CS for SB 7012                                   First Engrossed
    1                        A bill to be entitled                      
    2         An act relating to substance abuse and mental health;
    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
    7         purpose of the task force; providing for the
    8         composition and the duties of the task force;
    9         requiring the task force to submit reports to the
   10         Governor and the Legislature on an annual basis;
   11         providing for future repeal; amending s. 14.20195,
   12         F.S.; providing additional duties for the Suicide
   13         Prevention Coordinating Council; revising the
   14         composition of the council; amending s. 334.044, F.S.;
   15         requiring the Department of Transportation to work
   16         with the office in developing a plan relating to
   17         evidence-based suicide deterrents in certain
   18         locations; amending s. 394.455, F.S.; revising and
   19         providing definitions; amending s. 394.67, F.S.;
   20         defining the term “coordinated specialty care
   21         program”; amending s. 394.658, F.S.; revising the
   22         application criteria for the Criminal Justice, Mental
   23         Health, and Substance Abuse Reinvestment Grant Program
   24         to include support for coordinated specialty care
   25         programs; amending s. 394.4573, F.S.; requiring the
   26         Department of Children and Families to include
   27         specified information regarding coordinated specialty
   28         care programs in its annual assessment of behavioral
   29         health services; providing that a coordinated system
   30         of care includes coordinated specialty care programs;
   31         amending s. 394.463, F.S.; requiring that certain
   32         information be provided to the guardian or
   33         representative of a minor patient released from
   34         involuntary examination; amending s. 397.311, F.S.;
   35         revising a definition; amending s. 397.321, F.S.;
   36         removing the requirement that the department develop a
   37         certification process for community substance abuse
   38         prevention coalitions; amending s. 397.4012, F.S.;
   39         revising entities that are exempt from certain
   40         licensing requirements; amending s. 916.106, F.S.;
   41         revising a definition; amending ss. 916.13 and 916.15,
   42         F.S.; authorizing jails to share medical information
   43         pertaining to specified defendants with the Department
   44         of Children and Families; requiring the maintenance of
   45         psychotropic medications to specified defendants under
   46         certain circumstances; providing an exception;
   47         amending ss. 39.407, 394.495, 394.496, 394.674,
   48         394.74, 394.9085, 409.972, 464.012, and 744.2007,
   49         F.S.; conforming cross-references; providing an
   50         effective date.
   52  Be It Enacted by the Legislature of the State of Florida:
   54         Section 1. Paragraphs (a) and (d) of subsection (2) of
   55  section 14.2019, Florida Statutes, are amended, paragraphs (e)
   56  and (f) are added to that subsection, and subsection (5) is
   57  added to that section, to read:
   58         14.2019 Statewide Office for Suicide Prevention.—
   59         (2) The statewide office shall, within available resources:
   60         (a) Develop a network of community-based programs to
   61  improve suicide prevention initiatives. The network shall
   62  identify and work to eliminate barriers to providing suicide
   63  prevention services to individuals who are at risk of suicide.
   64  The network shall consist of stakeholders advocating suicide
   65  prevention, including, but not limited to, not-for-profit
   66  suicide prevention organizations, faith-based suicide prevention
   67  organizations, law enforcement agencies, first responders to
   68  emergency calls, veterans, servicemembers, suicide prevention
   69  community coalitions, schools and universities, mental health
   70  agencies, substance abuse treatment agencies, health care
   71  providers, and school personnel.
   72         (d) Coordinate education and training curricula in suicide
   73  prevention efforts for law enforcement personnel, first
   74  responders to emergency calls, veterans, servicemembers, health
   75  care providers, school employees, and other persons who may have
   76  contact with persons at risk of suicide.
   77         (e) Act as a clearinghouse for information and resources
   78  related to suicide prevention by:
   79         1. Disseminating and sharing evidence-based best practices
   80  relating to suicide prevention.
   81         2. Collecting and analyzing data on trends in suicide and
   82  suicide attempts annually by county, age, gender, profession,
   83  and other demographics as designated by the statewide office.
   84         (f) Advise the Department of Transportation on the
   85  implementation of evidence-based suicide deterrents in the
   86  design elements and features of infrastructure projects
   87  throughout the state.
   88         (5) The First Responders Suicide Deterrence Task Force, a
   89  task force as defined in s. 20.03(8), is created adjunct to the
   90  Statewide Office for Suicide Prevention.
   91         (a) The purpose of the task force is to make
   92  recommendations on how to reduce the incidence of suicide and
   93  attempted suicide among employed or retired first responders in
   94  the state.
   95         (b) The task force is composed of a representative of the
   96  statewide office and a representative of each of the following
   97  first responder organizations, nominated by the organization and
   98  appointed by the Secretary of Children and Families:
   99         1. The Florida Professional Firefighters’ Association.
  100         2. The Florida Police Benevolent Association.
  101         3. The Florida State Lodge of the Fraternal Order of
  102  Police.
  103         4. The Florida Sheriffs Association.
  104         5. The Florida Police Chiefs Association.
  105         6. The Florida Fire Chiefs’ Association.
  106         (c) The task force shall elect a chair from among its
  107  membership. Except as otherwise provided, the task force shall
  108  operate in a manner consistent with s. 20.052.
  109         (d) The task force shall identify or make recommendations
  110  on developing training programs and materials that would better
  111  enable first responders to cope with personal life stressors and
  112  stress related to their profession and foster an organizational
  113  culture that:
  114         1. Promotes mutual support and solidarity among active and
  115  retired first responders.
  116         2. Trains agency supervisors and managers to identify
  117  suicidal risk among active and retired first responders.
  118         3. Improves the use and awareness of existing resources
  119  among active and retired first responders.
  120         4. Educates active and retired first responders on suicide
  121  awareness and help-seeking.
  122         (e) The task force shall identify state and federal public
  123  resources, funding and grants, first responder association
  124  resources, and private resources to implement identified
  125  training programs and materials.
  126         (f) The task force shall report on its findings and
  127  recommendations for training programs and materials to deter
  128  suicide among active and retired first responders to the
  129  Governor, the President of the Senate, and the Speaker of the
  130  House of Representatives by each July 1, beginning in 2021, and
  131  through 2023.
  132         (g) This subsection is repealed July 1, 2023.
  133         Section 2. Paragraph (c) of subsection (1) and subsection
  134  (2) of section 14.20195, Florida Statutes, are amended, and
  135  paragraph (d) is added to subsection (1) of that section, to
  136  read:
  137         14.20195 Suicide Prevention Coordinating Council; creation;
  138  membership; duties.—There is created within the Statewide Office
  139  for Suicide Prevention a Suicide Prevention Coordinating
  140  Council. The council shall develop strategies for preventing
  141  suicide.
  142         (1) SCOPE OF ACTIVITY.—The Suicide Prevention Coordinating
  143  Council is a coordinating council as defined in s. 20.03 and
  144  shall:
  145         (c) Make findings and recommendations regarding suicide
  146  prevention programs and activities, including, but not limited
  147  to, the implementation of evidence-based mental health awareness
  148  and assistance training programs and suicide risk identification
  149  training in municipalities throughout the state. The council
  150  shall prepare an annual report and present it to the Governor,
  151  the President of the Senate, and the Speaker of the House of
  152  Representatives by January 1, each year. The annual report must
  153  describe the status of existing and planned initiatives
  154  identified in the statewide plan for suicide prevention and any
  155  recommendations arising therefrom.
  156         (d) In conjunction with the Department of Children and
  157  Families, advise members of the public on the locations and
  158  availability of local behavioral health providers.
  159         (2) MEMBERSHIP.—The Suicide Prevention Coordinating Council
  160  shall consist of 31 27 voting members and one nonvoting member.
  161         (a) Seventeen Thirteen members shall be appointed by the
  162  director of the Statewide Office for Suicide Prevention and
  163  shall represent the following organizations:
  164         1. The Florida Association of School Psychologists.
  165         2. The Florida Sheriffs Association.
  166         3. The Suicide Prevention Action Network USA.
  167         3.4. The Florida Initiative of Suicide Prevention.
  168         4.5. The Florida Suicide Prevention Coalition.
  169         5.6. The American Foundation of Suicide Prevention.
  170         6.7. The Florida School Board Association.
  171         7.8. The National Council for Suicide Prevention.
  172         8.9. The state chapter of AARP.
  173         9.10.The Florida Behavioral Health Association The Florida
  174  Alcohol and Drug Abuse Association.
  175         11. The Florida Council for Community Mental Health.
  176         10.12. The Florida Counseling Association.
  177         11.13. NAMI Florida.
  178         12. The Florida Medical Association.
  179         13. The Florida Osteopathic Medical Association.
  180         14. The Florida Psychiatric Society.
  181         15. The Florida Psychological Association.
  182         16. Veterans Florida.
  183         17. The Florida Association of Managing Entities.
  184         (b) The following state officials or their designees shall
  185  serve on the coordinating council:
  186         1. The Secretary of Elderly Affairs.
  187         2. The State Surgeon General.
  188         3. The Commissioner of Education.
  189         4. The Secretary of Health Care Administration.
  190         5. The Secretary of Juvenile Justice.
  191         6. The Secretary of Corrections.
  192         7. The executive director of the Department of Law
  193  Enforcement.
  194         8. The executive director of the Department of Veterans’
  195  Affairs.
  196         9. The Secretary of Children and Families.
  197         10. The executive director of the Department of Economic
  198  Opportunity.
  199         (c) The Governor shall appoint four additional members to
  200  the coordinating council. The appointees must have expertise
  201  that is critical to the prevention of suicide or represent an
  202  organization that is not already represented on the coordinating
  203  council.
  204         (d) For the members appointed by the director of the
  205  Statewide Office for Suicide Prevention, seven members shall be
  206  appointed to initial terms of 3 years, and seven members shall
  207  be appointed to initial terms of 4 years. For the members
  208  appointed by the Governor, two members shall be appointed to
  209  initial terms of 4 years, and two members shall be appointed to
  210  initial terms of 3 years. Thereafter, such members shall be
  211  appointed to terms of 4 years. Any vacancy on the coordinating
  212  council shall be filled in the same manner as the original
  213  appointment, and any member who is appointed to fill a vacancy
  214  occurring because of death, resignation, or ineligibility for
  215  membership shall serve only for the unexpired term of the
  216  member’s predecessor. A member is eligible for reappointment.
  217         (e) The director of the Statewide Office for Suicide
  218  Prevention is shall be a nonvoting member of the coordinating
  219  council and shall act as chair.
  220         (f) Members of the coordinating council shall serve without
  221  compensation. Any member of the coordinating council who is a
  222  public employee is entitled to reimbursement for per diem and
  223  travel expenses as provided in s. 112.061.
  224         Section 3. Present paragraph (c) of subsection (10) of
  225  section 334.044, Florida Statutes, is redesignated as paragraph
  226  (d), and a new paragraph (c) is added to that subsection, to
  227  read:
  228         334.044 Powers and duties of the department.—The department
  229  shall have the following general powers and duties:
  230         (10)
  231         (c) The department shall work with the Statewide Office for
  232  Suicide Prevention in developing a plan to consider the
  233  implementation of evidence-based suicide deterrents on all new
  234  infrastructure projects.
  235         Section 4. Subsections (10) through (48) of section
  236  394.455, Florida Statutes, are renumbered as subsections (11)
  237  through (49), respectively, present subsection (28) of that
  238  section is amended, and a new subsection (10) is added to that
  239  section, to read:
  240         394.455 Definitions.—As used in this part, the term:
  241         (10) “Coordinated specialty care program” means an
  242  evidence-based program for individuals who are experiencing the
  243  early indications of serious mental illness, especially symptoms
  244  of a first psychotic episode, and which includes, but is not
  245  limited to, intensive case management, individual or group
  246  therapy, supported employment, family education and supports,
  247  and the provision of appropriate psychotropic medication as
  248  needed.
  249         (29)(28) “Mental illness” means an impairment of the mental
  250  or emotional processes that exercise conscious control of one’s
  251  actions or of the ability to perceive or understand reality,
  252  which impairment substantially interferes with the person’s
  253  ability to meet the ordinary demands of living. For the purposes
  254  of this part, the term does not include a developmental
  255  disability as defined in chapter 393, intoxication, or
  256  conditions manifested only by dementia, traumatic brain injury,
  257  antisocial behavior, or substance abuse.
  258         Section 5. Subsections (3) through (24) of section 394.67,
  259  Florida Statutes, are renumbered as subsections (4) through
  260  (25), respectively, present subsection (3) of that section is
  261  amended, and a new subsection (3) is added to that section, to
  262  read:
  263         394.67 Definitions.—As used in this part, the term:
  264         (3) “Coordinated specialty care program” means an evidence
  265  based program for individuals who are experiencing the early
  266  indications of serious mental illness, especially symptoms of a
  267  first psychotic episode, and which includes, but is not limited
  268  to, intensive case management, individual or group therapy,
  269  supported employment, family education and supports, and the
  270  provision of appropriate psychotropic medication as needed.
  271         (4)(3) “Crisis services” means short-term evaluation,
  272  stabilization, and brief intervention services provided to a
  273  person who is experiencing an acute mental or emotional crisis,
  274  as defined in subsection (18) (17), or an acute substance abuse
  275  crisis, as defined in subsection (19) (18), to prevent further
  276  deterioration of the person’s mental health. Crisis services are
  277  provided in settings such as a crisis stabilization unit, an
  278  inpatient unit, a short-term residential treatment program, a
  279  detoxification facility, or an addictions receiving facility; at
  280  the site of the crisis by a mobile crisis response team; or at a
  281  hospital on an outpatient basis.
  282         Section 6. Paragraph (b) of subsection (1) of section
  283  394.658, Florida Statutes, is amended to read:
  284         394.658 Criminal Justice, Mental Health, and Substance
  285  Abuse Reinvestment Grant Program requirements.—
  286         (1) The Criminal Justice, Mental Health, and Substance
  287  Abuse Statewide Grant Review Committee, in collaboration with
  288  the Department of Children and Families, the Department of
  289  Corrections, the Department of Juvenile Justice, the Department
  290  of Elderly Affairs, and the Office of the State Courts
  291  Administrator, shall establish criteria to be used to review
  292  submitted applications and to select the county that will be
  293  awarded a 1-year planning grant or a 3-year implementation or
  294  expansion grant. A planning, implementation, or expansion grant
  295  may not be awarded unless the application of the county meets
  296  the established criteria.
  297         (b) The application criteria for a 3-year implementation or
  298  expansion grant shall require information from a county that
  299  demonstrates its completion of a well-established collaboration
  300  plan that includes public-private partnership models and the
  301  application of evidence-based practices. The implementation or
  302  expansion grants may support programs and diversion initiatives
  303  that include, but need not be limited to:
  304         1. Mental health courts.;
  305         2. Diversion programs.;
  306         3. Alternative prosecution and sentencing programs.;
  307         4. Crisis intervention teams.;
  308         5. Treatment accountability services.;
  309         6. Specialized training for criminal justice, juvenile
  310  justice, and treatment services professionals.;
  311         7. Service delivery of collateral services such as housing,
  312  transitional housing, and supported employment.; and
  313         8. Reentry services to create or expand mental health and
  314  substance abuse services and supports for affected persons.
  315         9. Coordinated specialty care programs.
  316         Section 7. Section 394.4573, Florida Statutes, is amended
  317  to read:
  318         394.4573 Coordinated system of care; annual assessment;
  319  essential elements; measures of performance; system improvement
  320  grants; reports.—On or before December 1 of each year, the
  321  department shall submit to the Governor, the President of the
  322  Senate, and the Speaker of the House of Representatives an
  323  assessment of the behavioral health services in this state. The
  324  assessment shall consider, at a minimum, the extent to which
  325  designated receiving systems function as no-wrong-door models,
  326  the availability of treatment and recovery services that use
  327  recovery-oriented and peer-involved approaches, the availability
  328  of less-restrictive services, and the use of evidence-informed
  329  practices. The assessment shall also consider the availability
  330  of and access to coordinated specialty care programs and
  331  identify any gaps in the availability of and access to such
  332  programs in the state. The department’s assessment shall
  333  consider, at a minimum, the needs assessments conducted by the
  334  managing entities pursuant to s. 394.9082(5). Beginning in 2017,
  335  the department shall compile and include in the report all plans
  336  submitted by managing entities pursuant to s. 394.9082(8) and
  337  the department’s evaluation of each plan.
  338         (1) As used in this section:
  339         (a) “Care coordination” means the implementation of
  340  deliberate and planned organizational relationships and service
  341  procedures that improve the effectiveness and efficiency of the
  342  behavioral health system by engaging in purposeful interactions
  343  with individuals who are not yet effectively connected with
  344  services to ensure service linkage. Examples of care
  345  coordination activities include development of referral
  346  agreements, shared protocols, and information exchange
  347  procedures. The purpose of care coordination is to enhance the
  348  delivery of treatment services and recovery supports and to
  349  improve outcomes among priority populations.
  350         (b) “Case management” means those direct services provided
  351  to a client in order to assess his or her needs, plan or arrange
  352  services, coordinate service providers, link the service system
  353  to a client, monitor service delivery, and evaluate patient
  354  outcomes to ensure the client is receiving the appropriate
  355  services.
  356         (c) “Coordinated system of care” means the full array of
  357  behavioral and related services in a region or community offered
  358  by all service providers, whether participating under contract
  359  with the managing entity or by another method of community
  360  partnership or mutual agreement.
  361         (d) “No-wrong-door model” means a model for the delivery of
  362  acute care services to persons who have mental health or
  363  substance use disorders, or both, which optimizes access to
  364  care, regardless of the entry point to the behavioral health
  365  care system.
  366         (2) The essential elements of a coordinated system of care
  367  include:
  368         (a) Community interventions, such as prevention, primary
  369  care for behavioral health needs, therapeutic and supportive
  370  services, crisis response services, and diversion programs.
  371         (b) A designated receiving system that consists of one or
  372  more facilities serving a defined geographic area and
  373  responsible for assessment and evaluation, both voluntary and
  374  involuntary, and treatment or triage of patients who have a
  375  mental health or substance use disorder, or co-occurring
  376  disorders.
  377         1. A county or several counties shall plan the designated
  378  receiving system using a process that includes the managing
  379  entity and is open to participation by individuals with
  380  behavioral health needs and their families, service providers,
  381  law enforcement agencies, and other parties. The county or
  382  counties, in collaboration with the managing entity, shall
  383  document the designated receiving system through written
  384  memoranda of agreement or other binding arrangements. The county
  385  or counties and the managing entity shall complete the plan and
  386  implement the designated receiving system by July 1, 2017, and
  387  the county or counties and the managing entity shall review and
  388  update, as necessary, the designated receiving system at least
  389  once every 3 years.
  390         2. To the extent permitted by available resources, the
  391  designated receiving system shall function as a no-wrong-door
  392  model. The designated receiving system may be organized in any
  393  manner which functions as a no-wrong-door model that responds to
  394  individual needs and integrates services among various
  395  providers. Such models include, but are not limited to:
  396         a. A central receiving system that consists of a designated
  397  central receiving facility that serves as a single entry point
  398  for persons with mental health or substance use disorders, or
  399  co-occurring disorders. The central receiving facility shall be
  400  capable of assessment, evaluation, and triage or treatment or
  401  stabilization of persons with mental health or substance use
  402  disorders, or co-occurring disorders.
  403         b. A coordinated receiving system that consists of multiple
  404  entry points that are linked by shared data systems, formal
  405  referral agreements, and cooperative arrangements for care
  406  coordination and case management. Each entry point shall be a
  407  designated receiving facility and shall, within existing
  408  resources, provide or arrange for necessary services following
  409  an initial assessment and evaluation.
  410         c. A tiered receiving system that consists of multiple
  411  entry points, some of which offer only specialized or limited
  412  services. Each service provider shall be classified according to
  413  its capabilities as either a designated receiving facility or
  414  another type of service provider, such as a triage center, a
  415  licensed detoxification facility, or an access center. All
  416  participating service providers shall, within existing
  417  resources, be linked by methods to share data, formal referral
  418  agreements, and cooperative arrangements for care coordination
  419  and case management.
  421  An accurate inventory of the participating service providers
  422  which specifies the capabilities and limitations of each
  423  provider and its ability to accept patients under the designated
  424  receiving system agreements and the transportation plan
  425  developed pursuant to this section shall be maintained and made
  426  available at all times to all first responders in the service
  427  area.
  428         (c) Transportation in accordance with a plan developed
  429  under s. 394.462.
  430         (d) Crisis services, including mobile response teams,
  431  crisis stabilization units, addiction receiving facilities, and
  432  detoxification facilities.
  433         (e) Case management. Each case manager or person directly
  434  supervising a case manager who provides Medicaid-funded targeted
  435  case management services shall hold a valid certification from a
  436  department-approved credentialing entity as defined in s.
  437  397.311(10) by July 1, 2017, and, thereafter, within 6 months
  438  after hire.
  439         (f) Care coordination that involves coordination with other
  440  local systems and entities, public and private, which are
  441  involved with the individual, such as primary care, child
  442  welfare, behavioral health care, and criminal and juvenile
  443  justice organizations.
  444         (g) Outpatient services.
  445         (h) Residential services.
  446         (i) Hospital inpatient care.
  447         (j) Aftercare and other postdischarge services.
  448         (k) Medication-assisted treatment and medication
  449  management.
  450         (l) Recovery support, including, but not limited to,
  451  support for competitive employment, educational attainment,
  452  independent living skills development, family support and
  453  education, wellness management and self-care, and assistance in
  454  obtaining housing that meets the individual’s needs. Such
  455  housing may include mental health residential treatment
  456  facilities, limited mental health assisted living facilities,
  457  adult family care homes, and supportive housing. Housing
  458  provided using state funds must provide a safe and decent
  459  environment free from abuse and neglect.
  460         (m) Care plans shall assign specific responsibility for
  461  initial and ongoing evaluation of the supervision and support
  462  needs of the individual and the identification of housing that
  463  meets such needs. For purposes of this paragraph, the term
  464  “supervision” means oversight of and assistance with compliance
  465  with the clinical aspects of an individual’s care plan.
  466         (n) Coordinated specialty care programs.
  467         (3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific
  468  appropriation by the Legislature, the department may award
  469  system improvement grants to managing entities based on a
  470  detailed plan to enhance services in accordance with the no
  471  wrong-door model as defined in subsection (1) and to address
  472  specific needs identified in the assessment prepared by the
  473  department pursuant to this section. Such a grant must be
  474  awarded through a performance-based contract that links payments
  475  to the documented and measurable achievement of system
  476  improvements.
  477         Section 8. Subsection (3) of section 394.463, Florida
  478  Statutes, is amended to read:
  479         394.463 Involuntary examination.—
  480         (3) NOTICE OF RELEASE.—Notice of the release shall be given
  481  to the patient’s guardian or representative, to any person who
  482  executed a certificate admitting the patient to the receiving
  483  facility, and to any court which ordered the patient’s
  484  evaluation. If the patient is a minor, information regarding the
  485  availability of a local mobile response service, suicide
  486  prevention resources, social supports, and local self-help
  487  groups must also be provided to the patient’s guardian or
  488  representative along with the notice of the release.
  489         Section 9. Paragraph (a) of subsection (26) of section
  490  397.311, Florida Statutes, is amended to read:
  491         397.311 Definitions.—As used in this chapter, except part
  492  VIII, the term:
  493         (26) Licensed service components include a comprehensive
  494  continuum of accessible and quality substance abuse prevention,
  495  intervention, and clinical treatment services, including the
  496  following services:
  497         (a) “Clinical treatment” means a professionally directed,
  498  deliberate, and planned regimen of services and interventions
  499  that are designed to reduce or eliminate the misuse of drugs and
  500  alcohol and promote a healthy, drug-free lifestyle. As defined
  501  by rule, “clinical treatment services” include, but are not
  502  limited to, the following licensable service components:
  503         1. “Addictions receiving facility” is a secure, acute care
  504  facility that provides, at a minimum, detoxification and
  505  stabilization services; is operated 24 hours per day, 7 days per
  506  week; and is designated by the department to serve individuals
  507  found to be substance use impaired as described in s. 397.675
  508  who meet the placement criteria for this component.
  509         2. “Day or night treatment” is a service provided in a
  510  nonresidential environment, with a structured schedule of
  511  treatment and rehabilitative services.
  512         3. “Day or night treatment with community housing” means a
  513  program intended for individuals who can benefit from living
  514  independently in peer community housing while participating in
  515  treatment services for a minimum of 5 hours a day for a minimum
  516  of 25 hours per week.
  517         4. “Detoxification” is a service involving subacute care
  518  that is provided on an inpatient or an outpatient basis to
  519  assist individuals to withdraw from the physiological and
  520  psychological effects of substance abuse and who meet the
  521  placement criteria for this component.
  522         5. “Intensive inpatient treatment” includes a planned
  523  regimen of evaluation, observation, medical monitoring, and
  524  clinical protocols delivered through an interdisciplinary team
  525  approach provided 24 hours per day, 7 days per week, in a highly
  526  structured, live-in environment.
  527         6. “Intensive outpatient treatment” is a service that
  528  provides individual or group counseling in a more structured
  529  environment, is of higher intensity and duration than outpatient
  530  treatment, and is provided to individuals who meet the placement
  531  criteria for this component.
  532         7. “Medication-assisted treatment for opioid use disorders
  533  opiate addiction” is a service that uses methadone or other
  534  medication as authorized by state and federal law, in
  535  combination with medical, rehabilitative, supportive, and
  536  counseling services in the treatment of individuals who are
  537  dependent on opioid drugs.
  538         8. “Outpatient treatment” is a service that provides
  539  individual, group, or family counseling by appointment during
  540  scheduled operating hours for individuals who meet the placement
  541  criteria for this component.
  542         9. “Residential treatment” is a service provided in a
  543  structured live-in environment within a nonhospital setting on a
  544  24-hours-per-day, 7-days-per-week basis, and is intended for
  545  individuals who meet the placement criteria for this component.
  546         Section 10. Subsection (16) of section 397.321, Florida
  547  Statutes, is amended to read:
  548         397.321 Duties of the department.—The department shall:
  549         (16) Develop a certification process by rule for community
  550  substance abuse prevention coalitions.
  551         Section 11. Section 397.4012, Florida Statutes, is amended
  552  to read:
  553         397.4012 Exemptions from licensure.—The following are
  554  exempt from the licensing provisions of this chapter:
  555         (1) A hospital or hospital-based component licensed under
  556  chapter 395.
  557         (2) A nursing home facility as defined in s. 400.021.
  558         (3) A substance abuse education program established
  559  pursuant to s. 1003.42.
  560         (4) A facility or institution operated by the Federal
  561  Government.
  562         (5) A physician or physician assistant licensed under
  563  chapter 458 or chapter 459.
  564         (6) A psychologist licensed under chapter 490.
  565         (7) A social worker, marriage and family therapist, or
  566  mental health counselor licensed under chapter 491.
  567         (8) A legally cognizable church or nonprofit religious
  568  organization or denomination providing substance abuse services,
  569  including prevention services, which are solely religious,
  570  spiritual, or ecclesiastical in nature. A church or nonprofit
  571  religious organization or denomination providing any of the
  572  licensed service components itemized under s. 397.311(26) is not
  573  exempt from substance abuse licensure but retains its exemption
  574  with respect to all services which are solely religious,
  575  spiritual, or ecclesiastical in nature.
  576         (9) Facilities licensed under chapter 393 which, in
  577  addition to providing services to persons with developmental
  578  disabilities, also provide services to persons developmentally
  579  at risk as a consequence of exposure to alcohol or other legal
  580  or illegal drugs while in utero.
  581         (10) DUI education and screening services provided pursuant
  582  to ss. 316.192, 316.193, 322.095, 322.271, and 322.291. Persons
  583  or entities providing treatment services must be licensed under
  584  this chapter unless exempted from licensing as provided in this
  585  section.
  586         (11) A facility licensed under s. 394.875 as a crisis
  587  stabilization unit.
  589  The exemptions from licensure in subsections (3), (4), (8), (9),
  590  and (10) this section do not apply to any service provider that
  591  receives an appropriation, grant, or contract from the state to
  592  operate as a service provider as defined in this chapter or to
  593  any substance abuse program regulated under pursuant to s.
  594  397.4014. Furthermore, this chapter may not be construed to
  595  limit the practice of a physician or physician assistant
  596  licensed under chapter 458 or chapter 459, a psychologist
  597  licensed under chapter 490, a psychotherapist licensed under
  598  chapter 491, or an advanced practice registered nurse licensed
  599  under part I of chapter 464, who provides substance abuse
  600  treatment, so long as the physician, physician assistant,
  601  psychologist, psychotherapist, or advanced practice registered
  602  nurse does not represent to the public that he or she is a
  603  licensed service provider and does not provide services to
  604  individuals under pursuant to part V of this chapter. Failure to
  605  comply with any requirement necessary to maintain an exempt
  606  status under this section is a misdemeanor of the first degree,
  607  punishable as provided in s. 775.082 or s. 775.083.
  608         Section 12. Subsection (14) of section 916.106, Florida
  609  Statutes, is amended to read:
  610         916.106 Definitions.—For the purposes of this chapter, the
  611  term:
  612         (14) “Mental illness” means an impairment of the emotional
  613  processes that exercise conscious control of one’s actions, or
  614  of the ability to perceive or understand reality, which
  615  impairment substantially interferes with the defendant’s ability
  616  to meet the ordinary demands of living. For the purposes of this
  617  chapter, the term does not apply to defendants who have only an
  618  intellectual disability or autism or a defendant with traumatic
  619  brain injury or dementia who lacks a co-occurring mental
  620  illness, and does not include intoxication or conditions
  621  manifested only by antisocial behavior or substance abuse
  622  impairment.
  623         Section 13. Subsection (2) of section 916.13, Florida
  624  Statutes, is amended to read:
  625         916.13 Involuntary commitment of defendant adjudicated
  626  incompetent.—
  627         (2) A defendant who has been charged with a felony and who
  628  has been adjudicated incompetent to proceed due to mental
  629  illness, and who meets the criteria for involuntary commitment
  630  under this chapter, may be committed to the department, and the
  631  department shall retain and treat the defendant.
  632         (a) Immediately after receipt of a completed copy of the
  633  court commitment order containing all documentation required by
  634  the applicable Florida Rules of Criminal Procedure, the
  635  department shall request all medical information relating to the
  636  defendant from the jail. The jail shall provide the department
  637  with all medical information relating to the defendant within 3
  638  business days after receipt of the department’s request or at
  639  the time the defendant enters the physical custody of the
  640  department, whichever is earlier.
  641         (b)(a) Within 6 months after the date of admission and at
  642  the end of any period of extended commitment, or at any time the
  643  administrator or his or her designee determines that the
  644  defendant has regained competency to proceed or no longer meets
  645  the criteria for continued commitment, the administrator or
  646  designee shall file a report with the court pursuant to the
  647  applicable Florida Rules of Criminal Procedure.
  648         (c)(b) A competency hearing must shall be held within 30
  649  days after the court receives notification that the defendant is
  650  competent to proceed or no longer meets the criteria for
  651  continued commitment. The defendant must be transported to the
  652  committing court’s jurisdiction for the hearing. If the
  653  defendant is receiving psychotropic medication at a mental
  654  health facility at the time he or she is discharged and
  655  transferred to the jail, the administering of such medication
  656  must continue unless the jail physician documents the need to
  657  change or discontinue it. The jail and department physicians
  658  shall collaborate to ensure that medication changes do not
  659  adversely affect the defendant’s mental health status or his or
  660  her ability to continue with court proceedings; however, the
  661  final authority regarding the administering of medication to an
  662  inmate in jail rests with the jail physician.
  663         Section 14. Subsections (3) and (5) of section 916.15,
  664  Florida Statutes, are amended to read:
  665         916.15 Involuntary commitment of defendant adjudicated not
  666  guilty by reason of insanity.—
  667         (3)(a) Every defendant acquitted of criminal charges by
  668  reason of insanity and found to meet the criteria for
  669  involuntary commitment may be committed and treated in
  670  accordance with the provisions of this section and the
  671  applicable Florida Rules of Criminal Procedure.
  672         (b) Immediately after receipt of a completed copy of the
  673  court commitment order containing all documentation required by
  674  the applicable Florida Rules of Criminal Procedure, the
  675  department shall request all medical information relating to the
  676  defendant from the jail. The jail shall provide the department
  677  with all medical information relating to the defendant within 3
  678  business days after receipt of the department’s request or at
  679  the time the defendant enters the physical custody of the
  680  department, whichever is earlier.
  681         (c) The department shall admit a defendant so adjudicated
  682  to an appropriate facility or program for treatment and shall
  683  retain and treat such defendant. No later than 6 months after
  684  the date of admission, prior to the end of any period of
  685  extended commitment, or at any time that the administrator or
  686  his or her designee determines shall have determined that the
  687  defendant no longer meets the criteria for continued commitment
  688  placement, the administrator or designee shall file a report
  689  with the court pursuant to the applicable Florida Rules of
  690  Criminal Procedure.
  691         (5) The commitment hearing shall be held within 30 days
  692  after the court receives notification that the defendant no
  693  longer meets the criteria for continued commitment. The
  694  defendant must be transported to the committing court’s
  695  jurisdiction for the hearing. Each defendant returning to a jail
  696  shall continue to receive the same psychotropic medications as
  697  prescribed by the facility physician at the time of discharge
  698  from a forensic or civil facility, unless the jail physician
  699  determines there is a compelling medical reason to change or
  700  discontinue the medication for the health and safety of the
  701  defendant. If the jail physician changes or discontinues the
  702  medication and the defendant is later determined at the
  703  competency hearing to be incompetent to stand trial and is
  704  recommitted to the department, the jail physician may not change
  705  or discontinue the defendant’s prescribed psychotropic
  706  medication upon the defendant’s next discharge from the forensic
  707  or civil facility.
  708         Section 15. Paragraph (a) of subsection (3) of section
  709  39.407, Florida Statutes, is amended to read:
  710         39.407 Medical, psychiatric, and psychological examination
  711  and treatment of child; physical, mental, or substance abuse
  712  examination of person with or requesting child custody.—
  713         (3)(a)1. Except as otherwise provided in subparagraph (b)1.
  714  or paragraph (e), before the department provides psychotropic
  715  medications to a child in its custody, the prescribing physician
  716  or a psychiatric nurse, as defined in s. 394.455, shall attempt
  717  to obtain express and informed consent, as defined in s.
  718  394.455(16) s. 394.455(15) and as described in s. 394.459(3)(a),
  719  from the child’s parent or legal guardian. The department must
  720  take steps necessary to facilitate the inclusion of the parent
  721  in the child’s consultation with the physician or psychiatric
  722  nurse, as defined in s. 394.455. However, if the parental rights
  723  of the parent have been terminated, the parent’s location or
  724  identity is unknown or cannot reasonably be ascertained, or the
  725  parent declines to give express and informed consent, the
  726  department may, after consultation with the prescribing
  727  physician or psychiatric nurse, as defined in s. 394.455, seek
  728  court authorization to provide the psychotropic medications to
  729  the child. Unless parental rights have been terminated and if it
  730  is possible to do so, the department shall continue to involve
  731  the parent in the decisionmaking process regarding the provision
  732  of psychotropic medications. If, at any time, a parent whose
  733  parental rights have not been terminated provides express and
  734  informed consent to the provision of a psychotropic medication,
  735  the requirements of this section that the department seek court
  736  authorization do not apply to that medication until such time as
  737  the parent no longer consents.
  738         2. Any time the department seeks a medical evaluation to
  739  determine the need to initiate or continue a psychotropic
  740  medication for a child, the department must provide to the
  741  evaluating physician or psychiatric nurse, as defined in s.
  742  394.455, all pertinent medical information known to the
  743  department concerning that child.
  744         Section 16. Subsection (3) of section 394.495, Florida
  745  Statutes, is amended to read:
  746         394.495 Child and adolescent mental health system of care;
  747  programs and services.—
  748         (3) Assessments must be performed by:
  749         (a) A professional as defined in s. 394.455(5), (7), (33),
  750  (32), (35), or (36), or (37);
  751         (b) A professional licensed under chapter 491; or
  752         (c) A person who is under the direct supervision of a
  753  qualified professional as defined in s. 394.455(5), (7), (33),
  754  (32), (35), or (36), or (37) or a professional licensed under
  755  chapter 491.
  756         Section 17. Subsection (5) of section 394.496, Florida
  757  Statutes, is amended to read:
  758         394.496 Service planning.—
  759         (5) A professional as defined in s. 394.455(5), (7), (33),
  760  (32), (35), or (36), or (37) or a professional licensed under
  761  chapter 491 must be included among those persons developing the
  762  services plan.
  763         Section 18. Paragraph (a) of subsection (1) of section
  764  394.674, Florida Statutes, is amended to read:
  765         394.674 Eligibility for publicly funded substance abuse and
  766  mental health services; fee collection requirements.—
  767         (1) To be eligible to receive substance abuse and mental
  768  health services funded by the department, an individual must be
  769  a member of at least one of the department’s priority
  770  populations approved by the Legislature. The priority
  771  populations include:
  772         (a) For adult mental health services:
  773         1. Adults who have severe and persistent mental illness, as
  774  designated by the department using criteria that include
  775  severity of diagnosis, duration of the mental illness, ability
  776  to independently perform activities of daily living, and receipt
  777  of disability income for a psychiatric condition. Included
  778  within this group are:
  779         a. Older adults in crisis.
  780         b. Older adults who are at risk of being placed in a more
  781  restrictive environment because of their mental illness.
  782         c. Persons deemed incompetent to proceed or not guilty by
  783  reason of insanity under chapter 916.
  784         d. Other persons involved in the criminal justice system.
  785         e. Persons diagnosed as having co-occurring mental illness
  786  and substance abuse disorders.
  787         2. Persons who are experiencing an acute mental or
  788  emotional crisis as defined in s. 394.67(18) s. 394.67(17).
  789         Section 19. Paragraph (a) of subsection (3) of section
  790  394.74, Florida Statutes, is amended to read:
  791         394.74 Contracts for provision of local substance abuse and
  792  mental health programs.—
  793         (3) Contracts shall include, but are not limited to:
  794         (a) A provision that, within the limits of available
  795  resources, substance abuse and mental health crisis services, as
  796  defined in s. 394.67(4) s. 394.67(3), shall be available to any
  797  individual residing or employed within the service area,
  798  regardless of ability to pay for such services, current or past
  799  health condition, or any other factor;
  800         Section 20. Subsection (6) of section 394.9085, Florida
  801  Statutes, is amended to read:
  802         394.9085 Behavioral provider liability.—
  803         (6) For purposes of this section, the terms “detoxification
  804  services,” “addictions receiving facility,” and “receiving
  805  facility” have the same meanings as those provided in ss.
  806  397.311(26)(a)3. ss. 397.311(26)(a)4., 397.311(26)(a)1., and
  807  394.455(40) 394.455(39), respectively.
  808         Section 21. Paragraph (b) of subsection (1) of section
  809  409.972, Florida Statutes, is amended to read:
  810         409.972 Mandatory and voluntary enrollment.—
  811         (1) The following Medicaid-eligible persons are exempt from
  812  mandatory managed care enrollment required by s. 409.965, and
  813  may voluntarily choose to participate in the managed medical
  814  assistance program:
  815         (b) Medicaid recipients residing in residential commitment
  816  facilities operated through the Department of Juvenile Justice
  817  or a treatment facility as defined in s. 394.455(48) s.
  818  394.455(47).
  819         Section 22. Paragraph (e) of subsection (4) of section
  820  464.012, Florida Statutes, is amended to read:
  821         464.012 Licensure of advanced practice registered nurses;
  822  fees; controlled substance prescribing.—
  823         (4) In addition to the general functions specified in
  824  subsection (3), an advanced practice registered nurse may
  825  perform the following acts within his or her specialty:
  826         (e) A psychiatric nurse, who meets the requirements in s.
  827  394.455(36) s. 394.455(35), within the framework of an
  828  established protocol with a psychiatrist, may prescribe
  829  psychotropic controlled substances for the treatment of mental
  830  disorders.
  831         Section 23. Subsection (7) of section 744.2007, Florida
  832  Statutes, is amended to read:
  833         744.2007 Powers and duties.—
  834         (7) A public guardian may not commit a ward to a treatment
  835  facility, as defined in s. 394.455(48) s. 394.455(47), without
  836  an involuntary placement proceeding as provided by law.
  837         Section 24. This act shall take effect July 1, 2020.