Florida Senate - 2022 COMMITTEE AMENDMENT
Bill No. SB 1262
Ì453624&Î453624
LEGISLATIVE ACTION
Senate . House
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The Committee on Children, Families, and Elder Affairs (Burgess)
recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Present subsections (47), (48), and (49) of
6 section 394.455, Florida Statutes, are redesignated as
7 subsections (48), (49), and (50), respectively, and a new
8 subsection (47) is added to that section, to read:
9 394.455 Definitions.—As used in this part, the term:
10 (47) ″Telehealth″ has the same meaning as provided in s.
11 456.47.
12 Section 2. Paragraphs (a), (b), and (c) of subsection (5)
13 of section 394.459, Florida Statutes, are amended, present
14 paragraphs (d), (e), and (f) are redesignated as paragraphs (e),
15 (f), and (g), respectively, and a new paragraph (d) is added to
16 that subsection, to read:
17 394.459 Rights of patients.—
18 (5) COMMUNICATION, ABUSE REPORTING, AND VISITS.—
19 (a) Each person receiving services in a facility providing
20 mental health services under this part has the right to
21 communicate freely and privately with persons outside the
22 facility unless a qualified professional determines it is
23 determined that such communication is likely to be harmful to
24 the person or others in a manner directly related to the
25 person’s clinical well-being, the clinical well-being of other
26 patients, or the general safety of staff. Each facility shall
27 make available as soon as reasonably possible to persons
28 receiving services a telephone that allows for free local calls
29 and access to a long-distance service. A facility is not
30 required to pay the costs of a patient’s long-distance calls.
31 The telephone shall be readily accessible to the patient and
32 shall be placed so that the patient may use it to communicate
33 privately and confidentially. The facility may establish
34 reasonable rules for the use of this telephone, provided that
35 the rules do not interfere with a patient’s access to a
36 telephone to report abuse pursuant to paragraph (f) (e).
37 (b) Each patient admitted to a facility under the
38 provisions of this part shall be allowed to receive, send, and
39 mail sealed, unopened correspondence; and no patient’s incoming
40 or outgoing correspondence shall be opened, delayed, held, or
41 censored by the facility unless a qualified professional
42 determines that such correspondence is likely to be harmful to
43 the patient or others in a manner directly related to the
44 patient’s clinical well-being, the clinical well-being of other
45 patients, or the general safety of staff. If there is reason to
46 believe that such correspondence it contains items or substances
47 which may be harmful to the patient or others, in which case the
48 administrator may direct reasonable examination of such mail and
49 may regulate the disposition of such items or substances.
50 (c) Each facility must permit immediate access to any
51 patient, subject to the patient’s right to deny or withdraw
52 consent at any time, by the patient’s family members, guardian,
53 guardian advocate, representative, Florida statewide or local
54 advocacy council, or attorney, unless a qualified professional
55 determines that such access would be detrimental to the patient
56 in a manner directly related to the patient’s clinical well
57 being, the clinical well-being of other patients, or the general
58 safety of staff.
59 (d) If a patient’s right to communicate with outside
60 persons; receive, send, or mail sealed, unopened correspondence;
61 or to receive visitors is restricted by the facility, written
62 notice of such restriction and the reasons for the restriction
63 shall be served on the patient, the patient’s attorney, and the
64 patient’s guardian, guardian advocate, or representative; a
65 qualified professional must document any restriction within 24
66 hours and such restriction shall be recorded on the patient’s
67 clinical record with the reasons therefor. The restriction of a
68 patient’s right to communicate or to receive visitors shall be
69 reviewed at least every 3 7 days. The right to communicate or
70 receive visitors shall not be restricted as a means of
71 punishment. Nothing in this paragraph shall be construed to
72 limit the provisions of paragraph (e)(d).
73 (e)(d) Each facility shall establish reasonable rules
74 governing visitors, visiting hours, and the use of telephones by
75 patients in the least restrictive possible manner. Patients
76 shall have the right to contact and to receive communication
77 from their attorneys at any reasonable time.
78 (f)(e) Each patient receiving mental health treatment in
79 any facility shall have ready access to a telephone in order to
80 report an alleged abuse. The facility staff shall orally and in
81 writing inform each patient of the procedure for reporting abuse
82 and shall make every reasonable effort to present the
83 information in a language the patient understands. A written
84 copy of that procedure, including the telephone number of the
85 central abuse hotline and reporting forms, shall be posted in
86 plain view.
87 (g)(f) The department shall adopt rules providing a
88 procedure for reporting abuse. Facility staff shall be required,
89 as a condition of employment, to become familiar with the
90 requirements and procedures for the reporting of abuse.
91 Section 3. Paragraph (b) of subsection (2) of section
92 394.4599, Florida Statutes, is amended to read:
93 394.4599 Notice.—
94 (2) INVOLUNTARY ADMISSION.—
95 (b) A receiving facility shall give prompt notice of the
96 whereabouts of an individual who is being involuntarily held for
97 examination to the individual’s guardian, guardian advocate,
98 health care surrogate or proxy, attorney or representative, or
99 other emergency contact identified through electronic databases
100 pursuant to s. 394.463(2)(a), by telephone or in person within
101 24 hours after the individual’s arrival at the facility. Contact
102 attempts shall be documented in the individual’s clinical record
103 and shall begin as soon as reasonably possible after the
104 individual’s arrival.
105 Section 4. Paragraph (a) of subsection (2) of section
106 394.4615, Florida Statutes, is amended to read:
107 394.4615 Clinical records; confidentiality.—
108 (2) The clinical record shall be released when:
109 (a) The patient or the patient’s guardian authorizes the
110 release. The guardian or guardian advocate shall be provided
111 access to the appropriate clinical records of the patient. The
112 patient or the patient’s guardian or guardian advocate may
113 authorize the release of information and clinical records to
114 appropriate persons to ensure the continuity of the patient’s
115 health care or mental health care. A receiving facility must
116 document that, within 24 hours of admission, individuals
117 admitted on a voluntary basis have been provided with the option
118 to authorize the release of information from their clinical
119 record to the individual’s health care surrogate or proxy,
120 attorney, representative, or other known emergency contact.
121 Section 5. Paragraphs (a), (e), (f), and (g) of subsection
122 (2) of section 394.463, Florida Statutes, are amended, and
123 subsection (5) is added to that section, to read:
124 394.463 Involuntary examination.—
125 (2) INVOLUNTARY EXAMINATION.—
126 (a) An involuntary examination may be initiated by any one
127 of the following means:
128 1. A circuit or county court may enter an ex parte order
129 stating that a person appears to meet the criteria for
130 involuntary examination and specifying the findings on which
131 that conclusion is based. The ex parte order for involuntary
132 examination must be based on written or oral sworn testimony
133 that includes specific facts that support the findings. If other
134 less restrictive means are not available, such as voluntary
135 appearance for outpatient evaluation, a law enforcement officer,
136 or other designated agent of the court, shall take the person
137 into custody and deliver him or her to an appropriate, or the
138 nearest, facility within the designated receiving system
139 pursuant to s. 394.462 for involuntary examination. The order of
140 the court shall be made a part of the patient’s clinical record.
141 A fee may not be charged for the filing of an order under this
142 subsection. A facility accepting the patient based on this order
143 must send a copy of the order to the department within 5 working
144 days. The order may be submitted electronically through existing
145 data systems, if available. The order shall be valid only until
146 the person is delivered to the facility or for the period
147 specified in the order itself, whichever comes first. If a time
148 limit is not specified in the order, the order is valid for 7
149 days after the date that the order was signed.
150 2. A law enforcement officer shall take a person who
151 appears to meet the criteria for involuntary examination into
152 custody and deliver the person or have him or her delivered to
153 an appropriate, or the nearest, facility within the designated
154 receiving system pursuant to s. 394.462 for examination. The
155 officer shall execute a written report detailing the
156 circumstances under which the person was taken into custody,
157 which must be made a part of the patient’s clinical record. The
158 report must include all emergency contact information for the
159 person that is readily accessible to the law enforcement
160 officer, including information available through electronic
161 databases maintained by the Department of Law Enforcement or by
162 the Department of Highway Safety and Motor Vehicles. Such
163 emergency contact information may be used by a receiving
164 facility only for the purpose of informing listed emergency
165 contacts of a patient’s whereabouts and shall otherwise remain
166 confidential and exempt pursuant to s. 119.0712(2)(d). Any
167 facility accepting the patient based on this report must send a
168 copy of the report to the department within 5 working days.
169 3. A physician, a physician assistant, a clinical
170 psychologist, a psychiatric nurse, an advanced practice
171 registered nurse registered under s. 464.0123, a mental health
172 counselor, a marriage and family therapist, or a clinical social
173 worker may execute a certificate stating that he or she has
174 examined a person within the preceding 48 hours and finds that
175 the person appears to meet the criteria for involuntary
176 examination and stating the observations upon which that
177 conclusion is based. If other less restrictive means, such as
178 voluntary appearance for outpatient evaluation, are not
179 available, a law enforcement officer shall take into custody the
180 person named in the certificate and deliver him or her to the
181 appropriate, or nearest, facility within the designated
182 receiving system pursuant to s. 394.462 for involuntary
183 examination. The law enforcement officer shall execute a written
184 report detailing the circumstances under which the person was
185 taken into custody. The report must include all emergency
186 contact information for the person that is readily accessible to
187 the law enforcement officer, including information available
188 through electronic databases maintained by the Department of Law
189 Enforcement or by the Department of Highway Safety and Motor
190 Vehicles. Such emergency contact information may be used by a
191 receiving facility only for the purpose of informing listed
192 emergency contacts of a patient’s whereabouts and shall
193 otherwise remain confidential and exempt pursuant to s.
194 119.0712(2)(d). The report and certificate shall be made a part
195 of the patient’s clinical record. Any facility accepting the
196 patient based on this certificate must send a copy of the
197 certificate to the department within 5 working days. The
198 document may be submitted electronically through existing data
199 systems, if applicable.
200
201 When sending the order, report, or certificate to the
202 department, a facility shall, at a minimum, provide information
203 about which action was taken regarding the patient under
204 paragraph (g), which information shall also be made a part of
205 the patient’s clinical record.
206 (e) The department shall receive and maintain the copies of
207 ex parte orders, involuntary outpatient services orders issued
208 pursuant to s. 394.4655, involuntary inpatient placement orders
209 issued pursuant to s. 394.467, professional certificates, and
210 law enforcement officers’ reports, and reports relating to the
211 transportation of patients. These documents shall be considered
212 part of the clinical record, governed by the provisions of s.
213 394.4615. These documents shall be used to prepare annual
214 reports analyzing the data obtained from these documents,
215 without information identifying patients, and shall provide
216 copies of reports to the department, the President of the
217 Senate, the Speaker of the House of Representatives, and the
218 minority leaders of the Senate and the House of Representatives.
219 (f) A patient shall be examined by a physician or a
220 clinical psychologist, or by a psychiatric nurse performing
221 within the framework of an established protocol with a
222 psychiatrist at a facility without unnecessary delay to
223 determine if the criteria for involuntary services are met.
224 Emergency treatment may be provided upon the order of a
225 physician if the physician determines that such treatment is
226 necessary for the safety of the patient or others. The patient
227 may not be released by the receiving facility or its contractor
228 without the documented approval of a psychiatrist or a clinical
229 psychologist or, if the receiving facility is owned or operated
230 by a hospital or health system, the release may also be approved
231 by a psychiatric nurse performing within the framework of an
232 established protocol with a psychiatrist, or an attending
233 emergency department physician with experience in the diagnosis
234 and treatment of mental illness after completion of an
235 involuntary examination pursuant to this subsection. A
236 psychiatric nurse may not approve the release of a patient if
237 the involuntary examination was initiated by a psychiatrist
238 unless the release is approved by the initiating psychiatrist.
239 The release may be approved through telehealth.
240 (g) The examination period must be for up to 72 hours. For
241 a minor, the examination shall be initiated within 12 hours
242 after the patient’s arrival at the facility. Within the
243 examination period or, if the examination period ends on a
244 weekend or holiday, no later than the next working day
245 thereafter, one of the following actions must be taken, based on
246 the individual needs of the patient:
247 1. The patient shall be released, unless he or she is
248 charged with a crime, in which case the patient shall be
249 returned to the custody of a law enforcement officer;
250 2. The patient shall be released, subject to subparagraph
251 1., for voluntary outpatient treatment;
252 3. The patient, unless he or she is charged with a crime,
253 shall be asked to give express and informed consent to placement
254 as a voluntary patient and, if such consent is given, the
255 patient shall be admitted as a voluntary patient; or
256 4. A petition for involuntary services shall be filed in
257 the circuit court if inpatient treatment is deemed necessary or
258 with the criminal county court, as defined in s. 394.4655(1), as
259 applicable. When inpatient treatment is deemed necessary, the
260 least restrictive treatment consistent with the optimum
261 improvement of the patient’s condition shall be made available.
262 When a petition is to be filed for involuntary outpatient
263 placement, it shall be filed by one of the petitioners specified
264 in s. 394.4655(4)(a). A petition for involuntary inpatient
265 placement shall be filed by the facility administrator. If a
266 patient’s 72-hour examination period ends on a weekend or
267 holiday, and the receiving facility:
268 a. Intends to file a petition for involuntary services,
269 such patient may be held at a receiving facility through the
270 next working day thereafter and such petition for involuntary
271 services must be filed no later than such date. If the receiving
272 facility fails to file a petition for involuntary services at
273 the close of the next working day, the patient shall be released
274 from the receiving facility.
275 b. Does not intend to file a petition for involuntary
276 services, a receiving facility may postpone release of a patient
277 until the next working day thereafter only if a qualified
278 professional documents that adequate discharge planning and
279 procedures in accordance with s. 394.468 are not possible until
280 the next working day.
281 (5) UNLAWFUL ACTIVITIES RELATING TO EXAMINATION AND
282 TREATMENT; PENALTIES.—
283 (a) A person may not knowingly and willfully:
284 1. Furnish false information for the purpose of obtaining
285 emergency or other involuntary admission of another;
286 2. Cause or otherwise secure, or conspire with or assist
287 another to cause or secure, any emergency or other involuntary
288 procedure of another person under false pretenses; or
289 3. Cause, or conspire with or assist another to cause, the
290 denial to any person of any right accorded pursuant to this
291 chapter.
292 (b) A person who violates this subsection commits a
293 misdemeanor of the first degree, punishable as provided in s.
294 775.082 and by a fine not exceeding $5,000.
295 Section 6. Section 394.468, Florida Statutes, is amended to
296 read:
297 394.468 Admission and discharge procedures.—
298 (1) Admission and discharge procedures and treatment
299 policies of the department are governed solely by this part.
300 Such procedures and policies shall not be subject to control by
301 court procedure rules. The matters within the purview of this
302 part are deemed to be substantive, not procedural.
303 (2) Discharge planning and procedures for any patient’s
304 release from a receiving facility or treatment facility must
305 include and document consideration of, at a minimum:
306 (a) Follow-up behavioral health appointments;
307 (b) Information on how to obtain prescribed medications;
308 and
309 (c) Information pertaining to:
310 1. Available living arrangements;
311 2. Transportation; and
312 3. Recovery support opportunities.
313 Section 7. Paragraph (c) of subsection (3) of section
314 394.9086, Florida Statutes, is amended, a new paragraph (d) is
315 added to that subsection, and subsection (5) of that section is
316 amended, to read:
317 394.9086 Commission on Mental Health and Substance Abuse.—
318 (3) MEMBERSHIP; TERM LIMITS; MEETINGS.—
319 (c) The commission shall convene no later than September 1,
320 2021. The commission shall meet quarterly or upon the call of
321 the chair. The commission shall hold its meetings in person at
322 locations throughout the state via teleconference or other
323 electronic means.
324 (d) Members of the commission are entitled to receive
325 reimbursement for per diem and travel expenses pursuant to s.
326 112.061.
327 (5) REPORTS.—By January 1, 2023 September 1, 2022, the
328 commission shall submit an interim report to the President of
329 the Senate, the Speaker of the House of Representatives, and the
330 Governor containing its findings and recommendations on how to
331 best provide and facilitate mental health and substance abuse
332 services in the state. The commission shall submit its final
333 report to the President of the Senate, the Speaker of the House
334 of Representatives, and the Governor by September 1, 2023.
335 Section 8. Subsection (5) is added to section 397.601,
336 Florida Statutes, to read:
337 397.601 Voluntary admissions.—
338 (5) A service provider must document that, within 24 hours
339 of admission, individuals admitted on a voluntary basis have
340 been provided with the option to authorize the release of
341 information from their clinical record to the individual’s
342 health care surrogate or proxy, attorney, representative, or
343 other known emergency contact.
344 Section 9. Section 397.6772, Florida Statutes, is amended
345 to read:
346 397.6772 Protective custody without consent.—
347 (1) If a person in circumstances which justify protective
348 custody as described in s. 397.677 fails or refuses to consent
349 to assistance and a law enforcement officer has determined that
350 a hospital or a licensed detoxification or addictions receiving
351 facility is the most appropriate place for the person, the
352 officer may, after giving due consideration to the expressed
353 wishes of the person:
354 (a) Take the person to a hospital or to a licensed
355 detoxification or addictions receiving facility against the
356 person’s will but without using unreasonable force. The officer
357 shall use the standard form developed by the department pursuant
358 to s. 397.321 to execute a written report detailing the
359 circumstances under which the person was taken into custody. The
360 report must include all emergency contact information for the
361 person that is readily accessible to the law enforcement
362 officer, including information available through electronic
363 databases maintained by the Department of Law Enforcement or by
364 the Department of Highway Safety and Motor Vehicles. Such
365 emergency contact information may be used by a hospital or
366 licensed detoxification or addictions receiving facility only
367 for the purpose of informing listed emergency contacts of a
368 patient’s whereabouts and shall otherwise remain confidential
369 and exempt pursuant to s. 119.0712(2)(d). The written report
370 shall be included in the patient’s clinical record; or
371 (b) In the case of an adult, detain the person for his or
372 her own protection in any municipal or county jail or other
373 appropriate detention facility.
374
375 Such detention is not to be considered an arrest for any
376 purpose, and no entry or other record may be made to indicate
377 that the person has been detained or charged with any crime. The
378 officer in charge of the detention facility must notify the
379 nearest appropriate licensed service provider within the first 8
380 hours after detention that the person has been detained. It is
381 the duty of the detention facility to arrange, as necessary, for
382 transportation of the person to an appropriate licensed service
383 provider with an available bed. Persons taken into protective
384 custody must be assessed by the attending physician within the
385 72-hour period and without unnecessary delay, to determine the
386 need for further services.
387 (2) The law enforcement officer must notify the nearest
388 relative of a minor in protective custody and must be notified
389 by the law enforcement officer, as must notify the nearest
390 relative or other known emergency contact of an adult, unless
391 the adult requests that there be no notification. The law
392 enforcement officer must document such notification, and any
393 attempts at notification, in the written report detailing the
394 circumstances under which the person was taken into custody as
395 required under paragraph (1)(a).
396 Section 10. Paragraph (b) of subsection (1) of section
397 409.972, Florida Statutes, is amended to read:
398 409.972 Mandatory and voluntary enrollment.—
399 (1) The following Medicaid-eligible persons are exempt from
400 mandatory managed care enrollment required by s. 409.965, and
401 may voluntarily choose to participate in the managed medical
402 assistance program:
403 (b) Medicaid recipients residing in residential commitment
404 facilities operated through the Department of Juvenile Justice
405 or a treatment facility as defined in s. 394.455(49) s.
406 394.455(48).
407 Section 11. Subsection (7) of section 744.2007, Florida
408 Statutes, is amended to read:
409 744.2007 Powers and duties.—
410 (7) A public guardian may not commit a ward to a treatment
411 facility, as defined in s. 394.455(49) s. 394.455(48), without
412 an involuntary placement proceeding as provided by law.
413 Section 12. This act shall take effect July 1, 2022.
414 ================= T I T L E A M E N D M E N T ================
415 And the title is amended as follows:
416 Delete everything before the enacting clause
417 and insert:
418 A bill to be entitled
419 An act relating to mental health and substance abuse;
420 amending s. 394.455, F.S.; defining the term
421 “telehealth”; amending s. 394.459, F.S.; revising the
422 conditions under which a patient’s communication with
423 persons outside of a receiving facility may be
424 restricted; revising the conditions under which a
425 patient’s sealed and unopened incoming or outgoing
426 correspondence may be restricted; revising the
427 conditions under which a patient’s visitation with
428 persons outside of a receiving facility may be
429 restricted; revising the frequency with which the
430 restriction on a patient’s right to receive visitors
431 must be reviewed; amending s. 394.4599, F.S.;
432 requiring a receiving facility to notify specified
433 emergency contacts of individuals who are being
434 involuntarily held for examination; amending s.
435 394.4615, F.S.; requiring receiving facilities to
436 document that an option to authorize the release of
437 specified information has been provided, within a
438 specified timeframe, to individuals admitted on a
439 voluntary basis; amending s. 394.463, F.S.; requiring
440 that reports issued by law enforcement officers when
441 delivering a person to a receiving facility contain
442 certain information related to emergency contacts;
443 limiting the use of certain information provided;
444 maintaining the confidential and exempt status of
445 certain information provided to a receiving facility;
446 requiring the Department of Children and Families to
447 receive and maintain reports relating to the
448 transportation of patients; authorizing receiving
449 facility discharge examinations to be conducted
450 through telehealth; requiring a facility administrator
451 to file a petition for involuntary placement by a
452 specified time; authorizing a receiving facility to
453 postpone the release of a patient if certain
454 requirements are met; prohibiting certain activities
455 relating to examination and treatment; providing a
456 criminal penalty; amending s. 394.468, F.S.; requiring
457 that discharge and planning procedures include and
458 document the consideration of specified factors and
459 actions; amending s. 394.9086; modifying meeting
460 requirements of the Commission on Mental Health and
461 Substance Abuse; authorizing reimbursement for per
462 diem and travel expenses; modifying the due date for
463 the Commission’s interim report; amending s. 397.601,
464 F.S.; requiring service providers to document that an
465 option to authorize the release of specified
466 information has been provided, within a specified
467 timeframe, to individuals admitted on a voluntary
468 basis; amending s. 397.6772, F.S.; requiring law
469 enforcement officers to include certain information
470 relating to emergency contacts in reports relating to
471 the delivery of a person to a hospital or licensed
472 detoxification or addictions receiving facility;
473 limiting the use of certain information provided;
474 maintaining the confidential and exempt status of
475 certain information provided to a hospital or licensed
476 detoxification or addictions receiving facility;
477 amending ss. 409.972 and 744.2007, F.S.; conforming
478 cross-references; providing an effective date.