent necessary to warn any potential victim or to
158 communicate the threat to a law enforcement agency. A
159 psychiatrist’s disclosure of confidential communications when
160 communicating a threat pursuant to this section may not be the
161 basis of any legal action or criminal or civil liability against
162 the psychiatrist No civil or criminal action shall be
163 instituted, and there shall be no liability on account of
164 disclosure of otherwise confidential communications by a
165 psychiatrist in disclosing a threat pursuant to this section.
166 Section 4. Section 490.0147, Florida Statutes, is amended
167 to read:
168 490.0147 Confidentiality and privileged communications.—
169 (1) Any communication between a psychologist any person
170 licensed under this chapter and her or his patient or client is
171 shall be confidential. This privilege may be waived under the
172 following conditions:
173 (a)(1) When the psychologist person licensed under this
174 chapter is a party defendant to a civil, criminal, or
175 disciplinary action arising from a complaint filed by the
176 patient or client, in which case the waiver shall be limited to
177 that action; or.
178 (b)(2) When the patient or client agrees to the waiver, in
179 writing, or when more than one person in a family is receiving
180 therapy, when each family member agrees to the waiver, in
181 writing.
182 (2) Such privilege must be waived, and the psychologist
183 shall disclose patient and client communications to the extent
184 necessary to warn any potential victim and to communicate the
185 threat to a law enforcement agency, if a patient or client has
186 communicated to the psychologist a specific threat to cause
187 serious bodily injury or death to an identified or readily
188 available person, and the psychologist makes a clinical judgment
189 that the patient or client has the apparent intent and ability
190 to imminently or immediately carry out such threat. A
191 psychologist’s disclosure of confidential communications when
192 communicating a threat pursuant to this subsection may not be
193 the basis of any legal action or criminal or civil liability
194 against the psychologist
195 (3) When there is a clear and immediate probability of
196 physical harm to the patient or client, to other individuals, or
197 to society and the person licensed under this chapter
198 communicates the information only to the potential victim,
199 appropriate family member, or law enforcement or other
200 appropriate authorities.
201 Section 5. Section 491.0147, Florida Statutes, is amended
202 to read:
203 491.0147 Confidentiality and privileged communications.—Any
204 communication between any person licensed or certified under
205 this chapter and her or his patient or client is shall be
206 confidential.
207 (1) This privilege secrecy may be waived under the
208 following conditions:
209 (a)(1) When the person licensed or certified under this
210 chapter is a party defendant to a civil, criminal, or
211 disciplinary action arising from a complaint filed by the
212 patient or client, in which case the waiver shall be limited to
213 that action.
214 (b)(2) When the patient or client agrees to the waiver, in
215 writing, or, when more than one person in a family is receiving
216 therapy, when each family member agrees to the waiver, in
217 writing.
218 (2) This privilege must be waived, and the person licensed
219 or certified under this chapter shall disclose patient and
220 client communications to the extent necessary to warn any
221 potential victim and to communicate the threat to a law
222 enforcement agency, if a patient or client has communicated to
223 such person a specific threat to cause serious bodily injury or
224 death to an identified or readily available person, and the
225 person licensed or certified under this chapter makes a clinical
226 judgment that the patient or client has the apparent intent and
227 ability to imminently or immediately carry out such threat. A
228 disclosure of confidential communications by a person licensed
229 or certified under this chapter when communicating a threat
230 pursuant to this subsection may not be the basis of any legal
231 action or criminal or civil liability against such person
232 (3) When, in the clinical judgment of the person licensed
233 or certified under this chapter, there is a clear and immediate
234 probability of physical harm to the patient or client, to other
235 individuals, or to society and the person licensed or certified
236 under this chapter communicates the information only to the
237 potential victim, appropriate family member, or law enforcement
238 or other appropriate authorities. There shall be no liability on
239 the part of, and no cause of action of any nature shall arise
240 against, a person licensed or certified under this chapter for
241 the disclosure of otherwise confidential communications under
242 this subsection.
243 Section 6. Section 1012.583, Florida Statutes, is amended
244 to read:
245 1012.583 Continuing education and inservice training for
246 youth suicide awareness and prevention.—
247 (1) By July 1, 2019 Beginning with the 2016-2017 school
248 year, the Department of Education, in consultation with the
249 Statewide Office for Suicide Prevention and suicide prevention
250 experts, shall develop a list of approved youth suicide
251 awareness and prevention training materials and suicide
252 screening instruments that may be used for training in youth
253 suicide awareness, suicide and prevention, and suicide screening
254 for instructional personnel in elementary school, middle school,
255 and high school. The approved list of materials:
256 (a) Must identify available standardized suicide screening
257 instruments appropriate for use with a school-age population and
258 which have validity and reliability and include information
259 about obtaining instruction in the administration and use of
260 such instruments.
261 (b)(a) Must include training on how to identify appropriate
262 mental health services and how to refer youth and their families
263 to those services.
264 (c)(b) May include materials currently being used by a
265 school district if such materials meet any criteria established
266 by the department.
267 (d)(c) May include programs that instructional personnel
268 can complete through a self-review of approved youth suicide
269 awareness and prevention materials.
270 (2) A school that chooses to incorporate 2 hours of
271 training offered pursuant to this section shall be considered a
272 “Suicide Prevention Certified School.” if it:
273 (a) Incorporates 2 hours of training offered pursuant to
274 this section. The training must be included in the existing
275 continuing education or inservice training requirements for
276 instructional personnel and may not add to the total hours
277 currently required by the department. A school that chooses to
278 participate in the training must require all instructional
279 personnel to participate.
280 (b) Has at least two school-based staff members certified
281 or otherwise deemed competent in the use of a suicide screening
282 instrument approved under subsection (1) and has a policy to use
283 such suicide risk screening instrument to evaluate a student’s
284 suicide risk before requesting the initiation of, or initiating,
285 an involuntary examination due to concerns about that student’s
286 suicide risk.
287 (3) A school that meets the criteria in subsection (2)
288 participates in the suicide awareness and prevention training
289 pursuant to this section must report its compliance
290 participation to the department. The department shall keep an
291 updated record of all Suicide Prevention Certified Schools and
292 shall post the list of these schools on the department’s
293 website. Each school shall also post on its own website whether
294 it is a Suicide Prevention Certified School, and each school
295 district shall post on its district website a list of the
296 Suicide Prevention Certified Schools in that district.
297 (4) A person has no cause of action for any loss or damage
298 caused by an act or omission resulting from the implementation
299 of this section or resulting from any training required by this
300 section unless the loss or damage was caused by willful or
301 wanton misconduct. This section does not create any new duty of
302 care or basis of liability.
303 (5) The State Board of Education may adopt rules to
304 implement this section.
305 Section 7. For the purpose of incorporating the amendment
306 made by this act to section 490.0147, Florida Statutes, in a
307 reference thereto, paragraph (u) of subsection (1) of section
308 490.009, Florida Statutes, is reenacted to read:
309 490.009 Discipline.—
310 (1) The following acts constitute grounds for denial of a
311 license or disciplinary action, as specified in s. 456.072(2):
312 (u) Failing to maintain in confidence a communication made
313 by a patient or client in the context of such services, except
314 as provided in s. 490.0147.
315 Section 8. For the purpose of incorporating the amendment
316 made by this act to section 491.0147, Florida Statutes, in a
317 reference thereto, paragraph (u) of subsection (1) of section
318 491.009, Florida Statutes, is reenacted to read:
319 491.009 Discipline.—
320 (1) The following acts constitute grounds for denial of a
321 license or disciplinary action, as specified in s. 456.072(2):
322 (u) Failure of the licensee, registered intern, or
323 certificateholder to maintain in confidence a communication made
324 by a patient or client in the context of such services, except
325 as provided in s. 491.0147.
326 Section 9. This act shall take effect upon becoming a law.