Florida Senate - 2020 CS for SB 7012
By the Committees on Appropriations; and Children, Families, and
Elder Affairs; and Senator Rouson
1 A bill to be entitled
2 An act relating to mental health and substance abuse;
3 amending s. 14.2019, F.S.; providing additional duties
4 for the Statewide Office for Suicide Prevention;
5 establishing the First Responders Suicide Deterrence
6 Task Force adjunct to the office; specifying the task
7 force’s purpose; providing for the composition and the
8 duties of the task force; requiring the task force to
9 submit reports to the Governor and the Legislature on
10 an annual basis; providing for future repeal; amending
11 s. 14.20195, F.S.; providing additional duties for the
12 Suicide Prevention Coordinating Council; revising the
13 composition of the council; amending s. 334.044, F.S.;
14 requiring the Department of Transportation to work
15 with the office in developing a plan relating to
16 evidence-based suicide deterrents in certain
17 locations; amending s. 394.455, F.S.; defining the
18 term “coordinated specialty care program”; revising
19 the definition of the term “mental illness”; amending
20 s. 394.4573, F.S.; revising the requirements for the
21 annual state behavioral health services assessment;
22 revising the essential elements of a coordinated
23 system of care; amending s. 394.463, F.S.; requiring
24 that certain information be provided to the guardian
25 or representative of a minor patient released from
26 involuntary examination; amending s. 394.658, F.S.;
27 revising the application criteria for the Criminal
28 Justice, Mental Health, and Substance Abuse
29 Reinvestment Grant Program to include support for
30 coordinated specialty care programs; amending s.
31 394.67, F.S.; defining the term “coordinated specialty
32 care program”; amending s. 397.311, F.S.; redefining
33 the term “medication-assisted treatment opiate
34 addiction” as “medication-assisted treatment for
35 opioid use disorders”; amending s. 397.321, F.S.;
36 deleting a provision requiring the Department of
37 Children and Families to develop a certification
38 process by rule for community substance abuse
39 prevention coalitions; amending s. 397.4012, F.S.;
40 revising applicability for certain licensure
41 exemptions; creating s. 456.0342, F.S.; providing
42 applicability; requiring specified persons to complete
43 certain suicide prevention education courses by a
44 specified date; requiring certain boards to include
45 the hours for such courses in the total hours of
46 continuing education required for the profession;
47 creating s. 786.1516, F.S.; defining the terms
48 “emergency care” and “suicide emergency”; providing
49 that persons providing certain emergency care are not
50 liable for civil damages or penalties under certain
51 circumstances; amending s. 916.106, F.S.; revising the
52 definition of the term “mental illness”; amending ss.
53 916.13 and 916.15, F.S.; requiring the department to
54 request a defendant’s medical information from a jail
55 within a certain timeframe after receiving a
56 commitment order and other required documentation;
57 requiring the jail to provide such information within
58 a certain timeframe; requiring the continued
59 administration of psychotropic medication to a
60 defendant if he or she is receiving such medication at
61 a mental health facility at the time that he or she is
62 discharged and transferred to the jail; providing an
63 exception; requiring the jail and department
64 physicians to collaborate on a defendant’s medication
65 changes for certain purposes; specifying that the jail
66 physician has the final authority regarding the
67 administering of medication to an inmate; amending ss.
68 1002.33 and 1012.583, F.S.; requiring charter schools
69 and public schools, respectively, to incorporate
70 certain training on suicide prevention in continuing
71 education and inservice training requirements;
72 providing that such schools must require all
73 instructional personnel to participate in the
74 training; requiring such schools to have a specified
75 minimum number of staff members who are certified or
76 deemed competent in the use of suicide screening
77 instruments; requiring such schools to have a policy
78 for such instruments; requiring such schools to report
79 certain compliance to the Department of Education;
80 conforming provisions to changes made by the act;
81 amending ss. 39.407, 394.495, 394.496, 394.674,
82 394.74, 394.9085, 409.972, 464.012, and 744.2007,
83 F.S.; conforming cross-references; requiring the
84 Office of Program Policy Analysis and Government
85 Accountability to perform a review of certain programs
86 and efforts relating to suicide prevention programs in
87 other states and make certain recommendations;
88 requiring the office to submit a report to the
89 Legislature by a specified date; providing an
90 appropriation; authorizing positions; providing an
91 effective date.
93 Be It Enacted by the Legislature of the State of Florida:
95 Section 1. Paragraphs (a) and (d) of subsection (2) of
96 section 14.2019, Florida Statutes, are amended, paragraphs (e)
97 and (f) are added to that subsection, and subsection (5) is
98 added to that section, to read:
99 14.2019 Statewide Office for Suicide Prevention.—
100 (2) The statewide office shall, within available resources:
101 (a) Develop a network of community-based programs to
102 improve suicide prevention initiatives. The network shall
103 identify and work to eliminate barriers to providing suicide
104 prevention services to individuals who are at risk of suicide.
105 The network shall consist of stakeholders advocating suicide
106 prevention, including, but not limited to, not-for-profit
107 suicide prevention organizations, faith-based suicide prevention
108 organizations, law enforcement agencies, first responders to
109 emergency calls, veterans, servicemembers, suicide prevention
110 community coalitions, schools and universities, mental health
111 agencies, substance abuse treatment agencies, health care
112 providers, and school personnel.
113 (d) Coordinate education and training curricula in suicide
114 prevention efforts for law enforcement personnel, first
115 responders to emergency calls, veterans, servicemembers, health
116 care providers, school employees, and other persons who may have
117 contact with persons at risk of suicide.
118 (e) Act as a clearinghouse for information and resources
119 related to suicide prevention by:
120 1. Disseminating and sharing evidence-based best practices
121 relating to suicide prevention;
122 2. Collecting and analyzing data on trends in suicide and
123 suicide attempts annually by county, age, gender, profession,
124 and other demographics as designated by the statewide office.
125 (f) Advise the Department of Transportation on the
126 implementation of evidence-based suicide deterrents in the
127 design elements and features of infrastructure projects
128 throughout the state.
129 (5) The First Responders Suicide Deterrence Task Force, a
130 task force as defined in s. 20.03(8), is created adjunct to the
131 Statewide Office for Suicide Prevention.
132 (a) The purpose of the task force is to make
133 recommendations on how to reduce the incidence of suicide and
134 attempted suicide among employed or retired first responders in
135 this state.
136 (b) The task force is composed of a representative of the
137 statewide office and a representative of each of the following
138 first responder organizations, nominated by the organization and
139 appointed by the Secretary of Children and Families:
140 1. The Florida Professional Firefighters.
141 2. The Florida Police Benevolent Association.
142 3. The Florida Fraternal Order of Police: State Lodge.
143 4. The Florida Sheriffs Association.
144 5. The Florida Police Chiefs Association.
145 6. The Florida Fire Chiefs’ Association.
146 (c) The task force shall elect a chair from among its
147 membership. Except as otherwise provided, the task force shall
148 operate in a manner consistent with s. 20.052.
149 (d) The task force shall identify or make recommendations
150 on developing training programs and materials that would better
151 enable first responders to cope with personal life stressors and
152 stress related to their profession and foster an organizational
153 culture that:
154 1. Promotes mutual support and solidarity among active and
155 retired first responders;
156 2. Trains agency supervisors and managers to identify
157 suicidal risk among active and retired first responders;
158 3. Improves the use and awareness of existing resources
159 among active and retired first responders; and
160 4. Educates active and retired first responders on suicide
161 awareness and help-seeking.
162 (e) The task force shall identify state and federal public
163 resources, funding and grants, first responder association
164 resources, and private resources to implement identified
165 training programs and materials.
166 (f) The task force shall report on its findings and
167 recommendations for training programs and materials to deter
168 suicide among active and retired first responders to the
169 Governor, the President of the Senate, and the Speaker of the
170 House of Representatives by each July 1, beginning in 2021, and
171 through 2023.
172 (g) This subsection is repealed July 1, 2023.
173 Section 2. Paragraph (c) of subsection (1) and subsection
174 (2) of section 14.20195, Florida Statutes, are amended, and
175 paragraph (d) is added to subsection (1) of that section, to
177 14.20195 Suicide Prevention Coordinating Council; creation;
178 membership; duties.—There is created within the Statewide Office
179 for Suicide Prevention a Suicide Prevention Coordinating
180 Council. The council shall develop strategies for preventing
182 (1) SCOPE OF ACTIVITY.—The Suicide Prevention Coordinating
183 Council is a coordinating council as defined in s. 20.03 and
185 (c) Make findings and recommendations regarding suicide
186 prevention programs and activities, including, but not limited
187 to, the implementation of evidence-based mental health awareness
188 and assistance training programs and gatekeeper training in
189 municipalities throughout the state. The council shall prepare
190 an annual report and present it to the Governor, the President
191 of the Senate, and the Speaker of the House of Representatives
192 by January 1, each year. The annual report must describe the
193 status of existing and planned initiatives identified in the
194 statewide plan for suicide prevention and any recommendations
195 arising therefrom.
196 (d) In conjunction with the Department of Children and
197 Families, advise members of the public on the locations and
198 availability of local behavioral health providers.
199 (2) MEMBERSHIP.—The Suicide Prevention Coordinating Council
200 shall consist of 32
27 voting members and one nonvoting member.
201 (a) Eighteen Thirteen members shall be appointed by the
202 director of the Statewide Office for Suicide Prevention and
203 shall represent the following organizations:
204 1. The Florida Association of School Psychologists.
205 2. The Florida Sheriffs Association.
206 3. The Suicide Prevention Action Network USA.
207 4. The Florida Initiative of Suicide Prevention.
208 5. The Florida Suicide Prevention Coalition.
209 6. The American Foundation of Suicide Prevention.
210 7. The Florida School Board Association.
211 8. The National Council for Suicide Prevention.
212 9. The state chapter of AARP.
213 10. The Florida Behavioral Health Association The Florida
214 Alcohol and Drug Abuse Association.
215 11. The Florida Council for Community Mental Health.
216 12. The Florida Counseling Association.
217 12. 13. NAMI Florida.
218 13. The Florida Medical Association.
219 14. The Florida Osteopathic Medical Association.
220 15. The Florida Psychiatric Society.
221 16. The Florida Psychological Association.
222 17. Veterans Florida.
223 18. The Florida Association of Managing Entities.
224 (b) The following state officials or their designees shall
225 serve on the coordinating council:
226 1. The Secretary of Elderly Affairs.
227 2. The State Surgeon General.
228 3. The Commissioner of Education.
229 4. The Secretary of Health Care Administration.
230 5. The Secretary of Juvenile Justice.
231 6. The Secretary of Corrections.
232 7. The executive director of the Department of Law
234 8. The executive director of the Department of Veterans’
236 9. The Secretary of Children and Families.
237 10. The executive director of the Department of Economic
239 (c) The Governor shall appoint four additional members to
240 the coordinating council. The appointees must have expertise
241 that is critical to the prevention of suicide or represent an
242 organization that is not already represented on the coordinating
244 (d) For the members appointed by the director of the
245 Statewide Office for Suicide Prevention, seven members shall be
246 appointed to initial terms of 3 years, and seven members shall
247 be appointed to initial terms of 4 years. For the members
248 appointed by the Governor, two members shall be appointed to
249 initial terms of 4 years, and two members shall be appointed to
250 initial terms of 3 years. Thereafter, such members shall be
251 appointed to terms of 4 years. Any vacancy on the coordinating
252 council shall be filled in the same manner as the original
253 appointment, and any member who is appointed to fill a vacancy
254 occurring because of death, resignation, or ineligibility for
255 membership shall serve only for the unexpired term of the
256 member’s predecessor. A member is eligible for reappointment.
257 (e) The director of the Statewide Office for Suicide
258 Prevention shall be a nonvoting member of the coordinating
259 council and shall act as chair.
260 (f) Members of the coordinating council shall serve without
261 compensation. Any member of the coordinating council who is a
262 public employee is entitled to reimbursement for per diem and
263 travel expenses as provided in s. 112.061.
264 Section 3. Present paragraph (c) of subsection (10) of
265 section 334.044, Florida Statutes, is redesignated as paragraph
266 (d), and a new paragraph (c) is added to that subsection, to
268 334.044 Powers and duties of the department.—The department
269 shall have the following general powers and duties:
271 (c) The department shall work with the Statewide Office for
272 Suicide Prevention in developing a plan to consider the
273 implementation of evidence-based suicide deterrents on all new
274 infrastructure projects.
275 Section 4. Present subsections (10) through (48) of section
276 394.455, Florida Statutes, are redesignated as subsections (11)
277 through (49), respectively, a new subsection (10) is added to
278 that section, and present subsection (28) of that section is
279 amended, to read:
280 394.455 Definitions.—As used in this part, the term:
281 (10) “Coordinated specialty care program” means an
282 evidence-based program for individuals who are experiencing the
283 early indications of serious mental illness, especially symptoms
284 of a first psychotic episode, and which includes, but is not
285 limited to, intensive case management, individual or group
286 therapy, supported employment, family education and supports,
287 and the provision of appropriate psychotropic medication as
289 (29) (28) “Mental illness” means an impairment of the mental
290 or emotional processes that exercise conscious control of one’s
291 actions or of the ability to perceive or understand reality,
292 which impairment substantially interferes with the person’s
293 ability to meet the ordinary demands of living. For the purposes
294 of this part, the term does not include a developmental
295 disability as defined in chapter 393, intoxication, or
296 conditions manifested only by dementia, traumatic brain injury,
297 antisocial behavior, or substance abuse.
298 Section 5. Section 394.4573, Florida Statutes, is amended
299 to read:
300 394.4573 Coordinated system of care; annual assessment;
301 essential elements; measures of performance; system improvement
302 grants; reports.—On or before December 1 of each year, the
303 department shall submit to the Governor, the President of the
304 Senate, and the Speaker of the House of Representatives an
305 assessment of the behavioral health services in this state. The
306 assessment shall consider, at a minimum, the extent to which
307 designated receiving systems function as no-wrong-door models,
308 the availability of treatment and recovery services that use
309 recovery-oriented and peer-involved approaches, the availability
310 of less-restrictive services, and the use of evidence-informed
311 practices. The assessment must also consider the availability of
312 and access to coordinated specialty care programs and identify
313 any gaps in the availability of and access to such programs in
314 the state. The department’s assessment shall consider, at a
315 minimum, the needs assessments conducted by the managing
316 entities pursuant to s. 394.9082(5). Beginning in 2017, the
317 department shall compile and include in the report all plans
318 submitted by managing entities pursuant to s. 394.9082(8) and
319 the department’s evaluation of each plan.
320 (1) As used in this section:
321 (a) “Care coordination” means the implementation of
322 deliberate and planned organizational relationships and service
323 procedures that improve the effectiveness and efficiency of the
324 behavioral health system by engaging in purposeful interactions
325 with individuals who are not yet effectively connected with
326 services to ensure service linkage. Examples of care
327 coordination activities include development of referral
328 agreements, shared protocols, and information exchange
329 procedures. The purpose of care coordination is to enhance the
330 delivery of treatment services and recovery supports and to
331 improve outcomes among priority populations.
332 (b) “Case management” means those direct services provided
333 to a client in order to assess his or her needs, plan or arrange
334 services, coordinate service providers, link the service system
335 to a client, monitor service delivery, and evaluate patient
336 outcomes to ensure the client is receiving the appropriate
338 (c) “Coordinated system of care” means the full array of
339 behavioral and related services in a region or community offered
340 by all service providers, whether participating under contract
341 with the managing entity or by another method of community
342 partnership or mutual agreement.
343 (d) “No-wrong-door model” means a model for the delivery of
344 acute care services to persons who have mental health or
345 substance use disorders, or both, which optimizes access to
346 care, regardless of the entry point to the behavioral health
347 care system.
348 (2) The essential elements of a coordinated system of care
350 (a) Community interventions, such as prevention, primary
351 care for behavioral health needs, therapeutic and supportive
352 services, crisis response services, and diversion programs.
353 (b) A designated receiving system that consists of one or
354 more facilities serving a defined geographic area and
355 responsible for assessment and evaluation, both voluntary and
356 involuntary, and treatment or triage of patients who have a
357 mental health or substance use disorder, or co-occurring
359 1. A county or several counties shall plan the designated
360 receiving system using a process that includes the managing
361 entity and is open to participation by individuals with
362 behavioral health needs and their families, service providers,
363 law enforcement agencies, and other parties. The county or
364 counties, in collaboration with the managing entity, shall
365 document the designated receiving system through written
366 memoranda of agreement or other binding arrangements. The county
367 or counties and the managing entity shall complete the plan and
368 implement the designated receiving system by July 1, 2017, and
369 the county or counties and the managing entity shall review and
370 update, as necessary, the designated receiving system at least
371 once every 3 years.
372 2. To the extent permitted by available resources, the
373 designated receiving system shall function as a no-wrong-door
374 model. The designated receiving system may be organized in any
375 manner which functions as a no-wrong-door model that responds to
376 individual needs and integrates services among various
377 providers. Such models include, but are not limited to:
378 a. A central receiving system that consists of a designated
379 central receiving facility that serves as a single entry point
380 for persons with mental health or substance use disorders, or
381 co-occurring disorders. The central receiving facility shall be
382 capable of assessment, evaluation, and triage or treatment or
383 stabilization of persons with mental health or substance use
384 disorders, or co-occurring disorders.
385 b. A coordinated receiving system that consists of multiple
386 entry points that are linked by shared data systems, formal
387 referral agreements, and cooperative arrangements for care
388 coordination and case management. Each entry point shall be a
389 designated receiving facility and shall, within existing
390 resources, provide or arrange for necessary services following
391 an initial assessment and evaluation.
392 c. A tiered receiving system that consists of multiple
393 entry points, some of which offer only specialized or limited
394 services. Each service provider shall be classified according to
395 its capabilities as either a designated receiving facility or
396 another type of service provider, such as a triage center, a
397 licensed detoxification facility, or an access center. All
398 participating service providers shall, within existing
399 resources, be linked by methods to share data, formal referral
400 agreements, and cooperative arrangements for care coordination
401 and case management.
403 An accurate inventory of the participating service providers
404 which specifies the capabilities and limitations of each
405 provider and its ability to accept patients under the designated
406 receiving system agreements and the transportation plan
407 developed pursuant to this section shall be maintained and made
408 available at all times to all first responders in the service
410 (c) Transportation in accordance with a plan developed
411 under s. 394.462.
412 (d) Crisis services, including mobile response teams,
413 crisis stabilization units, addiction receiving facilities, and
414 detoxification facilities.
415 (e) Case management. Each case manager or person directly
416 supervising a case manager who provides Medicaid-funded targeted
417 case management services shall hold a valid certification from a
418 department-approved credentialing entity as defined in s.
419 397.311(10) by July 1, 2017, and, thereafter, within 6 months
420 after hire.
421 (f) Care coordination that involves coordination with other
422 local systems and entities, public and private, which are
423 involved with the individual, such as primary care, child
424 welfare, behavioral health care, and criminal and juvenile
425 justice organizations.
426 (g) Outpatient services.
427 (h) Residential services.
428 (i) Hospital inpatient care.
429 (j) Aftercare and other postdischarge services.
430 (k) Medication-assisted treatment and medication
432 (l) Recovery support, including, but not limited to,
433 support for competitive employment, educational attainment,
434 independent living skills development, family support and
435 education, wellness management and self-care, and assistance in
436 obtaining housing that meets the individual’s needs. Such
437 housing may include mental health residential treatment
438 facilities, limited mental health assisted living facilities,
439 adult family care homes, and supportive housing. Housing
440 provided using state funds must provide a safe and decent
441 environment free from abuse and neglect.
442 (m) Care plans shall assign specific responsibility for
443 initial and ongoing evaluation of the supervision and support
444 needs of the individual and the identification of housing that
445 meets such needs. For purposes of this paragraph, the term
446 “supervision” means oversight of and assistance with compliance
447 with the clinical aspects of an individual’s care plan.
448 (n) Coordinated specialty care programs.
449 (3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific
450 appropriation by the Legislature, the department may award
451 system improvement grants to managing entities based on a
452 detailed plan to enhance services in accordance with the no
453 wrong-door model as defined in subsection (1) and to address
454 specific needs identified in the assessment prepared by the
455 department pursuant to this section. Such a grant must be
456 awarded through a performance-based contract that links payments
457 to the documented and measurable achievement of system
459 Section 6. Subsection (3) of section 394.463, Florida
460 Statutes, is amended to read:
461 394.463 Involuntary examination.—
462 (3) NOTICE OF RELEASE.—Notice of the release shall be given
463 to the patient’s guardian or representative, to any person who
464 executed a certificate admitting the patient to the receiving
465 facility, and to any court which ordered the patient’s
466 evaluation. If the patient is a minor, information regarding the
467 availability of a local mobile response service, suicide
468 prevention resources, social supports, and local self-help
469 groups must also be provided to the patient’s guardian or
470 representative along with the notice of the release.
471 Section 7. Paragraph (b) of subsection (1) of section
472 394.658, Florida Statutes, is amended to read:
473 394.658 Criminal Justice, Mental Health, and Substance
474 Abuse Reinvestment Grant Program requirements.—
475 (1) The Criminal Justice, Mental Health, and Substance
476 Abuse Statewide Grant Review Committee, in collaboration with
477 the Department of Children and Families, the Department of
478 Corrections, the Department of Juvenile Justice, the Department
479 of Elderly Affairs, and the Office of the State Courts
480 Administrator, shall establish criteria to be used to review
481 submitted applications and to select the county that will be
482 awarded a 1-year planning grant or a 3-year implementation or
483 expansion grant. A planning, implementation, or expansion grant
484 may not be awarded unless the application of the county meets
485 the established criteria.
486 (b) The application criteria for a 3-year implementation or
487 expansion grant shall require information from a county that
488 demonstrates its completion of a well-established collaboration
489 plan that includes public-private partnership models and the
490 application of evidence-based practices. The implementation or
491 expansion grants may support programs and diversion initiatives
492 that include, but need not be limited to:
493 1. Mental health courts;
494 2. Diversion programs;
495 3. Alternative prosecution and sentencing programs;
496 4. Crisis intervention teams;
497 5. Treatment accountability services;
498 6. Specialized training for criminal justice, juvenile
499 justice, and treatment services professionals;
500 7. Service delivery of collateral services such as housing,
501 transitional housing, and supported employment; and
502 8. Reentry services to create or expand mental health and
503 substance abuse services and supports for affected persons; and
504 9. Coordinated specialty care programs.
505 Section 8. Present subsections (3) through (24) of section
506 394.67, Florida Statutes, are redesignated as subsections (4)
507 through (25), respectively, a new subsection (3) is added to
508 that section, and present subsection (3) is amended, to read:
509 394.67 Definitions.—As used in this part, the term:
510 (3) “Coordinated specialty care program” means an evidence
511 based program for individuals who are experiencing the early
512 indications of serious mental illness, especially symptoms of a
513 first psychotic episode, and which includes, but is not limited
514 to, intensive case management, individual or group therapy,
515 supported employment, family education and supports, and the
516 provision of appropriate psychotropic medication as needed.
517 (4) (3) “Crisis services” means short-term evaluation,
518 stabilization, and brief intervention services provided to a
519 person who is experiencing an acute mental or emotional crisis,
520 as defined in subsection (18) (17), or an acute substance abuse
521 crisis, as defined in subsection (19) (18), to prevent further
522 deterioration of the person’s mental health. Crisis services are
523 provided in settings such as a crisis stabilization unit, an
524 inpatient unit, a short-term residential treatment program, a
525 detoxification facility, or an addictions receiving facility; at
526 the site of the crisis by a mobile crisis response team; or at a
527 hospital on an outpatient basis.
528 Section 9. Paragraph (a) of subsection (26) of section
529 397.311, Florida Statutes, is amended to read:
530 397.311 Definitions.—As used in this chapter, except part
531 VIII, the term:
532 (26) Licensed service components include a comprehensive
533 continuum of accessible and quality substance abuse prevention,
534 intervention, and clinical treatment services, including the
535 following services:
536 (a) “Clinical treatment” means a professionally directed,
537 deliberate, and planned regimen of services and interventions
538 that are designed to reduce or eliminate the misuse of drugs and
539 alcohol and promote a healthy, drug-free lifestyle. As defined
540 by rule, “clinical treatment services” include, but are not
541 limited to, the following licensable service components:
542 1. “Addictions receiving facility” is a secure, acute care
543 facility that provides, at a minimum, detoxification and
544 stabilization services; is operated 24 hours per day, 7 days per
545 week; and is designated by the department to serve individuals
546 found to be substance use impaired as described in s. 397.675
547 who meet the placement criteria for this component.
548 2. “Day or night treatment” is a service provided in a
549 nonresidential environment, with a structured schedule of
550 treatment and rehabilitative services.
551 3. “Day or night treatment with community housing” means a
552 program intended for individuals who can benefit from living
553 independently in peer community housing while participating in
554 treatment services for a minimum of 5 hours a day for a minimum
555 of 25 hours per week.
556 4. “Detoxification” is a service involving subacute care
557 that is provided on an inpatient or an outpatient basis to
558 assist individuals to withdraw from the physiological and
559 psychological effects of substance abuse and who meet the
560 placement criteria for this component.
561 5. “Intensive inpatient treatment” includes a planned
562 regimen of evaluation, observation, medical monitoring, and
563 clinical protocols delivered through an interdisciplinary team
564 approach provided 24 hours per day, 7 days per week, in a highly
565 structured, live-in environment.
566 6. “Intensive outpatient treatment” is a service that
567 provides individual or group counseling in a more structured
568 environment, is of higher intensity and duration than outpatient
569 treatment, and is provided to individuals who meet the placement
570 criteria for this component.
571 7. “Medication-assisted treatment for opioid use disorders
572 opiate addiction” is a service that uses methadone or other
573 medication as authorized by state and federal law, in
574 combination with medical, rehabilitative, supportive, and
575 counseling services in the treatment of individuals who are
576 dependent on opioid drugs.
577 8. “Outpatient treatment” is a service that provides
578 individual, group, or family counseling by appointment during
579 scheduled operating hours for individuals who meet the placement
580 criteria for this component.
581 9. “Residential treatment” is a service provided in a
582 structured live-in environment within a nonhospital setting on a
583 24-hours-per-day, 7-days-per-week basis, and is intended for
584 individuals who meet the placement criteria for this component.
585 Section 10. Subsection (16) of section 397.321, Florida
586 Statutes, is amended to read:
587 397.321 Duties of the department.—The department shall:
588 (16) Develop a certification process by rule for community
589 substance abuse prevention coalitions.
590 Section 11. Section 397.4012, Florida Statutes, is amended
591 to read:
592 397.4012 Exemptions from licensure.—The following are
593 exempt from the licensing provisions of this chapter:
594 (1) A hospital or hospital-based component licensed under
595 chapter 395.
596 (2) A nursing home facility as defined in s. 400.021.
597 (3) A substance abuse education program established
598 pursuant to s. 1003.42.
599 (4) A facility or institution operated by the Federal
601 (5) A physician or physician assistant licensed under
602 chapter 458 or chapter 459.
603 (6) A psychologist licensed under chapter 490.
604 (7) A social worker, marriage and family therapist, or
605 mental health counselor licensed under chapter 491.
606 (8) A legally cognizable church or nonprofit religious
607 organization or denomination providing substance abuse services,
608 including prevention services, which are solely religious,
609 spiritual, or ecclesiastical in nature. A church or nonprofit
610 religious organization or denomination providing any of the
611 licensed service components itemized under s. 397.311(26) is not
612 exempt from substance abuse licensure but retains its exemption
613 with respect to all services which are solely religious,
614 spiritual, or ecclesiastical in nature.
615 (9) Facilities licensed under chapter 393 which, in
616 addition to providing services to persons with developmental
617 disabilities, also provide services to persons developmentally
618 at risk as a consequence of exposure to alcohol or other legal
619 or illegal drugs while in utero.
620 (10) DUI education and screening services provided pursuant
621 to ss. 316.192, 316.193, 322.095, 322.271, and 322.291. Persons
622 or entities providing treatment services must be licensed under
623 this chapter unless exempted from licensing as provided in this
625 (11) A facility licensed under s. 394.875 as a crisis
626 stabilization unit.
628 The exemptions from licensure in subsections (3), (4), (8), (9),
629 and (10) this section do not apply to any service provider that
630 receives an appropriation, grant, or contract from the state to
631 operate as a service provider as defined in this chapter or to
632 any substance abuse program regulated under pursuant to s.
633 397.4014. Furthermore, this chapter may not be construed to
634 limit the practice of a physician or physician assistant
635 licensed under chapter 458 or chapter 459, a psychologist
636 licensed under chapter 490, a psychotherapist licensed under
637 chapter 491, or an advanced practice registered nurse licensed
638 under part I of chapter 464, who provides substance abuse
639 treatment, so long as the physician, physician assistant,
640 psychologist, psychotherapist, or advanced practice registered
641 nurse does not represent to the public that he or she is a
642 licensed service provider and does not provide services to
643 individuals under pursuant to part V of this chapter. Failure to
644 comply with any requirement necessary to maintain an exempt
645 status under this section is a misdemeanor of the first degree,
646 punishable as provided in s. 775.082 or s. 775.083.
647 Section 12. Section 456.0342, Florida Statutes, is created
648 to read:
649 456.0342 Required instruction on suicide prevention.—The
650 requirements of this section apply to each person licensed or
651 certified under chapter 458, chapter 459, or part I of chapter
653 (1) By January 1, 2022, each licensed or certified
654 practitioner shall complete a board-approved 2-hour continuing
655 education course on suicide prevention. The course must address
656 suicide risk assessment, treatment, and management.
657 (2) Each licensing board that requires a licensee or
658 certificateholder to complete a course pursuant to this section
659 must include the hours required for completion in the total
660 hours of continuing education required by law for such
662 Section 13. Section 786.1516, Florida Statutes, is created
663 to read:
664 786.1516 Immunity for providing assistance in a suicide
666 (1) As used in this section, the term:
667 (a) “Emergency care” means assistance or advice offered to
668 avoid, mitigate, or attempt to mitigate the effects of a suicide
670 (b) “Suicide emergency” means an occurrence that reasonably
671 indicates an individual is at risk of dying or attempting to die
672 by suicide.
673 (2) A person who provides emergency care at or near the
674 scene of a suicide emergency, gratuitously and in good faith, is
675 not liable for any civil damages or penalties as a result of any
676 act or omission by the person providing the emergency care
677 unless the person is grossly negligent or caused the suicide
679 Section 14. Subsection (14) of section 916.106, Florida
680 Statutes, is amended to read:
681 916.106 Definitions.—For the purposes of this chapter, the
683 (14) “Mental illness” means an impairment of the emotional
684 processes that exercise conscious control of one’s actions, or
685 of the ability to perceive or understand reality, which
686 impairment substantially interferes with the defendant’s ability
687 to meet the ordinary demands of living. For the purposes of this
688 chapter, the term does not apply to defendants who have only an
689 intellectual disability or autism or a defendant with traumatic
690 brain injury or dementia who lacks a co-occurring mental
691 illness, and does not include intoxication or conditions
692 manifested only by antisocial behavior or substance abuse
694 Section 15. Subsection (2) of section 916.13, Florida
695 Statutes, is amended to read:
696 916.13 Involuntary commitment of defendant adjudicated
698 (2) A defendant who has been charged with a felony, and who
699 has been adjudicated incompetent to proceed due to mental
700 illness, and who meets the criteria for involuntary commitment
701 under this chapter , may be committed to the department, and the
702 department shall retain and treat the defendant. Within 2
703 business days after receipt of a commitment order and other
704 required documents as stipulated in rule, the department must
705 request from the jail any and all medical information pertaining
706 to the defendant. Within 3 business days after receipt of such a
707 request, the jail shall provide such information to the
709 (a) Within 6 months after the date of admission and at the
710 end of any period of extended commitment, or at any time the
711 administrator or his or her designee determines that the
712 defendant has regained competency to proceed or no longer meets
713 the criteria for continued commitment, the administrator or
714 designee shall file a report with the court pursuant to the
715 applicable Florida Rules of Criminal Procedure.
716 (b) A competency hearing must shall be held within 30 days
717 after the court receives notification that the defendant is
718 competent to proceed or no longer meets the criteria for
719 continued commitment. The defendant must be transported to the
720 committing court’s jurisdiction for the hearing. If the
721 defendant is receiving psychotropic medication at a mental
722 health facility at the time he or she is discharged and
723 transferred to the jail, the administering of such medication
724 must continue unless the jail physician documents the need to
725 change or discontinue it. The jail and department physicians
726 shall collaborate to ensure that medication changes do not
727 adversely affect the defendant’s mental health status or his or
728 her ability to continue with court proceedings; however, the
729 final authority regarding the administering of medication to an
730 inmate in jail rests with the jail physician.
731 Section 16. Subsections (3) and (5) of section 916.15,
732 Florida Statutes, are amended to read:
733 916.15 Involuntary commitment of defendant adjudicated not
734 guilty by reason of insanity.—
735 (3) Every defendant acquitted of criminal charges by reason
736 of insanity and found to meet the criteria for involuntary
737 commitment may be committed and treated in accordance with the
738 provisions of this section and the applicable Florida Rules of
739 Criminal Procedure. The department shall admit a defendant so
740 adjudicated to an appropriate facility or program for treatment
741 and shall retain and treat such defendant. No later than 6
742 months after the date of admission, prior to the end of any
743 period of extended commitment, or at any time that the
744 administrator or his or her designee determines shall have
745 determined that the defendant no longer meets the criteria for
746 continued commitment placement, the administrator or designee
747 shall file a report with the court pursuant to the applicable
748 Florida Rules of Criminal Procedure. Within 2 business days
749 after receipt of a commitment order and other required documents
750 as stipulated in rule, the department must request from the jail
751 any and all medical information pertaining to the defendant.
752 Within 3 business days after receipt of such a request, the jail
753 shall provide such information to the department.
754 (5) The commitment hearing shall be held within 30 days
755 after the court receives notification that the defendant no
756 longer meets the criteria for continued commitment. The
757 defendant must be transported to the committing court’s
758 jurisdiction for the hearing. If the defendant is receiving
759 psychotropic medication at a mental health facility at the time
760 he or she is discharged and transferred to the jail, the
761 administering of such medication must continue unless the jail
762 physician documents the need to change or discontinue it. The
763 jail and department physicians shall collaborate to ensure that
764 medication changes do not adversely affect the defendant’s
765 mental health status or his or her ability to continue with
766 court proceedings; however, the final authority regarding the
767 administering of medication to an inmate in jail rests with the
768 jail physician.
769 Section 17. Present subsection (28) of section 1002.33,
770 Florida Statutes, is redesignated as subsection (29), and a new
771 subsection (28) is added to that section, to read:
772 1002.33 Charter schools.—
773 (28) CONTINUING EDUCATION AND INSERVICE TRAINING FOR YOUTH
774 SUICIDE AWARENESS AND PREVENTION.—
775 (a) By October 1, 2020, every charter school must:
776 1. Incorporate 2 hours of training offered pursuant to s.
777 1012.583. The training must be included in the existing
778 continuing education or inservice training requirements for
779 instructional personnel and may not add to the total hours
780 currently required by the department. Every charter school must
781 require all instructional personnel to participate.
782 2. Have at least two school-based staff members certified
783 or otherwise deemed competent in the use of a suicide screening
784 instrument approved under s. 1012.583(1) and have a policy to
785 use such suicide risk screening instrument to evaluate a
786 student’s suicide risk before requesting the initiation of, or
787 initiating, an involuntary examination due to concerns about
788 that student’s suicide risk.
789 (b) Every charter school must report its compliance with
790 this subsection to the department.
791 Section 18. Subsections (2) and (3) of section 1012.583,
792 Florida Statutes, are amended to read:
793 1012.583 Continuing education and inservice training for
794 youth suicide awareness and prevention.—
795 (2) By October 1, 2020, every public school must A school
796 shall be considered a “Suicide Prevention Certified School” if
798 (a) Incorporate Incorporates 2 hours of training offered
799 pursuant to this section. The training must be included in the
800 existing continuing education or inservice training requirements
801 for instructional personnel and may not add to the total hours
802 currently required by the department. Every public school A
803 school that chooses to participate in the training must require
804 all instructional personnel to participate.
805 (b) Have Has at least two school-based staff members
806 certified or otherwise deemed competent in the use of a suicide
807 screening instrument approved under subsection (1) and have has
808 a policy to use such suicide risk screening instrument to
809 evaluate a student’s suicide risk before requesting the
810 initiation of, or initiating, an involuntary examination due to
811 concerns about that student’s suicide risk.
812 (3) Every public school A school that meets the criteria in
813 subsection (2) must report its compliance with this section to
814 the department. The department shall keep an updated record of
815 all Suicide Prevention Certified Schools and shall post the list
816 of these schools on the department’s website. Each school shall
817 also post on its own website whether it is a Suicide Prevention
818 Certified School, and each school district shall post on its
819 district website a list of the Suicide Prevention Certified
820 Schools in that district.
821 Section 19. Paragraph (a) of subsection (3) of section
822 39.407, Florida Statutes, is amended to read:
823 39.407 Medical, psychiatric, and psychological examination
824 and treatment of child; physical, mental, or substance abuse
825 examination of person with or requesting child custody.—
826 (3)(a)1. Except as otherwise provided in subparagraph (b)1.
827 or paragraph (e), before the department provides psychotropic
828 medications to a child in its custody, the prescribing physician
829 or a psychiatric nurse, as defined in s. 394.455, shall attempt
830 to obtain express and informed consent, as defined in s.
831 394.455(16) s. 394.455(15) and as described in s. 394.459(3)(a),
832 from the child’s parent or legal guardian. The department must
833 take steps necessary to facilitate the inclusion of the parent
834 in the child’s consultation with the physician or psychiatric
835 nurse, as defined in s. 394.455. However, if the parental rights
836 of the parent have been terminated, the parent’s location or
837 identity is unknown or cannot reasonably be ascertained, or the
838 parent declines to give express and informed consent, the
839 department may, after consultation with the prescribing
840 physician or psychiatric nurse, as defined in s. 394.455, seek
841 court authorization to provide the psychotropic medications to
842 the child. Unless parental rights have been terminated and if it
843 is possible to do so, the department shall continue to involve
844 the parent in the decisionmaking process regarding the provision
845 of psychotropic medications. If, at any time, a parent whose
846 parental rights have not been terminated provides express and
847 informed consent to the provision of a psychotropic medication,
848 the requirements of this section that the department seek court
849 authorization do not apply to that medication until such time as
850 the parent no longer consents.
851 2. Any time the department seeks a medical evaluation to
852 determine the need to initiate or continue a psychotropic
853 medication for a child, the department must provide to the
854 evaluating physician or psychiatric nurse, as defined in s.
855 394.455, all pertinent medical information known to the
856 department concerning that child.
857 Section 20. Subsection (3) of section 394.495, Florida
858 Statutes, are amended to read:
859 394.495 Child and adolescent mental health system of care;
860 programs and services.—
861 (3) Assessments must be performed by:
862 (a) A professional as defined in s. 394.455(5), (7), (33)
863 (32), (36) (35), or (37) (36);
864 (b) A professional licensed under chapter 491; or
865 (c) A person who is under the direct supervision of a
866 qualified professional as defined in s. 394.455(5), (7), (33)
867 (32), (36) (35), or (37) (36) or a professional licensed under
868 chapter 491.
869 Section 21. Subsection (5) of section 394.496, Florida
870 Statutes, is amended to read:
871 394.496 Service planning.—
872 (5) A professional as defined in s. 394.455(5), (7), (33)
873 (32), (36) (35), or (37) (36) or a professional licensed under
874 chapter 491 must be included among those persons developing the
875 services plan.
876 Section 22. Paragraph (a) of subsection (1) of section
877 394.674, Florida Statutes, is amended to read:
878 394.674 Eligibility for publicly funded substance abuse and
879 mental health services; fee collection requirements.—
880 (1) To be eligible to receive substance abuse and mental
881 health services funded by the department, an individual must be
882 a member of at least one of the department’s priority
883 populations approved by the Legislature. The priority
884 populations include:
885 (a) For adult mental health services:
886 1. Adults who have severe and persistent mental illness, as
887 designated by the department using criteria that include
888 severity of diagnosis, duration of the mental illness, ability
889 to independently perform activities of daily living, and receipt
890 of disability income for a psychiatric condition. Included
891 within this group are:
892 a. Older adults in crisis.
893 b. Older adults who are at risk of being placed in a more
894 restrictive environment because of their mental illness.
895 c. Persons deemed incompetent to proceed or not guilty by
896 reason of insanity under chapter 916.
897 d. Other persons involved in the criminal justice system.
898 e. Persons diagnosed as having co-occurring mental illness
899 and substance abuse disorders.
900 2. Persons who are experiencing an acute mental or
901 emotional crisis as defined in s. 394.67(18) s. 394.67(17).
902 Section 23. Subsection (3) of section 394.74, Florida
903 Statutes, is amended to read:
904 394.74 Contracts for provision of local substance abuse and
905 mental health programs.—
906 (3) Contracts shall include, but are not limited to:
907 (a) A provision that, within the limits of available
908 resources, substance abuse and mental health crisis services, as
909 defined in s. 394.67(4) s. 394.67(3), shall be available to any
910 individual residing or employed within the service area,
911 regardless of ability to pay for such services, current or past
912 health condition, or any other factor;
913 (b) A provision that such services be available with
914 priority of attention being given to individuals who exhibit
915 symptoms of chronic or acute substance abuse or mental illness
916 and who are unable to pay the cost of receiving such services;
917 (c) A provision that every reasonable effort to collect
918 appropriate reimbursement for the cost of providing substance
919 abuse and mental health services to persons able to pay for
920 services, including first-party payments and third-party
921 payments, shall be made by facilities providing services
922 pursuant to this act;
923 (d) A program description and line-item operating budget by
924 program service component for substance abuse and mental health
925 services, provided the entire proposed operating budget for the
926 service provider will be displayed;
927 (e) A provision that client demographic, service, and
928 outcome information required for the department’s Mental Health
929 and Substance Abuse Data System be submitted to the department
930 by a date specified in the contract. The department may not pay
931 the provider unless the required information has been submitted
932 by the specified date; and
933 (f) A requirement that the contractor must conform to
934 department rules and the priorities established thereunder.
935 Section 24. Subsection (6) of section 394.9085, Florida
936 Statutes, is amended to read:
937 394.9085 Behavioral provider liability.—
938 (6) For purposes of this section, the terms “detoxification
939 services,” “addictions receiving facility,” and “receiving
940 facility” have the same meanings as those provided in ss.
941 397.311(26)(a)3. ss. 397.311(26)(a)4., 397.311(26)(a)1., and
942 394.455(40) 394.455(39), respectively.
943 Section 25. Paragraph (b) of subsection (1) of section
944 409.972, Florida Statutes, is amended to read:
945 409.972 Mandatory and voluntary enrollment.—
946 (1) The following Medicaid-eligible persons are exempt from
947 mandatory managed care enrollment required by s. 409.965, and
948 may voluntarily choose to participate in the managed medical
949 assistance program:
950 (b) Medicaid recipients residing in residential commitment
951 facilities operated through the Department of Juvenile Justice
952 or a treatment facility as defined in s. 394.455 (47).
953 Section 26. Paragraph (e) of subsection (4) of section
954 464.012, Florida Statutes, is amended to read:
955 464.012 Licensure of advanced practice registered nurses;
956 fees; controlled substance prescribing.—
957 (4) In addition to the general functions specified in
958 subsection (3), an advanced practice registered nurse may
959 perform the following acts within his or her specialty:
960 (e) A psychiatric nurse, who meets the requirements in s.
961 394.455(36) s. 394.455(35), within the framework of an
962 established protocol with a psychiatrist, may prescribe
963 psychotropic controlled substances for the treatment of mental
965 Section 27. Subsection (7) of section 744.2007, Florida
966 Statutes, is amended to read:
967 744.2007 Powers and duties.—
968 (7) A public guardian may not commit a ward to a treatment
969 facility, as defined in s. 394.455 (47), without an involuntary
970 placement proceeding as provided by law.
971 Section 28. The Office of Program Policy Analysis and
972 Government Accountability shall perform a review of suicide
973 prevention programs and efforts made by other states and make
974 recommendations on their applicability to this state. The office
975 shall submit a report containing the findings and
976 recommendations to the President of the Senate and the Speaker
977 of the House of Representatives by January 1, 2021.
978 Section 29. For the 2020-2021 fiscal year, the sums of
979 $418,036 in recurring funds and $8,896 in nonrecurring funds are
980 appropriated from the General Revenue Fund to the Department of
981 Children and Families, and two full-time equivalent positions
982 with associated salary rate of 90,384 are authorized, for the
983 purpose of implementing the requirements of this act.
984 Section 30. This act shall take effect July 1, 2020.