Florida Senate - 2024                             CS for SB 1784
       
       
        
       By the Committee on Fiscal Policy; and Senator Grall
       
       
       
       
       
       594-03814-24                                          20241784c1
    1                        A bill to be entitled                      
    2         An act relating to mental health and substance abuse;
    3         amending s. 394.455, F.S.; conforming a cross
    4         reference to changes made by the act; amending s.
    5         394.4572, F.S.; providing an exception to background
    6         screening requirements for certain licensed physicians
    7         and nurses; amending s. 394.459, F.S.; specifying a
    8         timeframe for recording restrictions in a patient’s
    9         clinical file; requiring that such recorded
   10         restriction be immediately served on certain parties;
   11         conforming a provision to changes made by the act;
   12         amending s. 394.4598, F.S.; authorizing certain
   13         psychiatric nurses to consult with guardian advocates
   14         for purposes of obtaining consent for treatment;
   15         amending s. 394.4599, F.S.; revising written notice
   16         requirements relating to filing petitions for
   17         involuntary services; amending s. 394.461, F.S.;
   18         authorizing the state to establish that a transfer
   19         evaluation was performed by providing the court with a
   20         copy of the evaluation before the close of the state’s
   21         case-in-chief; prohibiting the court from considering
   22         substantive information in the transfer evaluation;
   23         providing an exception; revising reporting
   24         requirements; amending s. 394.4615, F.S.; allowing a
   25         patient’s legal custodian to authorize release of the
   26         patient’s clinical records; conforming provisions to
   27         changes made by the act; amending s. 394.462, F.S.;
   28         authorizing a county to include alternative funding
   29         arrangements for transporting individuals to
   30         designated receiving facilities in the county’s
   31         transportation plan; conforming provisions to changes
   32         made by the act; amending s. 394.4625, F.S.; revising
   33         requirements relating to voluntary admissions to a
   34         facility for examination and treatment; requiring
   35         certain treating psychiatric nurses to document
   36         specified information in a patient’s clinical record
   37         within a specified timeframe of his or her voluntary
   38         admission for mental health treatment; requiring
   39         clinical psychologists who make determinations of
   40         involuntary placement at certain mental health
   41         facilities to have specified clinical experience;
   42         authorizing certain psychiatric nurses to order
   43         emergency treatment for certain patients; conforming
   44         provisions to changes made by the act; amending s.
   45         394.463, F.S.; authorizing, rather than requiring, law
   46         enforcement officers to take certain persons into
   47         custody for involuntary examinations; requiring a law
   48         enforcement officer to provide a parent or legal
   49         guardian of a minor being transported to certain
   50         facilities with specified facility information;
   51         providing an exception; requiring that written reports
   52         by law enforcement officers contain certain
   53         information; requiring a certain institute to collect
   54         and analyze certain documents and use them to prepare
   55         annual reports; providing requirements for such
   56         reports; requiring the institute to post such reports
   57         on its website; providing a due date for the annual
   58         reports; requiring the Department of Children and
   59         Families to post a specified report on its website;
   60         revising requirements for patient examinations at
   61         receiving facilities; revising requirements for
   62         petitions for involuntary services; revising
   63         requirements for releasing a patient from a receiving
   64         facility; requiring the department and the Agency for
   65         Health Care Administration to provide certain
   66         collected data to a specified institute; requiring the
   67         institute to analyze the collected data, identify
   68         patterns and trends, and make recommendations to
   69         decrease avoidable admissions; authorizing
   70         recommendations to be addressed in a specified manner;
   71         requiring the institute to publish a specified report
   72         on its website and submit the report to the Governor,
   73         Legislature, department, and agency by a certain date;
   74         amending s. 394.4655, F.S.; defining the term
   75         “involuntary outpatient placement”; authorizing a
   76         specified court to order an individual to involuntary
   77         outpatient placement; deleting provisions relating to
   78         criteria, retention of a patient, and petition for
   79         involuntary outpatient services and court proceedings
   80         relating to involuntary outpatient services; amending
   81         s. 394.467, F.S.; defining terms; revising
   82         requirements for ordering a person for involuntary
   83         services and treatment, petitions for involuntary
   84         service, appointment of counsel, and continuances of
   85         hearings, respectively; requiring clinical
   86         psychologists to have specified clinical experience in
   87         order to recommend involuntary services; authorizing
   88         certain psychiatric nurses to recommend involuntary
   89         services for mental health treatment; revising the
   90         conditions under which a court may waive the
   91         requirement for a patient to be present at an
   92         involuntary inpatient placement hearing; authorizing
   93         the court to permit witnesses to attend and testify
   94         remotely at the hearing through specified means;
   95         providing requirements for a witness to attend and
   96         testify remotely; requiring facilities to make certain
   97         clinical records available to a state attorney within
   98         a specified timeframe; specifying that such records
   99         remain confidential and may not be used for certain
  100         purposes; requiring the court to allow certain
  101         testimony from specified persons; providing
  102         requirements for certain parties and limitations on
  103         the court’s order if specified services or funding is
  104         not available; revising the length of time a court may
  105         require a patient to receive services; prohibiting
  106         courts from ordering individuals with developmental
  107         disabilities to be involuntarily placed in a state
  108         treatment facility; requiring courts to refer such
  109         individuals, and authorizing courts to refer certain
  110         other individuals, to specified agencies for
  111         evaluation and services; providing requirements for
  112         service plan modifications, noncompliance with
  113         involuntary outpatient services, and discharge,
  114         respectively; revising requirements for the procedure
  115         for continued involuntary services and return to
  116         facilities, respectively; amending s. 394.468, F.S.;
  117         revising requirements for discharge planning and
  118         procedures; providing requirements for the discharge
  119         transition process; creating s. 394.4915, F.S.;
  120         establishing the Office of Children’s Behavioral
  121         Health Ombudsman within the Department of Children and
  122         Families for a specified purpose; providing
  123         responsibilities of the office; requiring the
  124         department and managing entities to include specified
  125         information in a specified manner on their websites;
  126         amending ss. 394.495 and 394.496, F.S.; conforming
  127         provisions to changes made by the act; amending s.
  128         394.499, F.S.; revising eligibility requirements for
  129         children’s crisis stabilization unit/juvenile
  130         addictions receiving facility services; amending s.
  131         394.875, F.S.; deleting a limitation on the size of a
  132         crisis stabilization unit; deleting a requirement for
  133         the department to implement a certain demonstration
  134         project; creating s. 394.90826, F.S.; requiring the
  135         Department of Children and Families and the Agency for
  136         Health Care Administration to jointly establish
  137         regional behavioral health interagency collaboratives
  138         for certain purposes; providing objectives the
  139         collaboratives are to meet; specifying collaborative
  140         membership; requiring each collaborative to define
  141         objectives based on the needs of its region; requiring
  142         the department to define the regions served and to
  143         facilitate meetings; requiring the entities
  144         represented in a collaborative to provide certain
  145         assistance; amending s. 394.9085, F.S.; conforming a
  146         cross-reference to changes made by the act; amending
  147         s. 397.305, F.S.; revising the purpose of ch. 397,
  148         F.S., to include the most appropriate environment for
  149         substance abuse services; amending s. 397.311, F.S.;
  150         revising definitions; amending s. 397.401, F.S.;
  151         prohibiting certain service providers from exceeding
  152         their licensed capacity by more than a specified
  153         percentage or for more than a specified number of
  154         days; amending s. 397.4073, F.S.; providing an
  155         exception to background screening requirements for
  156         certain licensed physicians and nurses; amending s.
  157         397.501, F.S.; revising notice requirements for the
  158         right to counsel for certain individuals; amending s.
  159         397.581, F.S.; revising actions that constitute
  160         unlawful activities relating to assessment and
  161         treatment; providing penalties; amending s. 397.675,
  162         F.S.; revising the criteria for involuntary admissions
  163         for purposes of assessment and stabilization and for
  164         involuntary treatment; amending s. 397.6751, F.S.;
  165         revising service provider responsibilities relating to
  166         involuntary admissions; amending s. 397.681, F.S.;
  167         revising the jurisdiction of the courts with regard to
  168         certain petitions; specifying requirements for the
  169         court to allow a waiver of the respondent’s right to
  170         counsel relating to petitions for involuntary
  171         treatment; revising the circumstances under which
  172         courts are required to appoint counsel for respondents
  173         without regard to respondents’ wishes; renumbering and
  174         amending s. 397.693, F.S.; revising the circumstances
  175         under which a person may be the subject of a petition
  176         for court-ordered involuntary treatment; renumbering
  177         and amending s. 397.695, F.S.; authorizing the court
  178         to prohibit or a law enforcement agency to waive any
  179         service of process fees for petitioners determined to
  180         be indigent; renumbering and amending s. 397.6951,
  181         F.S.; revising the information required to be included
  182         in a petition for involuntary treatment services;
  183         authorizing a petitioner to include a certificate or
  184         report of a qualified professional with such petition;
  185         requiring such certificate or report to contain
  186         certain information; requiring that certain additional
  187         information be included if an emergency exists;
  188         renumbering and amending s. 397.6955, F.S.; revising
  189         when the office of criminal conflict and civil
  190         regional counsel represents a person in the filing of
  191         a petition for involuntary services and when a hearing
  192         must be held on such petition; requiring a law
  193         enforcement agency to effect service for initial
  194         treatment hearings; providing an exception; amending
  195         s. 397.6818, F.S.; authorizing the court to take
  196         certain actions and issue certain orders regarding a
  197         respondent’s involuntary assessment if emergency
  198         circumstances exist; providing a specified timeframe
  199         for taking such actions; prohibiting the service
  200         provider from holding the respondent for observation
  201         longer than a certain amount of time; providing
  202         exceptions; authorizing the court to issue or reissue
  203         a specified order under certain circumstances;,
  204         continue the case, and order a law enforcement officer
  205         or other agent to take the respondent into custody and
  206         deliver him or her to the service provider; providing
  207         that a case be dismissed under certain circumstances;
  208         amending s. 397.6957, F.S.; expanding the exemption
  209         from the requirement that a respondent be present at a
  210         hearing on a petition for involuntary treatment
  211         services; authorizing the court to order drug tests
  212         and to permit witnesses to attend and testify remotely
  213         at the hearing through certain means; deleting a
  214         provision requiring the court to appoint a guardian
  215         advocate under certain circumstances; prohibiting a
  216         respondent from being involuntarily ordered into
  217         treatment unless certain requirements are met;
  218         providing requirements relating to involuntary
  219         assessment and stabilization orders; providing
  220         requirements relating to involuntary treatment
  221         hearings; requiring that the assessment of a
  222         respondent occur before a specified time unless
  223         certain requirements are met; authorizing service
  224         providers to petition the court in writing for an
  225         extension of the observation period; providing service
  226         requirements for such petitions; authorizing the
  227         service provider to continue to hold the respondent if
  228         the court grants the petition; requiring a qualified
  229         professional to transmit his or her report to the
  230         clerk of the court within a specified timeframe;
  231         requiring the clerk of the court to enter the report
  232         into the court file; providing requirements for the
  233         report; providing that the report’s filing satisfies
  234         the requirements for release of certain individuals if
  235         it contains admission and discharge information;
  236         providing for the petition’s dismissal under certain
  237         circumstances; authorizing the court to initiate
  238         involuntary proceedings; requiring that, if a
  239         treatment order is issued, it must include certain
  240         findings; amending s. 397.697, F.S.; requiring that an
  241         individual meet certain requirements to qualify for
  242         involuntary outpatient treatment; revising the
  243         jurisdiction of the court with respect to certain
  244         orders entered in a case; specifying that certain
  245         hearings may be set by either the motion of a party or
  246         under the court’s own authority; requiring a certain
  247         institute to receive and maintain copies of certain
  248         documents and use them to prepare annual reports;
  249         providing requirements for such reports; requiring the
  250         institute to post such reports on its website and
  251         provide copies to the department and the Legislature;
  252         amending s. 397.6971, F.S.; conforming provisions to
  253         changes made by the act; amending s. 397.6975, F.S.;
  254         authorizing certain entities to file a petition for
  255         renewal of an involuntary treatment services order;
  256         revising the timeframe during which the court is
  257         required to schedule a hearing; deleting obsolete
  258         provisions; amending s. 397.6977, F.S.; providing
  259         requirements for discharge planning and procedures for
  260         a respondent’s release from involuntary treatment
  261         services; repealing ss. 397.6811, 397.6814, 397.6815,
  262         397.6819, 397.6821, 397.6822, and 397.6978, F.S.,
  263         relating to involuntary assessment and stabilization,
  264         contents of petitions, procedure, licensed service
  265         provider responsibilities, extension of time for
  266         completion of involuntary assessment and
  267         stabilization, disposition of the individual after
  268         involuntary assessment, and the appointment of
  269         guardian advocates, respectively; amending s. 916.13,
  270         F.S.; requiring the Department of Children and
  271         Families to complete and submit a competency
  272         evaluation report to the circuit court to determine
  273         whether a defendant adjudicated incompetent to proceed
  274         meets the criteria for involuntary civil commitment if
  275         it is determined that the defendant will not or is
  276         unlikely to regain competency; defining the term
  277         “competency evaluation report to the circuit court”;
  278         requiring a qualified professional to sign such report
  279         under penalty of perjury; providing requirements for
  280         such report; requiring a defendant who meets the
  281         criteria for involuntary examination to appear
  282         remotely for a hearing; authorizing court witnesses to
  283         appear remotely for the hearing; amending ss. 40.29,
  284         394.492, 409.972, 744.2007, and 916.107, F.S.;
  285         conforming cross-references and provisions to changes
  286         made by the act; providing an appropriation; providing
  287         an effective date.
  288          
  289  Be It Enacted by the Legislature of the State of Florida:
  290  
  291         Section 1. Subsection (23) of section 394.455, Florida
  292  Statutes, is amended to read:
  293         394.455 Definitions.—As used in this part, the term:
  294         (23) “Involuntary examination” means an examination
  295  performed under s. 394.463, s. 397.6772, s. 397.679, s.
  296  397.6798, or s. 397.6957 s. 397.6811 to determine whether a
  297  person qualifies for involuntary services.
  298         Section 2. Paragraph (e) is added to subsection (1) of
  299  section 394.4572, Florida Statutes, to read:
  300         394.4572 Screening of mental health personnel.—
  301         (1)
  302         (e)A physician licensed under chapter 458 or chapter 459
  303  or a nurse licensed under chapter 464 who was required to
  304  undergo background screening by the Department of Health as part
  305  of his or her initial licensure or the renewal of licensure, and
  306  who has an active and unencumbered license, is not subject to
  307  background screening pursuant to this section.
  308         Section 3. Paragraph (d) of subsection (3) and paragraph
  309  (d) of subsection (5) of section 394.459, Florida Statutes, are
  310  amended to read:
  311         394.459 Rights of patients.—
  312         (3) RIGHT TO EXPRESS AND INFORMED PATIENT CONSENT.—
  313         (d) The administrator of a receiving or treatment facility
  314  may, upon the recommendation of the patient’s attending
  315  physician, authorize emergency medical treatment, including a
  316  surgical procedure, if such treatment is deemed lifesaving, or
  317  if the situation threatens serious bodily harm to the patient,
  318  and permission of the patient or the patient’s guardian or
  319  guardian advocate cannot be obtained.
  320         (5) COMMUNICATION, ABUSE REPORTING, AND VISITS.—
  321         (d) If a patient’s right to communicate with outside
  322  persons; receive, send, or mail sealed, unopened correspondence;
  323  or receive visitors is restricted by the facility, a qualified
  324  professional must record the restriction and its underlying
  325  reasons in the patient’s clinical file within 24 hours. The
  326  notice of the restriction must immediately written notice of
  327  such restriction and the reasons for the restriction shall be
  328  served on the patient, the patient’s attorney, and the patient’s
  329  guardian, guardian advocate, or representative. A qualified
  330  professional must document any restriction within 24 hours, and
  331  such restriction shall be recorded on the patient’s clinical
  332  record with the reasons therefor. The restriction of a patient’s
  333  right to communicate or to receive visitors shall be reviewed at
  334  least every 3 days. The right to communicate or receive visitors
  335  shall not be restricted as a means of punishment. Nothing in
  336  this paragraph shall be construed to limit the provisions of
  337  paragraph (e).
  338         Section 4. Subsection (3) of section 394.4598, Florida
  339  Statutes, is amended to read:
  340         394.4598 Guardian advocate.—
  341         (3) A facility requesting appointment of a guardian
  342  advocate must, prior to the appointment, provide the prospective
  343  guardian advocate with information about the duties and
  344  responsibilities of guardian advocates, including the
  345  information about the ethics of medical decisionmaking. Before
  346  asking a guardian advocate to give consent to treatment for a
  347  patient, the facility shall provide to the guardian advocate
  348  sufficient information so that the guardian advocate can decide
  349  whether to give express and informed consent to the treatment,
  350  including information that the treatment is essential to the
  351  care of the patient, and that the treatment does not present an
  352  unreasonable risk of serious, hazardous, or irreversible side
  353  effects. Before giving consent to treatment, the guardian
  354  advocate must meet and talk with the patient and the patient’s
  355  physician or psychiatric nurse practicing within the framework
  356  of an established protocol with a psychiatrist in person, if at
  357  all possible, and by telephone, if not. The decision of the
  358  guardian advocate may be reviewed by the court, upon petition of
  359  the patient’s attorney, the patient’s family, or the facility
  360  administrator.
  361         Section 5. Paragraph (d) of subsection (2) of section
  362  394.4599, Florida Statutes, is amended to read:
  363         394.4599 Notice.—
  364         (2) INVOLUNTARY ADMISSION.—
  365         (d) The written notice of the filing of the petition for
  366  involuntary services for an individual being held must contain
  367  the following:
  368         1. Notice that the petition for:
  369         a. Involuntary services inpatient treatment pursuant to s.
  370  394.467 has been filed with the circuit court and the address of
  371  such court in the county in which the individual is hospitalized
  372  and the address of such court; or
  373         b. Involuntary outpatient services pursuant to s. 394.467
  374  s. 394.4655 has been filed with the criminal county court, as
  375  defined in s. 394.4655(1), or the circuit court, as applicable,
  376  in the county in which the individual is hospitalized and the
  377  address of such court.
  378         2. Notice that the office of the public defender has been
  379  appointed to represent the individual in the proceeding, if the
  380  individual is not otherwise represented by counsel.
  381         3. The date, time, and place of the hearing and the name of
  382  each examining expert and every other person expected to testify
  383  in support of continued detention.
  384         4. Notice that the individual, the individual’s guardian,
  385  guardian advocate, health care surrogate or proxy, or
  386  representative, or the administrator may apply for a change of
  387  venue for the convenience of the parties or witnesses or because
  388  of the condition of the individual.
  389         5. Notice that the individual is entitled to an independent
  390  expert examination and, if the individual cannot afford such an
  391  examination, that the court will provide for one.
  392         Section 6. Subsection (2) and paragraph (d) of subsection
  393  (4) of section 394.461, Florida Statutes, are amended to read:
  394         394.461 Designation of receiving and treatment facilities
  395  and receiving systems.—The department is authorized to designate
  396  and monitor receiving facilities, treatment facilities, and
  397  receiving systems and may suspend or withdraw such designation
  398  for failure to comply with this part and rules adopted under
  399  this part. The department may issue a conditional designation
  400  for up to 60 days to allow the implementation of corrective
  401  measures. Unless designated by the department, facilities are
  402  not permitted to hold or treat involuntary patients under this
  403  part.
  404         (2) TREATMENT FACILITY.—The department may designate any
  405  state-owned, state-operated, or state-supported facility as a
  406  state treatment facility. A civil patient shall not be admitted
  407  to a state treatment facility without previously undergoing a
  408  transfer evaluation. Before the close of the state’s case-in
  409  chief in a court hearing for involuntary placement in a state
  410  treatment facility, the state may establish that the transfer
  411  evaluation was performed and the document was properly executed
  412  by providing the court with a copy of the transfer evaluation.
  413  The court may not shall receive and consider the substantive
  414  information documented in the transfer evaluation unless the
  415  evaluator testifies at the hearing. Any other facility,
  416  including a private facility or a federal facility, may be
  417  designated as a treatment facility by the department, provided
  418  that such designation is agreed to by the appropriate governing
  419  body or authority of the facility.
  420         (4) REPORTING REQUIREMENTS.—
  421         (d) The department shall issue an annual report based on
  422  the data required pursuant to this subsection. The report shall
  423  include individual facilities’ data, as well as statewide
  424  totals. The report shall be posted on the department’s website
  425  submitted to the Governor, the President of the Senate, and the
  426  Speaker of the House of Representatives.
  427         Section 7. Paragraph (a) of subsection (2) and subsection
  428  (3) of section 394.4615, Florida Statutes, are amended to read:
  429         394.4615 Clinical records; confidentiality.—
  430         (2) The clinical record shall be released when:
  431         (a) The patient or the patient’s guardian or legal
  432  custodian authorizes the release. The guardian, or guardian
  433  advocate, or legal custodian shall be provided access to the
  434  appropriate clinical records of the patient. The patient or the
  435  patient’s guardian, or guardian advocate, or legal custodian may
  436  authorize the release of information and clinical records to
  437  appropriate persons to ensure the continuity of the patient’s
  438  health care or mental health care. A receiving facility must
  439  document that, within 24 hours of admission, individuals
  440  admitted on a voluntary basis have been provided with the option
  441  to authorize the release of information from their clinical
  442  record to the individual’s health care surrogate or proxy,
  443  attorney, representative, or other known emergency contact.
  444         (3) Information from the clinical record may be released in
  445  the following circumstances:
  446         (a) When a patient has communicated to a service provider a
  447  specific threat to cause serious bodily injury or death to an
  448  identified or a readily available person, if the service
  449  provider reasonably believes, or should reasonably believe
  450  according to the standards of his or her profession, that the
  451  patient has the apparent intent and ability to imminently or
  452  immediately carry out such threat. When such communication has
  453  been made, the administrator may authorize the release of
  454  sufficient information to provide adequate warning to the person
  455  threatened with harm by the patient.
  456         (b) When the administrator of the facility or secretary of
  457  the department deems release to a qualified researcher as
  458  defined in administrative rule, an aftercare treatment provider,
  459  or an employee or agent of the department is necessary for
  460  treatment of the patient, maintenance of adequate records,
  461  compilation of treatment data, aftercare planning, or evaluation
  462  of programs.
  463  
  464  For the purpose of determining whether a person meets the
  465  criteria for involuntary services outpatient placement or for
  466  preparing the proposed services treatment plan pursuant to s.
  467  394.4655 or s. 394.467 s. 394.4655, the clinical record may be
  468  released to the state attorney, the public defender or the
  469  patient’s private legal counsel, the court, and to the
  470  appropriate mental health professionals, including the service
  471  provider under s. 394.4655 or s. 394.467 identified in s.
  472  394.4655(7)(b)2., in accordance with state and federal law.
  473         Section 8. Section 394.462, Florida Statutes, is amended to
  474  read:
  475         394.462 Transportation.—A transportation plan shall be
  476  developed and implemented by each county in collaboration with
  477  the managing entity in accordance with this section. A county
  478  may enter into a memorandum of understanding with the governing
  479  boards of nearby counties to establish a shared transportation
  480  plan. When multiple counties enter into a memorandum of
  481  understanding for this purpose, the counties shall notify the
  482  managing entity and provide it with a copy of the agreement. The
  483  transportation plan shall describe methods of transport to a
  484  facility within the designated receiving system for individuals
  485  subject to involuntary examination under s. 394.463 or
  486  involuntary admission under s. 397.6772, s. 397.679, s.
  487  397.6798, or s. 397.6957 s. 397.6811, and may identify
  488  responsibility for other transportation to a participating
  489  facility when necessary and agreed to by the facility. The plan
  490  may rely on emergency medical transport services or private
  491  transport companies, as appropriate. The plan shall comply with
  492  the transportation provisions of this section and ss. 397.6772,
  493  397.6795, 397.6822, and 397.697.
  494         (1) TRANSPORTATION TO A RECEIVING FACILITY.—
  495         (a) Each county shall designate a single law enforcement
  496  agency within the county, or portions thereof, to take a person
  497  into custody upon the entry of an ex parte order or the
  498  execution of a certificate for involuntary examination by an
  499  authorized professional and to transport that person to the
  500  appropriate facility within the designated receiving system
  501  pursuant to a transportation plan.
  502         (b)1. The designated law enforcement agency may decline to
  503  transport the person to a receiving facility only if:
  504         a. The jurisdiction designated by the county has contracted
  505  on an annual basis with an emergency medical transport service
  506  or private transport company for transportation of persons to
  507  receiving facilities pursuant to this section at the sole cost
  508  of the county or as otherwise provided in the transportation
  509  plan developed by the county; and
  510         b. The law enforcement agency and the emergency medical
  511  transport service or private transport company agree that the
  512  continued presence of law enforcement personnel is not necessary
  513  for the safety of the person or others.
  514         2. The entity providing transportation may seek
  515  reimbursement for transportation expenses. The party responsible
  516  for payment for such transportation is the person receiving the
  517  transportation. The county shall seek reimbursement from the
  518  following sources in the following order:
  519         a. From a private or public third-party payor, if the
  520  person receiving the transportation has applicable coverage.
  521         b. From the person receiving the transportation.
  522         c. From a financial settlement for medical care, treatment,
  523  hospitalization, or transportation payable or accruing to the
  524  injured party.
  525         (c) A company that transports a patient pursuant to this
  526  subsection is considered an independent contractor and is solely
  527  liable for the safe and dignified transport of the patient. Such
  528  company must be insured and provide no less than $100,000 in
  529  liability insurance with respect to the transport of patients.
  530         (d) Any company that contracts with a governing board of a
  531  county to transport patients shall comply with the applicable
  532  rules of the department to ensure the safety and dignity of
  533  patients.
  534         (e) When a law enforcement officer takes custody of a
  535  person pursuant to this part, the officer may request assistance
  536  from emergency medical personnel if such assistance is needed
  537  for the safety of the officer or the person in custody.
  538         (f) When a member of a mental health overlay program or a
  539  mobile crisis response service is a professional authorized to
  540  initiate an involuntary examination pursuant to s. 394.463 or s.
  541  397.675 and that professional evaluates a person and determines
  542  that transportation to a receiving facility is needed, the
  543  service, at its discretion, may transport the person to the
  544  facility or may call on the law enforcement agency or other
  545  transportation arrangement best suited to the needs of the
  546  patient.
  547         (g) When any law enforcement officer has custody of a
  548  person based on either noncriminal or minor criminal behavior
  549  that meets the statutory guidelines for involuntary examination
  550  pursuant to s. 394.463, the law enforcement officer shall
  551  transport the person to the appropriate facility within the
  552  designated receiving system pursuant to a transportation plan.
  553  Persons who meet the statutory guidelines for involuntary
  554  admission pursuant to s. 397.675 may also be transported by law
  555  enforcement officers to the extent resources are available and
  556  as otherwise provided by law. Such persons shall be transported
  557  to an appropriate facility within the designated receiving
  558  system pursuant to a transportation plan.
  559         (h) When any law enforcement officer has arrested a person
  560  for a felony and it appears that the person meets the statutory
  561  guidelines for involuntary examination or placement under this
  562  part, such person must first be processed in the same manner as
  563  any other criminal suspect. The law enforcement agency shall
  564  thereafter immediately notify the appropriate facility within
  565  the designated receiving system pursuant to a transportation
  566  plan. The receiving facility shall be responsible for promptly
  567  arranging for the examination and treatment of the person. A
  568  receiving facility is not required to admit a person charged
  569  with a crime for whom the facility determines and documents that
  570  it is unable to provide adequate security, but shall provide
  571  examination and treatment to the person where he or she is held
  572  or by telemedicine.
  573         (i) If the appropriate law enforcement officer believes
  574  that a person has an emergency medical condition as defined in
  575  s. 395.002, the person may be first transported to a hospital
  576  for emergency medical treatment, regardless of whether the
  577  hospital is a designated receiving facility.
  578         (j) The costs of transportation, evaluation,
  579  hospitalization, and treatment incurred under this subsection by
  580  persons who have been arrested for violations of any state law
  581  or county or municipal ordinance may be recovered as provided in
  582  s. 901.35.
  583         (k) The appropriate facility within the designated
  584  receiving system pursuant to a transportation plan must accept
  585  persons brought by law enforcement officers, or an emergency
  586  medical transport service or a private transport company
  587  authorized by the county, for involuntary examination pursuant
  588  to s. 394.463.
  589         (l) The appropriate facility within the designated
  590  receiving system pursuant to a transportation plan must provide
  591  persons brought by law enforcement officers, or an emergency
  592  medical transport service or a private transport company
  593  authorized by the county, pursuant to s. 397.675, a basic
  594  screening or triage sufficient to refer the person to the
  595  appropriate services.
  596         (m) Each law enforcement agency designated pursuant to
  597  paragraph (a) shall establish a policy that reflects a single
  598  set of protocols for the safe and secure transportation and
  599  transfer of custody of the person. Each law enforcement agency
  600  shall provide a copy of the protocols to the managing entity.
  601         (n) When a jurisdiction has entered into a contract with an
  602  emergency medical transport service or a private transport
  603  company for transportation of persons to facilities within the
  604  designated receiving system, such service or company shall be
  605  given preference for transportation of persons from nursing
  606  homes, assisted living facilities, adult day care centers, or
  607  adult family-care homes, unless the behavior of the person being
  608  transported is such that transportation by a law enforcement
  609  officer is necessary.
  610         (o) This section may not be construed to limit emergency
  611  examination and treatment of incapacitated persons provided in
  612  accordance with s. 401.445.
  613         (2) TRANSPORTATION TO A TREATMENT FACILITY.—
  614         (a) If neither the patient nor any person legally obligated
  615  or responsible for the patient is able to pay for the expense of
  616  transporting a voluntary or involuntary patient to a treatment
  617  facility, the transportation plan established by the governing
  618  board of the county or counties must specify how the
  619  hospitalized patient will be transported to, from, and between
  620  facilities in a safe and dignified manner.
  621         (b) A company that transports a patient pursuant to this
  622  subsection is considered an independent contractor and is solely
  623  liable for the safe and dignified transportation of the patient.
  624  Such company must be insured and provide no less than $100,000
  625  in liability insurance with respect to the transport of
  626  patients.
  627         (c) A company that contracts with one or more counties to
  628  transport patients in accordance with this section shall comply
  629  with the applicable rules of the department to ensure the safety
  630  and dignity of patients.
  631         (d) County or municipal law enforcement and correctional
  632  personnel and equipment may not be used to transport patients
  633  adjudicated incapacitated or found by the court to meet the
  634  criteria for involuntary services placement pursuant to s.
  635  394.467, except in small rural counties where there are no cost
  636  efficient alternatives.
  637         (3) TRANSFER OF CUSTODY.—Custody of a person who is
  638  transported pursuant to this part, along with related
  639  documentation, shall be relinquished to a responsible individual
  640  at the appropriate receiving or treatment facility.
  641         Section 9. Paragraphs (a) and (f) of subsection (1) and
  642  subsection (5) of section 394.4625, Florida Statutes, are
  643  amended to read:
  644         394.4625 Voluntary admissions.—
  645         (1) AUTHORITY TO RECEIVE PATIENTS.—
  646         (a) A facility may receive for observation, diagnosis, or
  647  treatment any adult person 18 years of age or older who applies
  648  by express and informed consent for admission or any minor
  649  person age 17 or younger whose parent or legal guardian applies
  650  for admission. Such person may be admitted to the facility if
  651  found to show evidence of mental illness and to be suitable for
  652  treatment, and:
  653         1.If the person is an adult, he or she is found, to be
  654  competent to provide express and informed consent; or
  655         2.If the person is a minor, the parent or legal guardian
  656  provides express and informed consent and the facility performs,
  657  and to be suitable for treatment, such person 18 years of age or
  658  older may be admitted to the facility. A person age 17 or
  659  younger may be admitted only after a clinical review to verify
  660  the voluntariness of the minor’s assent.
  661         (f) Within 24 hours after admission of a voluntary patient,
  662  the treating admitting physician or psychiatric nurse practicing
  663  within the framework of an established protocol with a
  664  psychiatrist shall document in the patient’s clinical record
  665  that the patient is able to give express and informed consent
  666  for admission. If the patient is not able to give express and
  667  informed consent for admission, the facility shall either
  668  discharge the patient or transfer the patient to involuntary
  669  status pursuant to subsection (5).
  670         (5) TRANSFER TO INVOLUNTARY STATUS.—When a voluntary
  671  patient, or an authorized person on the patient’s behalf, makes
  672  a request for discharge, the request for discharge, unless
  673  freely and voluntarily rescinded, must be communicated to a
  674  physician, clinical psychologist with at least 3 years of
  675  postdoctoral experience in the practice of clinical psychology,
  676  or psychiatrist as quickly as possible, but not later than 12
  677  hours after the request is made. If the patient meets the
  678  criteria for involuntary placement, the administrator of the
  679  facility must file with the court a petition for involuntary
  680  placement, within 2 court working days after the request for
  681  discharge is made. If the petition is not filed within 2 court
  682  working days, the patient shall be discharged. Pending the
  683  filing of the petition, the patient may be held and emergency
  684  treatment rendered in the least restrictive manner, upon the
  685  written order of a physician or psychiatric nurse practicing
  686  within the framework of an established protocol with a
  687  psychiatrist, if it is determined that such treatment is
  688  necessary for the safety of the patient or others.
  689         Section 10. Subsection (1), paragraphs (a) and (e) through
  690  (h) of subsection (2), and subsection (4) of section 394.463,
  691  Florida Statutes, are amended to read:
  692         394.463 Involuntary examination.—
  693         (1) CRITERIA.—A person may be taken to a receiving facility
  694  for involuntary examination if there is reason to believe that
  695  the person has a mental illness and because of his or her mental
  696  illness:
  697         (a)1. The person has refused voluntary examination after
  698  conscientious explanation and disclosure of the purpose of the
  699  examination; or
  700         2. The person is unable to determine for himself or herself
  701  whether examination is necessary; and
  702         (b)1. Without care or treatment, the person is likely to
  703  suffer from neglect or refuse to care for himself or herself;
  704  such neglect or refusal poses a real and present threat of
  705  substantial harm to his or her well-being; and it is not
  706  apparent that such harm may be avoided through the help of
  707  willing, able, and responsible family members or friends or the
  708  provision of other services; or
  709         2. There is a substantial likelihood that without care or
  710  treatment the person will cause serious bodily harm to himself
  711  or herself or others in the near future, as evidenced by recent
  712  behavior.
  713         (2) INVOLUNTARY EXAMINATION.—
  714         (a) An involuntary examination may be initiated by any one
  715  of the following means:
  716         1. A circuit or county court may enter an ex parte order
  717  stating that a person appears to meet the criteria for
  718  involuntary examination and specifying the findings on which
  719  that conclusion is based. The ex parte order for involuntary
  720  examination must be based on written or oral sworn testimony
  721  that includes specific facts that support the findings. If other
  722  less restrictive means are not available, such as voluntary
  723  appearance for outpatient evaluation, a law enforcement officer,
  724  or other designated agent of the court, shall take the person
  725  into custody and deliver him or her to an appropriate, or the
  726  nearest, facility within the designated receiving system
  727  pursuant to s. 394.462 for involuntary examination. The order of
  728  the court shall be made a part of the patient’s clinical record.
  729  A fee may not be charged for the filing of an order under this
  730  subsection. A facility accepting the patient based on this order
  731  must send a copy of the order to the department within 5 working
  732  days. The order may be submitted electronically through existing
  733  data systems, if available. The order shall be valid only until
  734  the person is delivered to the facility or for the period
  735  specified in the order itself, whichever comes first. If a time
  736  limit is not specified in the order, the order is valid for 7
  737  days after the date that the order was signed.
  738         2. A law enforcement officer may shall take a person who
  739  appears to meet the criteria for involuntary examination into
  740  custody and deliver the person or have him or her delivered to
  741  an appropriate, or the nearest, facility within the designated
  742  receiving system pursuant to s. 394.462 for examination. A law
  743  enforcement officer transporting a person pursuant to this
  744  section subparagraph shall restrain the person in the least
  745  restrictive manner available and appropriate under the
  746  circumstances. If transporting a minor and the parent or legal
  747  guardian of the minor is present, before departing, the law
  748  enforcement officer must provide the parent or legal guardian of
  749  the minor with the name, address, and contact information for
  750  the facility within the designated receiving system to which the
  751  law enforcement officer is transporting the minor, subject to
  752  any safety and welfare concerns for the minor. The officer shall
  753  execute a written report detailing the circumstances under which
  754  the person was taken into custody, which must be made a part of
  755  the patient’s clinical record. The report must include all
  756  emergency contact information for the person that is readily
  757  accessible to the law enforcement officer, including information
  758  available through electronic databases maintained by the
  759  Department of Law Enforcement or by the Department of Highway
  760  Safety and Motor Vehicles. Such emergency contact information
  761  may be used by a receiving facility only for the purpose of
  762  informing listed emergency contacts of a patient’s whereabouts
  763  pursuant to s. 119.0712(2)(d). Any facility accepting the
  764  patient based on this report must send a copy of the report to
  765  the department within 5 working days.
  766         3. A physician, a physician assistant, a clinical
  767  psychologist, a psychiatric nurse, an advanced practice
  768  registered nurse registered under s. 464.0123, a mental health
  769  counselor, a marriage and family therapist, or a clinical social
  770  worker may execute a certificate stating that he or she has
  771  examined a person within the preceding 48 hours and finds that
  772  the person appears to meet the criteria for involuntary
  773  examination and stating the observations upon which that
  774  conclusion is based. If other less restrictive means, such as
  775  voluntary appearance for outpatient evaluation, are not
  776  available, a law enforcement officer shall take into custody the
  777  person named in the certificate and deliver him or her to the
  778  appropriate, or nearest, facility within the designated
  779  receiving system pursuant to s. 394.462 for involuntary
  780  examination. The law enforcement officer shall execute a written
  781  report detailing the circumstances under which the person was
  782  taken into custody and include all emergency contact information
  783  required under subparagraph 2. The report must include all
  784  emergency contact information for the person that is readily
  785  accessible to the law enforcement officer, including information
  786  available through electronic databases maintained by the
  787  Department of Law Enforcement or by the Department of Highway
  788  Safety and Motor Vehicles. Such emergency contact information
  789  may be used by a receiving facility only for the purpose of
  790  informing listed emergency contacts of a patient’s whereabouts
  791  pursuant to s. 119.0712(2)(d). The report and certificate shall
  792  be made a part of the patient’s clinical record. Any facility
  793  accepting the patient based on this certificate must send a copy
  794  of the certificate to the department within 5 working days. The
  795  document may be submitted electronically through existing data
  796  systems, if applicable.
  797  
  798  When sending the order, report, or certificate to the
  799  department, a facility shall, at a minimum, provide information
  800  about which action was taken regarding the patient under
  801  paragraph (g), which information shall also be made a part of
  802  the patient’s clinical record.
  803         (e) The department shall receive and maintain the copies of
  804  ex parte orders, involuntary outpatient services orders issued
  805  pursuant to ss. 394.4655 and 394.467 s. 394.4655, involuntary
  806  inpatient placement orders issued pursuant to s. 394.467,
  807  professional certificates, law enforcement officers’ reports,
  808  and reports relating to the transportation of patients. These
  809  documents shall be considered part of the clinical record,
  810  governed by the provisions of s. 394.4615. These documents shall
  811  be provided to the institute established under s. 1004.44 by the
  812  department and used by the institute to prepare annual reports
  813  analyzing the data obtained from these documents, without
  814  including the personal identifying information of the patient.
  815  The information in the reports may include, but need not be
  816  limited to, a state level analysis of involuntary examinations,
  817  including a description of demographic characteristics of
  818  individuals and the geographic locations of involuntary
  819  examinations; counts of the number of involuntary examinations
  820  at each receiving facility; and reporting and analysis of trends
  821  for involuntary examinations within this state. The report must
  822  also include counts of and provide demographic, geographic, and
  823  other relevant information about individuals with a
  824  developmental disability, as defined in s. 393.063, or a
  825  traumatic brain injury or dementia who were taken to a receiving
  826  facility for involuntary examination pursuant to s. 394.463 and
  827  determined not to have a co-occurring mental illness. The
  828  institute identifying patients, and shall post the reports on
  829  its website and provide copies of such reports to the
  830  department, the President of the Senate, the Speaker of the
  831  House of Representatives, and the minority leaders of the Senate
  832  and the House of Representatives by November 30 of each year.
  833         (f) A patient shall be examined by a physician or a
  834  clinical psychologist, or by a psychiatric nurse performing
  835  within the framework of an established protocol with a
  836  psychiatrist at a facility without unnecessary delay to
  837  determine if the criteria for involuntary services are met. Such
  838  examination must include, but not be limited to, consideration
  839  of the patient’s treatment history at the facility and any
  840  information regarding the patient’s condition and behavior
  841  provided by knowledgeable individuals. Repeated admittance for
  842  involuntary examination during a short period of time despite
  843  implementation of appropriate discharge plans may be evidence
  844  that the criteria under subparagraph (1)(b)1. are met. An
  845  individual’s basic needs being served while admitted to the
  846  facility may not be considered evidence that criteria under
  847  subparagraph (1)(b)1. are met. Emergency treatment may be
  848  provided upon the order of a physician if the physician
  849  determines that such treatment is necessary for the safety of
  850  the patient or others. The patient may not be released by the
  851  receiving facility or its contractor without the documented
  852  approval of a psychiatrist or a clinical psychologist or, if the
  853  receiving facility is owned or operated by a hospital, health
  854  system, or nationally accredited community mental health center,
  855  the release may also be approved by a psychiatric nurse
  856  performing within the framework of an established protocol with
  857  a psychiatrist, or an attending emergency department physician
  858  with experience in the diagnosis and treatment of mental illness
  859  after completion of an involuntary examination pursuant to this
  860  subsection. A psychiatric nurse may not approve the release of a
  861  patient if the involuntary examination was initiated by a
  862  psychiatrist unless the release is approved by the initiating
  863  psychiatrist. The release may be approved through telehealth.
  864         (g) The examination period must be for up to 72 hours and
  865  begins when a patient arrives at the receiving facility. For a
  866  minor, the examination shall be initiated within 12 hours after
  867  the patient’s arrival at the facility. Within the examination
  868  period, one of the following actions must be taken, based on the
  869  individual needs of the patient:
  870         1. The patient shall be released, unless he or she is
  871  charged with a crime, in which case the patient shall be
  872  returned to the custody of a law enforcement officer;
  873         2. The patient shall be released, subject to subparagraph
  874  1., for voluntary outpatient treatment;
  875         3. The patient, unless he or she is charged with a crime,
  876  shall be asked to give express and informed consent to placement
  877  as a voluntary patient and, if such consent is given, the
  878  patient shall be admitted as a voluntary patient; or
  879         4. A petition for involuntary services shall be filed in
  880  the circuit court if inpatient treatment is deemed necessary or
  881  with the criminal county court, as defined in s. 394.4655(1), as
  882  applicable. When inpatient treatment is deemed necessary, the
  883  least restrictive treatment consistent with the optimum
  884  improvement of the patient’s condition shall be made available.
  885  The When a petition must is to be filed for involuntary
  886  outpatient placement, it shall be filed by one of the
  887  petitioners specified in s. 394.467, and the court shall dismiss
  888  an untimely filed petition s. 394.4655(4)(a). A petition for
  889  involuntary inpatient placement shall be filed by the facility
  890  administrator. If a patient’s 72-hour examination period ends on
  891  a weekend or holiday, including the hours before the ordinary
  892  business hours on the morning of the next working day, and the
  893  receiving facility:
  894         a. Intends to file a petition for involuntary services,
  895  such patient may be held at the a receiving facility through the
  896  next working day thereafter and the such petition for
  897  involuntary services must be filed no later than such date. If
  898  the receiving facility fails to file the a petition by for
  899  involuntary services at the ordinary close of business on the
  900  next working day, the patient must shall be released from the
  901  receiving facility following approval pursuant to paragraph (f).
  902         b. Does not intend to file a petition for involuntary
  903  services, the a receiving facility may postpone release of a
  904  patient until the next working day thereafter only if a
  905  qualified professional documents that adequate discharge
  906  planning and procedures in accordance with s. 394.468, and
  907  approval pursuant to paragraph (f), are not possible until the
  908  next working day.
  909         (h) A person for whom an involuntary examination has been
  910  initiated who is being evaluated or treated at a hospital for an
  911  emergency medical condition specified in s. 395.002 must be
  912  examined by a facility within the examination period specified
  913  in paragraph (g). The examination period begins when the patient
  914  arrives at the hospital and ceases when the attending physician
  915  documents that the patient has an emergency medical condition.
  916  If the patient is examined at a hospital providing emergency
  917  medical services by a professional qualified to perform an
  918  involuntary examination and is found as a result of that
  919  examination not to meet the criteria for involuntary outpatient
  920  services pursuant to s. 394.467 s. 394.4655(2) or involuntary
  921  inpatient placement pursuant to s. 394.467(1), the patient may
  922  be offered voluntary outpatient or inpatient services or
  923  placement, if appropriate, or released directly from the
  924  hospital providing emergency medical services. The finding by
  925  the professional that the patient has been examined and does not
  926  meet the criteria for involuntary inpatient services or
  927  involuntary outpatient placement must be entered into the
  928  patient’s clinical record. This paragraph is not intended to
  929  prevent a hospital providing emergency medical services from
  930  appropriately transferring a patient to another hospital before
  931  stabilization if the requirements of s. 395.1041(3)(c) have been
  932  met.
  933         (4) DATA ANALYSIS.—
  934         (a)The department shall provide the data Using data
  935  collected under paragraph (2)(a) and s. 1006.07(10), and child
  936  welfare data related to involuntary examinations, to the
  937  institute established under s. 1004.44. The Agency for Health
  938  Care Administration shall provide Medicaid data to the
  939  institute, as requested by the institute, related to involuntary
  940  examination of children enrolled in Medicaid for the purpose of
  941  administering the program and improving service provision for
  942  such children. The department and agency shall enter into any
  943  necessary agreements with the institute to provide such data.
  944  The institute department shall, at a minimum, use such data to
  945  analyze data on both the initiation of involuntary examinations
  946  of children and the initiation of involuntary examinations of
  947  students who are removed from a school; identify any patterns or
  948  trends and cases in which involuntary examinations are
  949  repeatedly initiated on the same child or student; study root
  950  causes for such patterns, trends, or repeated involuntary
  951  examinations; and make recommendations to encourage the use of
  952  alternatives to eliminate inappropriate initiations of such
  953  examinations.
  954         (b)The institute shall analyze service data on individuals
  955  who are high utilizers of crisis stabilization services provided
  956  in designated receiving facilities, and shall, at a minimum,
  957  identify any patterns or trends and make recommendations to
  958  decrease avoidable admissions. Recommendations may be addressed
  959  in the department’s contracts with the behavioral health
  960  managing entities and in the contracts between the Agency for
  961  Health Care Administration and the Medicaid managed medical
  962  assistance plans.
  963         (c) The institute department shall publish submit a report
  964  on its findings and recommendations on its website and submit
  965  the report to the Governor, the President of the Senate, and the
  966  Speaker of the House of Representatives, the department, and the
  967  Agency for Health Care Administration by November 1 of each odd
  968  numbered year.
  969         Section 11. Section 394.4655, Florida Statutes, is amended
  970  to read:
  971         394.4655 Involuntary outpatient services.—
  972         (1) DEFINITIONS.—As used in this section, the term:
  973         (a) “Court” means a circuit court or a criminal county
  974  court.
  975         (b) “Criminal county court” means a county court exercising
  976  its original jurisdiction in a misdemeanor case under s. 34.01.
  977         (c)“Involuntary outpatient placement” means involuntary
  978  outpatient services as defined in s. 394.467.
  979         (2) A criminal county court may order an individual to
  980  involuntary outpatient placement under s. 394.467. CRITERIA FOR
  981  INVOLUNTARY OUTPATIENT SERVICES.—A person may be ordered to
  982  involuntary outpatient services upon a finding of the court, by
  983  clear and convincing evidence, that the person meets all of the
  984  following criteria:
  985         (a)The person is 18 years of age or older.
  986         (b)The person has a mental illness.
  987         (c)The person is unlikely to survive safely in the
  988  community without supervision, based on a clinical
  989  determination.
  990         (d)The person has a history of lack of compliance with
  991  treatment for mental illness.
  992         (e)The person has:
  993         1.At least twice within the immediately preceding 36
  994  months been involuntarily admitted to a receiving or treatment
  995  facility as defined in s. 394.455, or has received mental health
  996  services in a forensic or correctional facility. The 36-month
  997  period does not include any period during which the person was
  998  admitted or incarcerated; or
  999         2.Engaged in one or more acts of serious violent behavior
 1000  toward self or others, or attempts at serious bodily harm to
 1001  himself or herself or others, within the preceding 36 months.
 1002         (f)The person is, as a result of his or her mental
 1003  illness, unlikely to voluntarily participate in the recommended
 1004  treatment plan and has refused voluntary services for treatment
 1005  after sufficient and conscientious explanation and disclosure of
 1006  why the services are necessary or is unable to determine for
 1007  himself or herself whether services are necessary.
 1008         (g)In view of the person’s treatment history and current
 1009  behavior, the person is in need of involuntary outpatient
 1010  services in order to prevent a relapse or deterioration that
 1011  would be likely to result in serious bodily harm to himself or
 1012  herself or others, or a substantial harm to his or her well
 1013  being as set forth in s. 394.463(1).
 1014         (h)It is likely that the person will benefit from
 1015  involuntary outpatient services.
 1016         (i)All available, less restrictive alternatives that would
 1017  offer an opportunity for improvement of his or her condition
 1018  have been judged to be inappropriate or unavailable.
 1019         (3)INVOLUNTARY OUTPATIENT SERVICES.—
 1020         (a)1.A patient who is being recommended for involuntary
 1021  outpatient services by the administrator of the facility where
 1022  the patient has been examined may be retained by the facility
 1023  after adherence to the notice procedures provided in s.
 1024  394.4599. The recommendation must be supported by the opinion of
 1025  a psychiatrist and the second opinion of a clinical psychologist
 1026  or another psychiatrist, both of whom have personally examined
 1027  the patient within the preceding 72 hours, that the criteria for
 1028  involuntary outpatient services are met. However, if the
 1029  administrator certifies that a psychiatrist or clinical
 1030  psychologist is not available to provide the second opinion, the
 1031  second opinion may be provided by a licensed physician who has
 1032  postgraduate training and experience in diagnosis and treatment
 1033  of mental illness, a physician assistant who has at least 3
 1034  years’ experience and is supervised by such licensed physician
 1035  or a psychiatrist, a clinical social worker, or by a psychiatric
 1036  nurse. Any second opinion authorized in this subparagraph may be
 1037  conducted through a face-to-face examination, in person or by
 1038  electronic means. Such recommendation must be entered on an
 1039  involuntary outpatient services certificate that authorizes the
 1040  facility to retain the patient pending completion of a hearing.
 1041  The certificate must be made a part of the patient’s clinical
 1042  record.
 1043         2.If the patient has been stabilized and no longer meets
 1044  the criteria for involuntary examination pursuant to s.
 1045  394.463(1), the patient must be released from the facility while
 1046  awaiting the hearing for involuntary outpatient services. Before
 1047  filing a petition for involuntary outpatient services, the
 1048  administrator of the facility or a designated department
 1049  representative must identify the service provider that will have
 1050  primary responsibility for service provision under an order for
 1051  involuntary outpatient services, unless the person is otherwise
 1052  participating in outpatient psychiatric treatment and is not in
 1053  need of public financing for that treatment, in which case the
 1054  individual, if eligible, may be ordered to involuntary treatment
 1055  pursuant to the existing psychiatric treatment relationship.
 1056         3.The service provider shall prepare a written proposed
 1057  treatment plan in consultation with the patient or the patient’s
 1058  guardian advocate, if appointed, for the court’s consideration
 1059  for inclusion in the involuntary outpatient services order that
 1060  addresses the nature and extent of the mental illness and any
 1061  co-occurring substance use disorder that necessitate involuntary
 1062  outpatient services. The treatment plan must specify the likely
 1063  level of care, including the use of medication, and anticipated
 1064  discharge criteria for terminating involuntary outpatient
 1065  services. Service providers may select and supervise other
 1066  individuals to implement specific aspects of the treatment plan.
 1067  The services in the plan must be deemed clinically appropriate
 1068  by a physician, clinical psychologist, psychiatric nurse, mental
 1069  health counselor, marriage and family therapist, or clinical
 1070  social worker who consults with, or is employed or contracted
 1071  by, the service provider. The service provider must certify to
 1072  the court in the proposed plan whether sufficient services for
 1073  improvement and stabilization are currently available and
 1074  whether the service provider agrees to provide those services.
 1075  If the service provider certifies that the services in the
 1076  proposed treatment plan are not available, the petitioner may
 1077  not file the petition. The service provider must notify the
 1078  managing entity if the requested services are not available. The
 1079  managing entity must document such efforts to obtain the
 1080  requested services.
 1081         (b)If a patient in involuntary inpatient placement meets
 1082  the criteria for involuntary outpatient services, the
 1083  administrator of the facility may, before the expiration of the
 1084  period during which the facility is authorized to retain the
 1085  patient, recommend involuntary outpatient services. The
 1086  recommendation must be supported by the opinion of a
 1087  psychiatrist and the second opinion of a clinical psychologist
 1088  or another psychiatrist, both of whom have personally examined
 1089  the patient within the preceding 72 hours, that the criteria for
 1090  involuntary outpatient services are met. However, if the
 1091  administrator certifies that a psychiatrist or clinical
 1092  psychologist is not available to provide the second opinion, the
 1093  second opinion may be provided by a licensed physician who has
 1094  postgraduate training and experience in diagnosis and treatment
 1095  of mental illness, a physician assistant who has at least 3
 1096  years’ experience and is supervised by such licensed physician
 1097  or a psychiatrist, a clinical social worker, or by a psychiatric
 1098  nurse. Any second opinion authorized in this subparagraph may be
 1099  conducted through a face-to-face examination, in person or by
 1100  electronic means. Such recommendation must be entered on an
 1101  involuntary outpatient services certificate, and the certificate
 1102  must be made a part of the patient’s clinical record.
 1103         (c)1.The administrator of the treatment facility shall
 1104  provide a copy of the involuntary outpatient services
 1105  certificate and a copy of the state mental health discharge form
 1106  to the managing entity in the county where the patient will be
 1107  residing. For persons who are leaving a state mental health
 1108  treatment facility, the petition for involuntary outpatient
 1109  services must be filed in the county where the patient will be
 1110  residing.
 1111         2.The service provider that will have primary
 1112  responsibility for service provision shall be identified by the
 1113  designated department representative before the order for
 1114  involuntary outpatient services and must, before filing a
 1115  petition for involuntary outpatient services, certify to the
 1116  court whether the services recommended in the patient’s
 1117  discharge plan are available and whether the service provider
 1118  agrees to provide those services. The service provider must
 1119  develop with the patient, or the patient’s guardian advocate, if
 1120  appointed, a treatment or service plan that addresses the needs
 1121  identified in the discharge plan. The plan must be deemed to be
 1122  clinically appropriate by a physician, clinical psychologist,
 1123  psychiatric nurse, mental health counselor, marriage and family
 1124  therapist, or clinical social worker, as defined in this
 1125  chapter, who consults with, or is employed or contracted by, the
 1126  service provider.
 1127         3.If the service provider certifies that the services in
 1128  the proposed treatment or service plan are not available, the
 1129  petitioner may not file the petition. The service provider must
 1130  notify the managing entity if the requested services are not
 1131  available. The managing entity must document such efforts to
 1132  obtain the requested services.
 1133         (4)PETITION FOR INVOLUNTARY OUTPATIENT SERVICES.—
 1134         (a)A petition for involuntary outpatient services may be
 1135  filed by:
 1136         1.The administrator of a receiving facility; or
 1137         2.The administrator of a treatment facility.
 1138         (b)Each required criterion for involuntary outpatient
 1139  services must be alleged and substantiated in the petition for
 1140  involuntary outpatient services. A copy of the certificate
 1141  recommending involuntary outpatient services completed by a
 1142  qualified professional specified in subsection (3) must be
 1143  attached to the petition. A copy of the proposed treatment plan
 1144  must be attached to the petition. Before the petition is filed,
 1145  the service provider shall certify that the services in the
 1146  proposed plan are available. If the necessary services are not
 1147  available, the petition may not be filed. The service provider
 1148  must notify the managing entity if the requested services are
 1149  not available. The managing entity must document such efforts to
 1150  obtain the requested services.
 1151         (c)The petition for involuntary outpatient services must
 1152  be filed in the county where the patient is located, unless the
 1153  patient is being placed from a state treatment facility, in
 1154  which case the petition must be filed in the county where the
 1155  patient will reside. When the petition has been filed, the clerk
 1156  of the court shall provide copies of the petition and the
 1157  proposed treatment plan to the department, the managing entity,
 1158  the patient, the patient’s guardian or representative, the state
 1159  attorney, and the public defender or the patient’s private
 1160  counsel. A fee may not be charged for filing a petition under
 1161  this subsection.
 1162         (5)APPOINTMENT OF COUNSEL.—Within 1 court working day
 1163  after the filing of a petition for involuntary outpatient
 1164  services, the court shall appoint the public defender to
 1165  represent the person who is the subject of the petition, unless
 1166  the person is otherwise represented by counsel. The clerk of the
 1167  court shall immediately notify the public defender of the
 1168  appointment. The public defender shall represent the person
 1169  until the petition is dismissed, the court order expires, or the
 1170  patient is discharged from involuntary outpatient services. An
 1171  attorney who represents the patient must be provided access to
 1172  the patient, witnesses, and records relevant to the presentation
 1173  of the patient’s case and shall represent the interests of the
 1174  patient, regardless of the source of payment to the attorney.
 1175         (6)CONTINUANCE OF HEARING.—The patient is entitled, with
 1176  the concurrence of the patient’s counsel, to at least one
 1177  continuance of the hearing. The continuance shall be for a
 1178  period of up to 4 weeks.
 1179         (7)HEARING ON INVOLUNTARY OUTPATIENT SERVICES.—
 1180         (a)1.The court shall hold the hearing on involuntary
 1181  outpatient services within 5 working days after the filing of
 1182  the petition, unless a continuance is granted. The hearing must
 1183  be held in the county where the petition is filed, must be as
 1184  convenient to the patient as is consistent with orderly
 1185  procedure, and must be conducted in physical settings not likely
 1186  to be injurious to the patient’s condition. If the court finds
 1187  that the patient’s attendance at the hearing is not consistent
 1188  with the best interests of the patient and if the patient’s
 1189  counsel does not object, the court may waive the presence of the
 1190  patient from all or any portion of the hearing. The state
 1191  attorney for the circuit in which the patient is located shall
 1192  represent the state, rather than the petitioner, as the real
 1193  party in interest in the proceeding.
 1194         2.The court may appoint a magistrate to preside at the
 1195  hearing. One of the professionals who executed the involuntary
 1196  outpatient services certificate shall be a witness. The patient
 1197  and the patient’s guardian or representative shall be informed
 1198  by the court of the right to an independent expert examination.
 1199  If the patient cannot afford such an examination, the court
 1200  shall ensure that one is provided, as otherwise provided by law.
 1201  The independent expert’s report is confidential and not
 1202  discoverable, unless the expert is to be called as a witness for
 1203  the patient at the hearing. The court shall allow testimony from
 1204  individuals, including family members, deemed by the court to be
 1205  relevant under state law, regarding the person’s prior history
 1206  and how that prior history relates to the person’s current
 1207  condition. The testimony in the hearing must be given under
 1208  oath, and the proceedings must be recorded. The patient may
 1209  refuse to testify at the hearing.
 1210         (b)1.If the court concludes that the patient meets the
 1211  criteria for involuntary outpatient services pursuant to
 1212  subsection (2), the court shall issue an order for involuntary
 1213  outpatient services. The court order shall be for a period of up
 1214  to 90 days. The order must specify the nature and extent of the
 1215  patient’s mental illness. The order of the court and the
 1216  treatment plan must be made part of the patient’s clinical
 1217  record. The service provider shall discharge a patient from
 1218  involuntary outpatient services when the order expires or any
 1219  time the patient no longer meets the criteria for involuntary
 1220  placement. Upon discharge, the service provider shall send a
 1221  certificate of discharge to the court.
 1222         2.The court may not order the department or the service
 1223  provider to provide services if the program or service is not
 1224  available in the patient’s local community, if there is no space
 1225  available in the program or service for the patient, or if
 1226  funding is not available for the program or service. The service
 1227  provider must notify the managing entity if the requested
 1228  services are not available. The managing entity must document
 1229  such efforts to obtain the requested services. A copy of the
 1230  order must be sent to the managing entity by the service
 1231  provider within 1 working day after it is received from the
 1232  court. The order may be submitted electronically through
 1233  existing data systems. After the order for involuntary services
 1234  is issued, the service provider and the patient may modify the
 1235  treatment plan. For any material modification of the treatment
 1236  plan to which the patient or, if one is appointed, the patient’s
 1237  guardian advocate agrees, the service provider shall send notice
 1238  of the modification to the court. Any material modifications of
 1239  the treatment plan which are contested by the patient or the
 1240  patient’s guardian advocate, if applicable, must be approved or
 1241  disapproved by the court consistent with subsection (3).
 1242         3.If, in the clinical judgment of a physician, the patient
 1243  has failed or has refused to comply with the treatment ordered
 1244  by the court, and, in the clinical judgment of the physician,
 1245  efforts were made to solicit compliance and the patient may meet
 1246  the criteria for involuntary examination, a person may be
 1247  brought to a receiving facility pursuant to s. 394.463. If,
 1248  after examination, the patient does not meet the criteria for
 1249  involuntary inpatient placement pursuant to s. 394.467, the
 1250  patient must be discharged from the facility. The involuntary
 1251  outpatient services order shall remain in effect unless the
 1252  service provider determines that the patient no longer meets the
 1253  criteria for involuntary outpatient services or until the order
 1254  expires. The service provider must determine whether
 1255  modifications should be made to the existing treatment plan and
 1256  must attempt to continue to engage the patient in treatment. For
 1257  any material modification of the treatment plan to which the
 1258  patient or the patient’s guardian advocate, if applicable,
 1259  agrees, the service provider shall send notice of the
 1260  modification to the court. Any material modifications of the
 1261  treatment plan which are contested by the patient or the
 1262  patient’s guardian advocate, if applicable, must be approved or
 1263  disapproved by the court consistent with subsection (3).
 1264         (c)If, at any time before the conclusion of the initial
 1265  hearing on involuntary outpatient services, it appears to the
 1266  court that the person does not meet the criteria for involuntary
 1267  outpatient services under this section but, instead, meets the
 1268  criteria for involuntary inpatient placement, the court may
 1269  order the person admitted for involuntary inpatient examination
 1270  under s. 394.463. If the person instead meets the criteria for
 1271  involuntary assessment, protective custody, or involuntary
 1272  admission pursuant to s. 397.675, the court may order the person
 1273  to be admitted for involuntary assessment for a period of 5 days
 1274  pursuant to s. 397.6811. Thereafter, all proceedings are
 1275  governed by chapter 397.
 1276         (d)At the hearing on involuntary outpatient services, the
 1277  court shall consider testimony and evidence regarding the
 1278  patient’s competence to consent to services. If the court finds
 1279  that the patient is incompetent to consent to treatment, it
 1280  shall appoint a guardian advocate as provided in s. 394.4598.
 1281  The guardian advocate shall be appointed or discharged in
 1282  accordance with s. 394.4598.
 1283         (e)The administrator of the receiving facility or the
 1284  designated department representative shall provide a copy of the
 1285  court order and adequate documentation of a patient’s mental
 1286  illness to the service provider for involuntary outpatient
 1287  services. Such documentation must include any advance directives
 1288  made by the patient, a psychiatric evaluation of the patient,
 1289  and any evaluations of the patient performed by a psychologist
 1290  or a clinical social worker.
 1291         (8)PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
 1292  SERVICES.—
 1293         (a)1.If the person continues to meet the criteria for
 1294  involuntary outpatient services, the service provider shall, at
 1295  least 10 days before the expiration of the period during which
 1296  the treatment is ordered for the person, file in the court that
 1297  issued the order for involuntary outpatient services a petition
 1298  for continued involuntary outpatient services. The court shall
 1299  immediately schedule a hearing on the petition to be held within
 1300  15 days after the petition is filed.
 1301         2.The existing involuntary outpatient services order
 1302  remains in effect until disposition on the petition for
 1303  continued involuntary outpatient services.
 1304         3.A certificate shall be attached to the petition which
 1305  includes a statement from the person’s physician or clinical
 1306  psychologist justifying the request, a brief description of the
 1307  patient’s treatment during the time he or she was receiving
 1308  involuntary services, and an individualized plan of continued
 1309  treatment.
 1310         4.The service provider shall develop the individualized
 1311  plan of continued treatment in consultation with the patient or
 1312  the patient’s guardian advocate, if applicable. When the
 1313  petition has been filed, the clerk of the court shall provide
 1314  copies of the certificate and the individualized plan of
 1315  continued services to the department, the patient, the patient’s
 1316  guardian advocate, the state attorney, and the patient’s private
 1317  counsel or the public defender.
 1318         (b)Within 1 court working day after the filing of a
 1319  petition for continued involuntary outpatient services, the
 1320  court shall appoint the public defender to represent the person
 1321  who is the subject of the petition, unless the person is
 1322  otherwise represented by counsel. The clerk of the court shall
 1323  immediately notify the public defender of such appointment. The
 1324  public defender shall represent the person until the petition is
 1325  dismissed or the court order expires or the patient is
 1326  discharged from involuntary outpatient services. Any attorney
 1327  representing the patient shall have access to the patient,
 1328  witnesses, and records relevant to the presentation of the
 1329  patient’s case and shall represent the interests of the patient,
 1330  regardless of the source of payment to the attorney.
 1331         (c)Hearings on petitions for continued involuntary
 1332  outpatient services must be before the court that issued the
 1333  order for involuntary outpatient services. The court may appoint
 1334  a magistrate to preside at the hearing. The procedures for
 1335  obtaining an order pursuant to this paragraph must meet the
 1336  requirements of subsection (7), except that the time period
 1337  included in paragraph (2)(e) is not applicable in determining
 1338  the appropriateness of additional periods of involuntary
 1339  outpatient placement.
 1340         (d)Notice of the hearing must be provided as set forth in
 1341  s. 394.4599. The patient and the patient’s attorney may agree to
 1342  a period of continued outpatient services without a court
 1343  hearing.
 1344         (e)The same procedure must be repeated before the
 1345  expiration of each additional period the patient is placed in
 1346  treatment.
 1347         (f)If the patient has previously been found incompetent to
 1348  consent to treatment, the court shall consider testimony and
 1349  evidence regarding the patient’s competence. Section 394.4598
 1350  governs the discharge of the guardian advocate if the patient’s
 1351  competency to consent to treatment has been restored.
 1352         Section 12. Section 394.467, Florida Statutes, is amended
 1353  to read:
 1354         394.467 Involuntary services inpatient placement.—
 1355         (1)DEFINITIONS.—As used in this section, the term:
 1356         (a)“Court” means a circuit court.
 1357         (b)“Involuntary inpatient placement” means placement in a
 1358  secure receiving or treatment facility providing stabilization
 1359  and treatment services to a person 18 years of age or older who
 1360  does not voluntarily consent to services under this chapter, or
 1361  a minor who does not voluntarily assent to services under this
 1362  chapter.
 1363         (c)“Involuntary outpatient services” means services
 1364  provided in the community to a person who does not voluntarily
 1365  consent to or participate in services under this chapter.
 1366         (d)“Services plan” means an individualized plan detailing
 1367  the recommended behavioral health services and supports, based
 1368  on a thorough assessment of the needs of the patient, to
 1369  safeguard and enhance the patient’s health and well-being in the
 1370  community.
 1371         (2)(1) CRITERIA FOR INVOLUNTARY SERVICES.—A person may be
 1372  ordered by a court to be provided for involuntary services
 1373  inpatient placement for treatment upon a finding of the court,
 1374  by clear and convincing evidence, that the person meets the
 1375  following criteria:
 1376         (a)Involuntary outpatient services.—A person ordered to
 1377  involuntary outpatient services must meet the following
 1378  criteria:
 1379         1. The person has a mental illness and because of his or
 1380  her mental illness:
 1381         a. He or she is unlikely to voluntarily participate in a
 1382  recommended services plan and has refused voluntary services for
 1383  treatment after sufficient and conscientious explanation and
 1384  disclosure of why the services are necessary; or
 1385         b. He or she is unable to determine for himself or herself
 1386  whether services are necessary.
 1387         2. The person is unlikely to survive safely in the
 1388  community without supervision, based on a clinical
 1389  determination.
 1390         3. The person has a history of lack of compliance with
 1391  treatment for mental illness.
 1392         4. In view of the person’s treatment history and current
 1393  behavior, the person is in need of involuntary outpatient
 1394  services in order to prevent a relapse or deterioration that
 1395  would be likely to result in serious bodily harm to himself or
 1396  herself or others, or a substantial harm to his or her well
 1397  being as set forth in s. 394.463(1).
 1398         5. It is likely that the person will benefit from
 1399  involuntary outpatient services.
 1400         6. All available less restrictive alternatives that would
 1401  offer an opportunity for improvement of the person’s condition
 1402  have been deemed to be inappropriate or unavailable.
 1403         (b) Involuntary inpatient placement.—A person ordered to
 1404  involuntary inpatient placement must meet the following
 1405  criteria:
 1406         1.(a)The person He or she has a mental illness and because
 1407  of his or her mental illness:
 1408         1.a. He or she has refused voluntary inpatient placement
 1409  for treatment after sufficient and conscientious explanation and
 1410  disclosure of the purpose of inpatient placement for treatment;
 1411  or
 1412         b. He or she Is unable to determine for himself or herself
 1413  whether inpatient placement is necessary; and
 1414         2.a. The person He or she is incapable of surviving alone
 1415  or with the help of willing, able, and responsible family or
 1416  friends, including available alternative services, and, without
 1417  treatment, is likely to suffer from neglect or refuse to care
 1418  for himself or herself, and such neglect or refusal poses a real
 1419  and present threat of substantial harm to his or her well-being;
 1420  or
 1421         b. Without treatment, there is a substantial likelihood
 1422  that in the near future the person he or she will inflict
 1423  serious bodily harm on self or others, as evidenced by recent
 1424  behavior causing, attempting to cause, or threatening to cause
 1425  such harm; and
 1426         c.(b)All available less restrictive treatment alternatives
 1427  that would offer an opportunity for improvement of the person’s
 1428  his or her condition have been deemed judged to be inappropriate
 1429  or unavailable.
 1430         (3)(2)RECOMMENDATION FOR INVOLUNTARY SERVICES AND
 1431  ADMISSION TO A TREATMENT FACILITY.—A patient may be recommended
 1432  for involuntary inpatient placement, involuntary outpatient
 1433  services, or a combination of both.
 1434         (a)A patient may be retained by a facility for involuntary
 1435  services or involuntarily placed in a treatment facility upon
 1436  the recommendation of the administrator of the facility where
 1437  the patient has been examined and after adherence to the notice
 1438  and hearing procedures provided in s. 394.4599. However, if a
 1439  patient who is being recommended for only involuntary outpatient
 1440  services has been stabilized and no longer meets the criteria
 1441  for involuntary examination pursuant to s. 394.463(1), the
 1442  patient must be released from the facility while awaiting the
 1443  hearing for involuntary outpatient services.
 1444         (b) The recommendation must be supported by the opinion of
 1445  a psychiatrist and the second opinion of a clinical psychologist
 1446  with at least 3 years of clinical experience, or another
 1447  psychiatrist, or a psychiatric nurse practicing within the
 1448  framework of an established protocol with a psychiatrist, both
 1449  of whom have personally examined the patient services within the
 1450  preceding 72 hours, that the criteria for involuntary inpatient
 1451  placement are met. For involuntary inpatient placement, the
 1452  patient must have been examined within the preceding 72 hours.
 1453  For involuntary outpatient services, the patient must have been
 1454  examined within the preceding 30 days.
 1455         (c)If However, if the administrator certifies that a
 1456  psychiatrist or clinical psychologist with at least 3 years of
 1457  clinical experience is not available to provide a the second
 1458  opinion, the petitioner must certify that a clinical
 1459  psychologist is not available and the second opinion may be
 1460  provided by a licensed physician who has postgraduate training
 1461  and experience in diagnosis and treatment of mental illness, a
 1462  clinical psychologist, or by a psychiatric nurse.
 1463         (d) Any opinion authorized in this subsection may be
 1464  conducted through a face-to-face or in-person examination, in
 1465  person, or by electronic means. Recommendations for involuntary
 1466  services must be Such recommendation shall be entered on a
 1467  petition for involuntary services, which shall be made a part of
 1468  the patient’s clinical record. The petition must either
 1469  authorize the facility to retain the patient pending completion
 1470  of a hearing or authorize inpatient placement certificate that
 1471  authorizes the facility to retain the patient pending transfer
 1472  to a treatment facility or completion of a hearing.
 1473         (4)(3) PETITION FOR INVOLUNTARY SERVICES INPATIENT
 1474  PLACEMENT.—
 1475         (a)A petition for involuntary services may be filed by:
 1476         1. The administrator of a receiving the facility;
 1477         2.The administrator of a treatment facility; or
 1478         3. A service provider who is treating the person being
 1479  petitioned.
 1480         (b)A shall file a petition for involuntary inpatient
 1481  placement, or inpatient placement followed by outpatient
 1482  services, must be filed in the court in the county where the
 1483  patient is located.
 1484         (c)A petition for involuntary outpatient services must be
 1485  filed in the county where the patient is located, unless the
 1486  patient is being placed from a state treatment facility, in
 1487  which case the petition must be filed in the county where the
 1488  patient will reside.
 1489         (d)1.The petitioner must state in the petition:
 1490         a.Whether the petitioner is recommending inpatient
 1491  placement, outpatient services, or both.
 1492         b.The length of time recommended for each type of
 1493  involuntary services.
 1494         c.The reasons for the recommendation.
 1495         2.If recommending involuntary outpatient services, or a
 1496  combination of involuntary inpatient placement and outpatient
 1497  services, the petitioner must identify the service provider that
 1498  has agreed to provide services for the person under an order for
 1499  involuntary outpatient services, unless the person is otherwise
 1500  participating in outpatient psychiatric treatment and is not in
 1501  need of public financing for that treatment, in which case the
 1502  individual, if eligible, may be ordered to involuntary treatment
 1503  pursuant to the existing psychiatric treatment relationship.
 1504         3.If recommending an immediate order to involuntary
 1505  outpatient services, the petitioner must prepare a written
 1506  proposed services plan in consultation with the patient or the
 1507  patient’s guardian advocate, if appointed, for the court’s
 1508  consideration for inclusion in the involuntary outpatient
 1509  services order that addresses the nature and extent of the
 1510  mental illness and any co-occurring substance use disorder that
 1511  necessitate involuntary outpatient services. The services plan
 1512  must specify the likely needed level of care, including the use
 1513  of medication, and anticipated discharge criteria for
 1514  terminating involuntary outpatient services. The services in the
 1515  plan must be deemed clinically appropriate by a physician,
 1516  clinical psychologist, psychiatric nurse, mental health
 1517  counselor, marriage and family therapist, or clinical social
 1518  worker who consults with, or is employed or contracted by, the
 1519  service provider. If the services in the proposed services plan
 1520  are not available, the petitioner may not file the petition. The
 1521  petitioner must notify the managing entity if the requested
 1522  services are not available. The managing entity shall document
 1523  such efforts to obtain the requested service. The service
 1524  provider who accepts the patient for involuntary outpatient
 1525  services is responsible for the development of a comprehensive
 1526  treatment plan.
 1527         (e)Each required criterion for the recommended involuntary
 1528  services must be alleged and substantiated in the petition. A
 1529  copy of the recommended services plan, if applicable, must be
 1530  attached to the petition. The court shall accept petitions and
 1531  other documentation with electronic signatures.
 1532         (f)When the petition has been filed Upon filing, the clerk
 1533  of the court shall provide copies of the petition and, if
 1534  applicable, the recommended services plan to the department, the
 1535  managing entity, the patient, the patient’s guardian or
 1536  representative, and the state attorney, and the public defender
 1537  or the patient’s private counsel of the judicial circuit in
 1538  which the patient is located. A fee may not be charged for the
 1539  filing of a petition under this subsection.
 1540         (5)(4) APPOINTMENT OF COUNSEL.—Within 1 court working day
 1541  after the filing of a petition for involuntary services
 1542  inpatient placement, the court shall appoint the public defender
 1543  to represent the person who is the subject of the petition,
 1544  unless the person is otherwise represented by counsel or
 1545  ineligible. The clerk of the court shall immediately notify the
 1546  public defender of such appointment. The public defender shall
 1547  represent the person until the petition is dismissed, the court
 1548  order expires, or the patient is discharged from involuntary
 1549  services. Any attorney who represents representing the patient
 1550  shall be provided have access to the patient, witnesses, and
 1551  records relevant to the presentation of the patient’s case and
 1552  shall represent the interests of the patient, regardless of the
 1553  source of payment to the attorney.
 1554         (6)(5) CONTINUANCE OF HEARING.—The patient and the state
 1555  are independently is entitled, with the concurrence of the
 1556  patient’s counsel, to seek a at least one continuance of the
 1557  hearing for up to 4 weeks. The patient must be granted a request
 1558  for an initial continuance of up to 7 calendar days. The patient
 1559  may request additional continuances for up to 21 additional
 1560  calendar days in total, which shall only be granted by a showing
 1561  of good cause and due diligence by the patient and patient’s
 1562  counsel before requesting the continuance. The state may request
 1563  one continuance of up to 7 calendar days, which shall only be
 1564  granted by a showing of good cause and due diligence by the
 1565  state before requesting the continuance. The state’s failure to
 1566  timely review any readily available document or failure to
 1567  attempt to contact a known witness does not warrant a
 1568  continuance.
 1569         (7)(6) HEARING ON INVOLUNTARY SERVICES INPATIENT
 1570  PLACEMENT.—
 1571         (a)1. The court shall hold a the hearing on the involuntary
 1572  services petition inpatient placement within 5 court working
 1573  days after the filing of the petition, unless a continuance is
 1574  granted.
 1575         2. The court must hold any hearing on involuntary
 1576  outpatient services in the county where the petition is filed. A
 1577  hearing on involuntary inpatient placement, or a combination of
 1578  involuntary inpatient placement and involuntary outpatient
 1579  services, Except for good cause documented in the court file,
 1580  the hearing must be held in the county or the facility, as
 1581  appropriate, where the patient is located, except for good cause
 1582  documented in the court file.
 1583         3.A hearing on involuntary services must be as convenient
 1584  to the patient as is consistent with orderly procedure, and
 1585  shall be conducted in physical settings not likely to be
 1586  injurious to the patient’s condition. If the court finds that
 1587  the patient’s attendance at the hearing is not consistent with
 1588  the best interests of the patient, or the patient knowingly,
 1589  intelligently, and voluntarily waives his or her right to be
 1590  present, and if the patient’s counsel does not object, the court
 1591  may waive the attendance presence of the patient from all or any
 1592  portion of the hearing. The state attorney for the circuit in
 1593  which the patient is located shall represent the state, rather
 1594  than the petitioner, as the real party in interest in the
 1595  proceeding. The facility shall make the respondent’s clinical
 1596  records available to the state attorney and the respondent’s
 1597  attorney so that the state can evaluate and prepare its case.
 1598  However, these records shall remain confidential, and the state
 1599  attorney may not use any record obtained under this part for
 1600  criminal investigation or prosecution purposes, or for any
 1601  purpose other than the patient’s civil commitment under this
 1602  chapter petitioning facility administrator, as the real party in
 1603  interest in the proceeding.
 1604         (b)3. The court may appoint a magistrate to preside at the
 1605  hearing. Upon a finding of good cause, the court may permit all
 1606  witnesses, including, but not limited to, medical professionals
 1607  who are or have been involved with the patient’s treatment, to
 1608  remotely attend and testify at the hearing under oath through
 1609  audio-video teleconference. A witness intending to remotely
 1610  attend and testify must provide the parties with all relevant
 1611  documents by the close of business on the day before the
 1612  hearing. One of the professionals who executed the petition for
 1613  involuntary services inpatient placement certificate must shall
 1614  be a witness. The patient and the patient’s guardian or
 1615  representative shall be informed by the court of the right to an
 1616  independent expert examination. If the patient cannot afford
 1617  such an examination, the court must shall ensure that one is
 1618  provided, as otherwise provided for by law. The independent
 1619  expert’s report is confidential and not discoverable, unless the
 1620  expert is to be called as a witness for the patient at the
 1621  hearing. The court shall allow testimony from persons, including
 1622  family members, deemed by the court to be relevant under state
 1623  law, regarding the person’s prior history and how that prior
 1624  history relates to the person’s current condition. The testimony
 1625  in the hearing must be given under oath, and the proceedings
 1626  must be recorded. The patient may refuse to testify at the
 1627  hearing.
 1628         (c)(b)At the hearing, the court shall consider testimony
 1629  and evidence regarding the patient’s competence to consent to
 1630  services and treatment. If the court finds that the patient is
 1631  incompetent to consent to treatment, it must appoint a guardian
 1632  advocate as provided in s. 394.4598.
 1633         (8)ORDERS OF THE COURT.—
 1634         (a)1. If the court concludes that the patient meets the
 1635  criteria for involuntary services, the court may order a patient
 1636  to involuntary inpatient placement, involuntary outpatient
 1637  services, or a combination of involuntary services depending on
 1638  the criteria met and which type of involuntary services best
 1639  meet the needs of the patient. However, if the court orders the
 1640  patient to involuntary outpatient services, the court may not
 1641  order the department or the service provider to provide services
 1642  if the program or service is not available in the patient’s
 1643  local community, if there is no space available in the program
 1644  or service for the patient, or if funding is not available for
 1645  the program or service. The petitioner must notify the managing
 1646  entity if the requested services are not available. The managing
 1647  entity must document such efforts to obtain the requested
 1648  services. A copy of the order must be sent to the managing
 1649  entity by the service provider within 1 working day after it is
 1650  received from the court.
 1651         2.The order must specify the nature and extent of the
 1652  patient’s mental illness.
 1653         3.a.An order for only involuntary outpatient services
 1654  shall be for a period of up to 90 days.
 1655         b.An order for involuntary inpatient placement, or a
 1656  combination of inpatient placement and outpatient services, may
 1657  be for a period of up to 6 months.
 1658         4.An order for a combination of involuntary services must
 1659  specify the length of time the patient shall be ordered for
 1660  involuntary inpatient placement and involuntary outpatient
 1661  services.
 1662         5.The order of the court and the patient’s services plan,
 1663  if applicable, must be made part of the patient’s clinical
 1664  record.
 1665         (b)If the court orders a patient into involuntary
 1666  inpatient placement, the court it may order that the patient be
 1667  transferred to a treatment facility, or, if the patient is at a
 1668  treatment facility, that the patient be retained there or be
 1669  treated at any other appropriate facility, or that the patient
 1670  receive services, on an involuntary basis, for up to 90 days.
 1671  However, any order for involuntary mental health services in a
 1672  treatment facility may be for up to 6 months. The order shall
 1673  specify the nature and extent of the patient’s mental illness.
 1674  The court may not order an individual with a developmental
 1675  disability as defined in s. 393.063 or a traumatic brain injury
 1676  or dementia who lacks a co-occurring mental illness to be
 1677  involuntarily placed in a state treatment facility. The facility
 1678  shall discharge a patient any time the patient no longer meets
 1679  the criteria for involuntary inpatient placement, unless the
 1680  patient has transferred to voluntary status.
 1681         (c) If at any time before the conclusion of a the hearing
 1682  on involuntary services, inpatient placement it appears to the
 1683  court that the patient person does not meet the criteria for
 1684  involuntary inpatient placement under this section, but instead
 1685  meets the criteria for involuntary outpatient services, the
 1686  court may order the person evaluated for involuntary outpatient
 1687  services pursuant to s. 394.4655. The petition and hearing
 1688  procedures set forth in s. 394.4655 shall apply. If the person
 1689  instead meets the criteria for involuntary assessment,
 1690  protective custody, or involuntary admission or treatment
 1691  pursuant to s. 397.675, then the court may order the person to
 1692  be admitted for involuntary assessment for a period of 5 days
 1693  pursuant to s. 397.6757 s. 397.6811. Thereafter, all proceedings
 1694  are governed by chapter 397.
 1695         (d)At the hearing on involuntary inpatient placement, the
 1696  court shall consider testimony and evidence regarding the
 1697  patient’s competence to consent to treatment. If the court finds
 1698  that the patient is incompetent to consent to treatment, it
 1699  shall appoint a guardian advocate as provided in s. 394.4598.
 1700         (d)(e) The administrator of the petitioning facility or the
 1701  designated department representative shall provide a copy of the
 1702  court order and adequate documentation of a patient’s mental
 1703  illness to the service provider for involuntary outpatient
 1704  services or the administrator of a treatment facility if the
 1705  patient is ordered for involuntary inpatient placement, whether
 1706  by civil or criminal court. The documentation must include any
 1707  advance directives made by the patient, a psychiatric evaluation
 1708  of the patient, and any evaluations of the patient performed by
 1709  a psychiatric nurse, a clinical psychologist, a marriage and
 1710  family therapist, a mental health counselor, or a clinical
 1711  social worker. The administrator of a treatment facility may
 1712  refuse admission to any patient directed to its facilities on an
 1713  involuntary basis, whether by civil or criminal court order, who
 1714  is not accompanied by adequate orders and documentation.
 1715         (9)SERVICE PLAN MODIFICATION.—After the order for
 1716  involuntary outpatient services is issued, the service provider
 1717  and the patient may modify the services plan. For any material
 1718  modification of the services plan to which the patient or, if
 1719  one is appointed, the patient’s guardian advocate agrees, the
 1720  service provider shall send notice of the modification to the
 1721  court. Any material modifications of the services plan which are
 1722  contested by the patient or the patient’s guardian advocate, if
 1723  applicable, must be approved or disapproved by the court
 1724  consistent with subsection (4).
 1725         (10)NONCOMPLIANCE WITH INVOLUNTARY OUTPATIENT SERVICES.
 1726  If, in the clinical judgment of a physician, a patient receiving
 1727  involuntary outpatient services has failed or has refused to
 1728  comply with the services plan ordered by the court, and efforts
 1729  were made to solicit compliance, the service provider must
 1730  report such noncompliance to the court. The involuntary
 1731  outpatient services order shall remain in effect unless the
 1732  service provider determines that the patient no longer meets the
 1733  criteria for involuntary outpatient services or until the order
 1734  expires. The service provider must determine whether
 1735  modifications should be made to the existing services plan and
 1736  must attempt to continue to engage the patient in treatment. For
 1737  any material modification of the services plan to which the
 1738  patient or the patient’s guardian advocate, if applicable,
 1739  agrees, the service provider shall send notice of the
 1740  modification to the court. Any material modifications of the
 1741  services plan which are contested by the patient or the
 1742  patient’s guardian advocate, if applicable, must be approved or
 1743  disapproved by the court consistent with subsection (4).
 1744         (11)(7) PROCEDURE FOR CONTINUED INVOLUNTARY SERVICES
 1745  INPATIENT PLACEMENT.—
 1746         (a)A petition for continued involuntary services must be
 1747  filed if the patient continues to meets the criteria for
 1748  involuntary services.
 1749         (b)1.If a patient receiving involuntary outpatient
 1750  services continues to meet the criteria for involuntary
 1751  outpatient services, the service provider must file in the court
 1752  that issued the initial order for involuntary outpatient
 1753  services a petition for continued involuntary outpatient
 1754  services.
 1755         2.If a patient in involuntary inpatient placement
 1756         (a)Hearings on petitions for continued involuntary
 1757  inpatient placement of an individual placed at any treatment
 1758  facility are administrative hearings and must be conducted in
 1759  accordance with s. 120.57(1), except that any order entered by
 1760  the administrative law judge is final and subject to judicial
 1761  review in accordance with s. 120.68. Orders concerning patients
 1762  committed after successfully pleading not guilty by reason of
 1763  insanity are governed by s. 916.15.
 1764         (b)If the patient continues to meet the criteria for
 1765  involuntary inpatient placement and is being treated at a
 1766  receiving treatment facility, the administrator must shall,
 1767  before the expiration of the period the receiving treatment
 1768  facility is authorized to retain the patient, file in the court
 1769  that issued the initial order for involuntary inpatient
 1770  placement a petition requesting authorization for continued
 1771  involuntary inpatient placement.
 1772         3.Hearings on petitions for continued involuntary
 1773  inpatient placement of an individual placed at any treatment
 1774  facility are administrative hearings and must be conducted in
 1775  accordance with s. 120.57(1), except that any order entered by
 1776  the judge is final and subject to judicial review in accordance
 1777  with s. 120.68. Orders concerning patients committed after
 1778  successfully pleading not guilty by reason of insanity are
 1779  governed by s. 916.15.
 1780         4. The court shall immediately schedule a hearing on the
 1781  petition to be held within 15 days after the petition is filed.
 1782         5.The existing involuntary services order shall remain in
 1783  effect until disposition on the petition for continued
 1784  involuntary services.
 1785         (c) The petition request must be accompanied by a statement
 1786  from the patient’s physician, psychiatrist, psychiatric nurse,
 1787  or clinical psychologist justifying the request, a brief
 1788  description of the patient’s treatment during the time he or she
 1789  was receiving involuntary services involuntarily placed, and an
 1790  individualized plan of continued treatment developed in
 1791  consultation with the patient or the patient’s guardian
 1792  advocate, if applicable. When the petition has been filed, the
 1793  clerk of the court shall provide copies of the petition and the
 1794  individualized plan of continued services to the department, the
 1795  patient, the patient’s guardian advocate, the state attorney,
 1796  and the patient’s private counsel or the public defender.
 1797         (d)The court shall appoint counsel to represent the person
 1798  who is the subject of the petition for continued involuntary
 1799  services in accordance with subsection (5), unless the person is
 1800  otherwise represented by counsel or ineligible.
 1801         (e)Hearings on petitions for continued involuntary
 1802  outpatient services must be before the court that issued the
 1803  order for involuntary outpatient services. However, the patient
 1804  may agree to a period of continued outpatient services without a
 1805  court hearing.
 1806         (f)Hearings on petitions for continued involuntary
 1807  inpatient placement in receiving facilities must be held in the
 1808  county or the facility, as appropriate, where the patient is
 1809  located.
 1810         (g)The court may appoint a magistrate to preside at the
 1811  hearing. The procedures for obtaining an order pursuant to this
 1812  paragraph must meet the requirements of subsection (7).
 1813         (h) Notice of the hearing must be provided as set forth
 1814  provided in s. 394.4599.
 1815         (i) If a patient’s attendance at the hearing is voluntarily
 1816  waived, the administrative law judge must determine that the
 1817  patient knowingly, intelligently, and voluntarily waived his or
 1818  her right to be present, waiver is knowing and voluntary before
 1819  waiving the presence of the patient from all or a portion of the
 1820  hearing. Alternatively, if at the hearing the administrative law
 1821  judge finds that attendance at the hearing is not consistent
 1822  with the best interests of the patient, the administrative law
 1823  judge may waive the presence of the patient from all or any
 1824  portion of the hearing, unless the patient, through counsel,
 1825  objects to the waiver of presence. The testimony in the hearing
 1826  must be under oath, and the proceedings must be recorded.
 1827         (c)Unless the patient is otherwise represented or is
 1828  ineligible, he or she shall be represented at the hearing on the
 1829  petition for continued involuntary inpatient placement by the
 1830  public defender of the circuit in which the facility is located.
 1831         (j)(d) If at a hearing it is shown that the patient
 1832  continues to meet the criteria for involuntary services
 1833  inpatient placement, the court administrative law judge shall
 1834  issue an sign the order for continued involuntary outpatient
 1835  services inpatient placement for up to 90 days or. However, any
 1836  order for involuntary inpatient placement, or mental health
 1837  services in a combination of involuntary services, treatment
 1838  facility may be for up to 6 months. The same procedure shall be
 1839  repeated before the expiration of each additional period the
 1840  patient is retained.
 1841         (k)If the patient has been ordered to undergo involuntary
 1842  services and has previously been found incompetent to consent to
 1843  treatment, the court must consider testimony and evidence
 1844  regarding the patient’s competence. If the patient’s competency
 1845  to consent to treatment is restored, the discharge of the
 1846  guardian advocate is governed by s. 394.4598. If the patient has
 1847  been ordered to undergo involuntary inpatient placement only and
 1848  the patient’s competency to consent to treatment is restored,
 1849  the administrative law judge may issue, to the court that found
 1850  the patient incompetent to consent to treatment, a recommended
 1851  order that the patient’s competence be restored and that any
 1852  guardian advocate previously appointed be discharged.
 1853         (l)(e) If continued involuntary inpatient placement is
 1854  necessary for a patient in involuntary inpatient placement who
 1855  was admitted while serving a criminal sentence, but his or her
 1856  sentence is about to expire, or for a minor involuntarily
 1857  placed, but who is about to reach the age of 18, the
 1858  administrator shall petition the administrative law judge for an
 1859  order authorizing continued involuntary inpatient placement.
 1860  
 1861  The procedure required in this subsection must be followed
 1862  before the expiration of each additional period the patient is
 1863  involuntarily receiving services.
 1864         (12)(8) RETURN TO FACILITY.—If a patient has been ordered
 1865  to undergo involuntary inpatient placement involuntarily held at
 1866  a treatment facility under this part leaves the facility without
 1867  the administrator’s authorization, the administrator may
 1868  authorize a search for the patient and his or her return to the
 1869  facility. The administrator may request the assistance of a law
 1870  enforcement agency in this regard.
 1871         (13)DISCHARGE.—The patient shall be discharged upon
 1872  expiration of the court order or at any time the patient no
 1873  longer meets the criteria for involuntary services, unless the
 1874  patient has transferred to voluntary status. Upon discharge, the
 1875  service provider or facility shall send a certificate of
 1876  discharge to the court.
 1877         Section 13. Subsection (2) of section 394.468, Florida
 1878  Statutes, is amended, and subsection (3) is added to that
 1879  section, to read:
 1880         394.468 Admission and discharge procedures.—
 1881         (2) Discharge planning and procedures for any patient’s
 1882  release from a receiving facility or treatment facility must
 1883  include and document the patient’s needs, and actions to address
 1884  such needs, for consideration of, at a minimum, all of the
 1885  following:
 1886         (a) Follow-up behavioral health appointments;
 1887         (b) Information on how to obtain prescribed medications;
 1888  and
 1889         (c) Information pertaining to:
 1890         1. Available living arrangements;
 1891         2. Transportation; and
 1892         (d)Referral to:
 1893         1.Care coordination services. The patient must be referred
 1894  for care coordination services if the patient meets the criteria
 1895  as a member of a priority population as determined by the
 1896  department under s. 394.9082(3)(c) and is in need of such
 1897  services.
 1898         2.3. Recovery support opportunities under s.
 1899  394.4573(2)(l), including, but not limited to, connection to a
 1900  peer specialist.
 1901         (3)During the discharge transition process and while the
 1902  patient is present unless determined inappropriate by a
 1903  physician or psychiatric nurse practicing within the framework
 1904  of an established protocol with a psychiatrist, a receiving
 1905  facility shall coordinate, face-to-face or through electronic
 1906  means, discharge plans to a less restrictive community
 1907  behavioral health provider, a peer specialist, a case manager,
 1908  or a care coordination service. The transition process must, at
 1909  a minimum, include all of the following criteria:
 1910         (a)Implementation of policies and procedures outlining
 1911  strategies for how the receiving facility will comprehensively
 1912  address the needs of patients who demonstrate a high use of
 1913  receiving facility services to avoid or reduce future use of
 1914  crisis stabilization services. For any such patient, policies
 1915  and procedures must, at a minimum, include a review of the
 1916  effectiveness of previous discharge plans created by the
 1917  facility for the patient, and the new discharge plan must
 1918  address problems experienced with implementation of previous
 1919  discharge plans.
 1920         (b)Developing, and including in discharge paperwork, a
 1921  personalized crisis prevention plan that identifies stressors,
 1922  early warning signs or symptoms, and strategies to deal with a
 1923  crisis.
 1924         (c)Requiring a staff member to seek to engage a family
 1925  member, legal guardian, legal representative, or natural support
 1926  in discharge planning and meet face to face or through
 1927  electronic means to review the discharge instructions, including
 1928  prescribed medications, follow-up appointments, and any other
 1929  recommended services or follow-up resources, and document the
 1930  outcome of such meeting.
 1931         (d)When the recommended level of care at discharge is not
 1932  immediately available to the patient, the receiving facility
 1933  must, at a minimum, initiate a referral to an appropriate
 1934  provider to meet the needs of the patient to continue care until
 1935  the recommended level of care is available.
 1936         Section 14. Section 394.4915, Florida Statutes, is created
 1937  to read:
 1938         394.4915Office of Children’s Behavioral Health Ombudsman.
 1939  The Office of Children’s Behavioral Health Ombudsman is
 1940  established within the department for the purpose of being a
 1941  central point to receive complaints on behalf of children and
 1942  adolescents with behavioral health disorders and who are
 1943  receiving state-funded services and use such information to
 1944  improve the child and adolescent mental health treatment and
 1945  support system. The department and managing entities shall
 1946  include information about and contact information for the office
 1947  placed prominently on their websites on easily accessible web
 1948  pages related to children and adolescent behavioral health
 1949  services. To the extent permitted by available resources, the
 1950  office shall, at a minimum:
 1951         (1)Receive and direct to the appropriate contact within
 1952  the department, the Agency for Health Care Administration, or
 1953  the appropriate organizations providing behavioral health
 1954  services complaints from children and adolescents and their
 1955  families about the child and adolescent mental health treatment
 1956  and support system.
 1957         (2)Maintain records of complaints received and the actions
 1958  taken.
 1959         (3)Be a resource to identify and explain relevant policies
 1960  or procedures to children, adolescents, and their families about
 1961  the child and adolescent mental health treatment and support
 1962  system.
 1963         (4)Provide recommendations to the department to address
 1964  systemic problems within the child and adolescent mental health
 1965  treatment and support system which are leading to complaints.
 1966  The department shall include an analysis of complaints and
 1967  recommendations in the report required under s. 394.4573.
 1968         (5)Engage in functions that may improve the child and
 1969  adolescent mental health treatment and support system.
 1970         Section 15. Subsection (3) of section 394.495, Florida
 1971  Statutes, is amended to read:
 1972         394.495 Child and adolescent mental health system of care;
 1973  programs and services.—
 1974         (3) Assessments must be performed by:
 1975         (a) A clinical psychologist, clinical social worker,
 1976  physician, psychiatric nurse, or psychiatrist, as those terms
 1977  are defined in s. 394.455 professional as defined in s.
 1978  394.455(5), (7), (33), (36), or (37);
 1979         (b) A professional licensed under chapter 491; or
 1980         (c) A person who is under the direct supervision of a
 1981  clinical psychologist, clinical social worker, physician,
 1982  psychiatric nurse, or psychiatrist, as those terms are defined
 1983  in s. 394.455, qualified professional as defined in s.
 1984  394.455(5), (7), (33), (36), or (37) or a professional licensed
 1985  under chapter 491.
 1986         Section 16. Subsection (5) of section 394.496, Florida
 1987  Statutes, is amended to read:
 1988         394.496 Service planning.—
 1989         (5) A clinical psychologist, clinical social worker,
 1990  physician, psychiatric nurse, or psychiatrist, as those terms
 1991  are defined in s. 394.455, professional as defined in s.
 1992  394.455(5), (7), (33), (36), or (37) or a professional licensed
 1993  under chapter 491 must be included among those persons
 1994  developing the services plan.
 1995         Section 17. Paragraph (a) of subsection (2) of section
 1996  394.499, Florida Statutes, is amended to read:
 1997         394.499 Integrated children’s crisis stabilization
 1998  unit/juvenile addictions receiving facility services.—
 1999         (2) Children eligible to receive integrated children’s
 2000  crisis stabilization unit/juvenile addictions receiving facility
 2001  services include:
 2002         (a) A minor whose parent makes person under 18 years of age
 2003  for whom voluntary application based on the parent’s express and
 2004  informed consent, and the requirements of s. 394.4625(1)(a) are
 2005  met is made by his or her guardian, if such person is found to
 2006  show evidence of mental illness and to be suitable for treatment
 2007  pursuant to s. 394.4625. A person under 18 years of age may be
 2008  admitted for integrated facility services only after a hearing
 2009  to verify that the consent to admission is voluntary.
 2010         Section 18. Paragraphs (a) and (d) of subsection (1) of
 2011  section 394.875, Florida Statutes, are amended to read:
 2012         394.875 Crisis stabilization units, residential treatment
 2013  facilities, and residential treatment centers for children and
 2014  adolescents; authorized services; license required.—
 2015         (1)(a) The purpose of a crisis stabilization unit is to
 2016  stabilize and redirect a client to the most appropriate and
 2017  least restrictive community setting available, consistent with
 2018  the client’s needs. Crisis stabilization units may screen,
 2019  assess, and admit for stabilization persons who present
 2020  themselves to the unit and persons who are brought to the unit
 2021  under s. 394.463. Clients may be provided 24-hour observation,
 2022  medication prescribed by a physician, or psychiatrist, or
 2023  psychiatric nurse practicing within the framework of an
 2024  established protocol with a psychiatrist, and other appropriate
 2025  services. Crisis stabilization units shall provide services
 2026  regardless of the client’s ability to pay and shall be limited
 2027  in size to a maximum of 30 beds.
 2028         (d)The department is directed to implement a demonstration
 2029  project in circuit 18 to test the impact of expanding beds
 2030  authorized in crisis stabilization units from 30 to 50 beds.
 2031  Specifically, the department is directed to authorize existing
 2032  public or private crisis stabilization units in circuit 18 to
 2033  expand bed capacity to a maximum of 50 beds and to assess the
 2034  impact such expansion would have on the availability of crisis
 2035  stabilization services to clients.
 2036         Section 19. Section 394.90826, Florida Statutes, is created
 2037  to read:
 2038         394.90826Behavioral health interagency collaboration.—
 2039         (1) The department and the Agency for Health Care
 2040  Administration shall jointly establish behavioral health
 2041  interagency collaboratives throughout this state with the goal
 2042  of identifying and addressing ongoing challenges within the
 2043  behavioral health system at the local level to improve the
 2044  accessibility, availability, and quality of behavioral health
 2045  services. The objectives of the regional collaboratives are to:
 2046         a. Facilitate enhanced interagency communication and
 2047  collaboration.
 2048         b. Develop and promote regional strategies tailored to
 2049  address community-level challenges in the behavioral health
 2050  system.
 2051         (2) The regional collaborative membership shall, at a
 2052  minimum, be composed of representatives serving the region from
 2053  the following:
 2054         a. Department of Children and Families;
 2055         b. Agency for Health Care Administration;
 2056         c. Agency for Persons with Disabilities;
 2057         d. Department of Elder Affairs;
 2058         e. Department of Health;
 2059         f. Department of Education;
 2060         g. School districts;
 2061         h. Area agencies on aging;
 2062         i. Community-based care lead agencies, as defined in s.
 2063  409.986(3)(d);
 2064         j. Managing entities, as defined in s. 394.9082;
 2065         k. Behavioral health services providers;
 2066         l. Hospitals;
 2067         m. Medicaid Managed Medical Assistance Plans;
 2068         n. Police departments; and
 2069         o. Sheriffs’ offices.
 2070         (3) Each regional collaborative shall define the objectives
 2071  of that collaborative based upon the specific needs of the
 2072  region, and the local communities located within the region, to
 2073  achieve the specified goals.
 2074         (4) The department shall define the region to be served by
 2075  each collaborative and shall be responsible for facilitating
 2076  meetings.
 2077         (5) All entities represented on the regional collaboratives
 2078  shall provide assistance as appropriate and reasonably necessary
 2079  to fulfill the goals of the regional collaboratives.
 2080         Section 20. Subsection (6) of section 394.9085, Florida
 2081  Statutes, is amended to read:
 2082         394.9085 Behavioral provider liability.—
 2083         (6) For purposes of this section, the terms “detoxification
 2084  services,” “addictions receiving facility,” and “receiving
 2085  facility” have the same meanings as those provided in ss.
 2086  397.311(26)(a)4. 397.311(26)(a)3., 397.311(26)(a)1., and
 2087  394.455(41) 394.455(40), respectively.
 2088         Section 21. Subsection (3) of section 397.305, Florida
 2089  Statutes, is amended to read:
 2090         397.305 Legislative findings, intent, and purpose.—
 2091         (3) It is the purpose of this chapter to provide for a
 2092  comprehensive continuum of accessible and quality substance
 2093  abuse prevention, intervention, clinical treatment, and recovery
 2094  support services in the most appropriate and least restrictive
 2095  environment which promotes long-term recovery while protecting
 2096  and respecting the rights of individuals, primarily through
 2097  community-based private not-for-profit providers working with
 2098  local governmental programs involving a wide range of agencies
 2099  from both the public and private sectors.
 2100         Section 22. Subsections (19) and (23) of section 397.311,
 2101  Florida Statutes, are amended to read:
 2102         397.311 Definitions.—As used in this chapter, except part
 2103  VIII, the term:
 2104         (19) “Impaired” or “substance abuse impaired” means having
 2105  a substance use disorder or a condition involving the use of
 2106  alcoholic beverages, illicit or prescription drugs, or any
 2107  psychoactive or mood-altering substance in such a manner as to
 2108  induce mental, emotional, or physical problems or and cause
 2109  socially dysfunctional behavior.
 2110         (23) “Involuntary treatment services” means an array of
 2111  behavioral health services that may be ordered by the court for
 2112  persons with substance abuse impairment or co-occurring
 2113  substance abuse impairment and mental health disorders.
 2114         Section 23. Subsection (6) is added to section 397.401,
 2115  Florida Statutes, to read:
 2116         397.401 License required; penalty; injunction; rules
 2117  waivers.—
 2118         (6)A service provider operating an addictions receiving
 2119  facility or providing detoxification on a nonhospital inpatient
 2120  basis may not exceed its licensed capacity by more than 10
 2121  percent and may not exceed its licensed capacity for more than 3
 2122  consecutive working days or for more than 7 days in 1 month.
 2123         Section 24. Paragraph (i) is added to subsection (1) of
 2124  section 397.4073, Florida Statutes, to read:
 2125         397.4073 Background checks of service provider personnel.—
 2126         (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND
 2127  EXCEPTIONS.—
 2128         (i)A physician licensed under chapter 458 or chapter 459
 2129  or a nurse licensed under chapter 464 who was required to
 2130  undergo background screening by the Department of Health as part
 2131  of his or her initial licensure or the renewal of licensure, and
 2132  who has an active and unencumbered license, is not subject to
 2133  background screening pursuant to this section.
 2134         Section 25. Subsection (8) of section 397.501, Florida
 2135  Statutes, is amended to read:
 2136         397.501 Rights of individuals.—Individuals receiving
 2137  substance abuse services from any service provider are
 2138  guaranteed protection of the rights specified in this section,
 2139  unless otherwise expressly provided, and service providers must
 2140  ensure the protection of such rights.
 2141         (8) RIGHT TO COUNSEL.—Each individual must be informed that
 2142  he or she has the right to be represented by counsel in any
 2143  judicial involuntary proceeding for involuntary assessment,
 2144  stabilization, or treatment services and that he or she, or if
 2145  the individual is a minor his or her parent, legal guardian, or
 2146  legal custodian, may apply immediately to the court to have an
 2147  attorney appointed if he or she cannot afford one.
 2148         Section 26. Section 397.581, Florida Statutes, is amended
 2149  to read:
 2150         397.581 Unlawful activities relating to assessment and
 2151  treatment; penalties.—
 2152         (1) A person may not knowingly and willfully:
 2153         (a)Furnish furnishing false information for the purpose of
 2154  obtaining emergency or other involuntary admission of another
 2155  person for any person is a misdemeanor of the first degree,
 2156  punishable as provided in s. 775.082 and by a fine not exceeding
 2157  $5,000.
 2158         (b)(2)Cause or otherwise secure, or conspire with or
 2159  assist another to cause or secure Causing or otherwise securing,
 2160  or conspiring with or assisting another to cause or secure,
 2161  without reason for believing a person to be impaired, any
 2162  emergency or other involuntary procedure of another for the
 2163  person under false pretenses is a misdemeanor of the first
 2164  degree, punishable as provided in s. 775.082 and by a fine not
 2165  exceeding $5,000.
 2166         (c)(3)Cause, or conspire with or assist another to cause,
 2167  without lawful justification Causing, or conspiring with or
 2168  assisting another to cause, the denial to any person of any
 2169  right accorded pursuant to this chapter.
 2170         (2)A person who violates subsection (1) commits is a
 2171  misdemeanor of the first degree, punishable as provided in s.
 2172  775.082 and by a fine not exceeding $5,000.
 2173         Section 27. Section 397.675, Florida Statutes, is amended
 2174  to read:
 2175         397.675 Criteria for involuntary admissions, including
 2176  protective custody, emergency admission, and other involuntary
 2177  assessment, involuntary treatment, and alternative involuntary
 2178  assessment for minors, for purposes of assessment and
 2179  stabilization, and for involuntary treatment.—A person meets the
 2180  criteria for involuntary admission if there is good faith reason
 2181  to believe that the person is substance abuse impaired or has a
 2182  substance use disorder and a co-occurring mental health disorder
 2183  and, because of such impairment or disorder:
 2184         (1) Has lost the power of self-control with respect to
 2185  substance abuse; and
 2186         (2)(a) Is in need of substance abuse services and, by
 2187  reason of substance abuse impairment, his or her judgment has
 2188  been so impaired that he or she is incapable of appreciating his
 2189  or her need for such services and of making a rational decision
 2190  in that regard, although mere refusal to receive such services
 2191  does not constitute evidence of lack of judgment with respect to
 2192  his or her need for such services; or
 2193         (b) Without care or treatment, is likely to suffer from
 2194  neglect or refuse to care for himself or herself; that such
 2195  neglect or refusal poses a real and present threat of
 2196  substantial harm to his or her well-being; and that it is not
 2197  apparent that such harm may be avoided through the help of
 2198  willing, able, and responsible family members or friends or the
 2199  provision of other services, or there is substantial likelihood
 2200  that the person has inflicted, or threatened to or attempted to
 2201  inflict, or, unless admitted, is likely to inflict, physical
 2202  harm on himself, herself, or another.
 2203         Section 28. Subsection (1) of section 397.6751, Florida
 2204  Statutes, is amended to read:
 2205         397.6751 Service provider responsibilities regarding
 2206  involuntary admissions.—
 2207         (1) It is the responsibility of the service provider to:
 2208         (a) Ensure that a person who is admitted to a licensed
 2209  service component meets the admission criteria specified in s.
 2210  397.675;
 2211         (b) Ascertain whether the medical and behavioral conditions
 2212  of the person, as presented, are beyond the safe management
 2213  capabilities of the service provider;
 2214         (c) Provide for the admission of the person to the service
 2215  component that represents the most appropriate and least
 2216  restrictive available setting that is responsive to the person’s
 2217  treatment needs;
 2218         (d) Verify that the admission of the person to the service
 2219  component does not result in a census in excess of its licensed
 2220  service capacity;
 2221         (e) Determine whether the cost of services is within the
 2222  financial means of the person or those who are financially
 2223  responsible for the person’s care; and
 2224         (f) Take all necessary measures to ensure that each
 2225  individual in treatment is provided with a safe environment, and
 2226  to ensure that each individual whose medical condition or
 2227  behavioral problem becomes such that he or she cannot be safely
 2228  managed by the service component is discharged and referred to a
 2229  more appropriate setting for care.
 2230         Section 29. Section 397.681, Florida Statutes, is amended
 2231  to read:
 2232         397.681 Involuntary petitions; general provisions; court
 2233  jurisdiction and right to counsel.—
 2234         (1) JURISDICTION.—The courts have jurisdiction of
 2235  involuntary assessment and stabilization petitions and
 2236  involuntary treatment petitions for substance abuse impaired
 2237  persons, and such petitions must be filed with the clerk of the
 2238  court in the county where the person is located. The clerk of
 2239  the court may not charge a fee for the filing of a petition
 2240  under this section. The chief judge may appoint a general or
 2241  special magistrate to preside over all or part of the
 2242  proceedings. The alleged impaired person is named as the
 2243  respondent.
 2244         (2) RIGHT TO COUNSEL.— A respondent has the right to
 2245  counsel at every stage of a judicial proceeding relating to a
 2246  petition for his or her involuntary assessment and a petition
 2247  for his or her involuntary treatment for substance abuse
 2248  impairment, but the respondent may waive that right if the
 2249  respondent is present and the court finds that such waiver is
 2250  made knowingly, intelligently, and voluntarily. A respondent who
 2251  desires counsel and is unable to afford private counsel has the
 2252  right to court-appointed counsel and to the benefits of s.
 2253  57.081. If the court believes that the respondent needs or
 2254  desires the assistance of counsel, the court shall appoint such
 2255  counsel for the respondent without regard to the respondent’s
 2256  wishes. If the respondent is a minor not otherwise represented
 2257  in the proceeding, the court shall immediately appoint a
 2258  guardian ad litem to act on the minor’s behalf.
 2259         Section 30. Section 397.693, Florida Statutes, is
 2260  renumbered as section 397.68111, Florida Statutes, and amended
 2261  to read:
 2262         397.68111 397.693 Involuntary treatment.—A person may be
 2263  the subject of a petition for court-ordered involuntary
 2264  treatment pursuant to this part, if that person:
 2265         (1)Reasonably appears to meet meets the criteria for
 2266  involuntary admission provided in s. 397.675; and:
 2267         (2)(1) Has been placed under protective custody pursuant to
 2268  s. 397.677 within the previous 10 days;
 2269         (3)(2) Has been subject to an emergency admission pursuant
 2270  to s. 397.679 within the previous 10 days; or
 2271         (4)(3) Has been assessed by a qualified professional within
 2272  30 5 days;
 2273         (4)Has been subject to involuntary assessment and
 2274  stabilization pursuant to s. 397.6818 within the previous 12
 2275  days; or
 2276         (5)Has been subject to alternative involuntary admission
 2277  pursuant to s. 397.6822 within the previous 12 days.
 2278         Section 31. Section 397.695, Florida Statutes, is
 2279  renumbered as section 397.68112, Florida Statutes, and amended
 2280  to read:
 2281         397.68112 397.695 Involuntary services; persons who may
 2282  petition.—
 2283         (1) If the respondent is an adult, a petition for
 2284  involuntary treatment services may be filed by the respondent’s
 2285  spouse or legal guardian, any relative, a service provider, or
 2286  an adult who has direct personal knowledge of the respondent’s
 2287  substance abuse impairment and his or her prior course of
 2288  assessment and treatment.
 2289         (2) If the respondent is a minor, a petition for
 2290  involuntary treatment services may be filed by a parent, legal
 2291  guardian, or service provider.
 2292         (3)The court may prohibit, or a law enforcement agency may
 2293  waive, any service of process fees if a petitioner is determined
 2294  to be indigent.
 2295         Section 32. Section 397.6951, Florida Statutes, is
 2296  renumbered as section 397.68141, Florida Statutes, and amended
 2297  to read:
 2298         397.68141 397.6951 Contents of petition for involuntary
 2299  treatment services.—A petition for involuntary services must
 2300  contain the name of the respondent; the name of the petitioner
 2301  or petitioners; the relationship between the respondent and the
 2302  petitioner; the name of the respondent’s attorney, if known; the
 2303  findings and recommendations of the assessment performed by the
 2304  qualified professional; and the factual allegations presented by
 2305  the petitioner establishing the need for involuntary outpatient
 2306  services for substance abuse impairment. The factual allegations
 2307  must demonstrate:
 2308         (1) The reason for the petitioner’s belief that the
 2309  respondent is substance abuse impaired;
 2310         (2) The reason for the petitioner’s belief that because of
 2311  such impairment the respondent has lost the power of self
 2312  control with respect to substance abuse; and
 2313         (3)(a) The reason the petitioner believes that the
 2314  respondent has inflicted or is likely to inflict physical harm
 2315  on himself or herself or others unless the court orders the
 2316  involuntary services; or
 2317         (b) The reason the petitioner believes that the
 2318  respondent’s refusal to voluntarily receive care is based on
 2319  judgment so impaired by reason of substance abuse that the
 2320  respondent is incapable of appreciating his or her need for care
 2321  and of making a rational decision regarding that need for care.
 2322         (4)The petition may be accompanied by a certificate or
 2323  report of a qualified professional who examined the respondent
 2324  within 30 days before the petition was filed. The certificate or
 2325  report must include the qualified professional’s findings
 2326  relating to his or her assessment of the patient and his or her
 2327  treatment recommendations. If the respondent was not assessed
 2328  before the filing of an involuntary treatment petition or
 2329  refused to submit to an evaluation, the lack of assessment or
 2330  refusal must be noted in the petition.
 2331         (5)If there is an emergency, the petition must also
 2332  describe the respondent’s exigent circumstances and include a
 2333  request for an ex parte assessment and stabilization order that
 2334  must be executed pursuant to s. 397.68151.
 2335         Section 33. Section 397.6955, Florida Statutes, is
 2336  renumbered as section 397.68151, Florida Statutes, and amended
 2337  to read:
 2338         397.68151 397.6955 Duties of court upon filing of petition
 2339  for involuntary services.—
 2340         (1) Upon the filing of a petition for involuntary services
 2341  for a substance abuse impaired person with the clerk of the
 2342  court, the court shall immediately determine whether the
 2343  respondent is represented by an attorney or whether the
 2344  appointment of counsel for the respondent is appropriate. If the
 2345  court appoints counsel for the person, the clerk of the court
 2346  shall immediately notify the office of criminal conflict and
 2347  civil regional counsel, created pursuant to s. 27.511, of the
 2348  appointment. The office of criminal conflict and civil regional
 2349  counsel shall represent the person until the petition is
 2350  dismissed, the court order expires, or the person is discharged
 2351  from involuntary treatment services, or the office is otherwise
 2352  discharged by the court. An attorney who that represents the
 2353  person named in the petition shall have access to the person,
 2354  witnesses, and records relevant to the presentation of the
 2355  person’s case and shall represent the interests of the person,
 2356  regardless of the source of payment to the attorney.
 2357         (2) The court shall schedule a hearing to be held on the
 2358  petition within 10 court working 5 days unless a continuance is
 2359  granted. The court may appoint a magistrate to preside at the
 2360  hearing.
 2361         (3) A copy of the petition and notice of the hearing must
 2362  be provided to the respondent; the respondent’s parent,
 2363  guardian, or legal custodian, in the case of a minor; the
 2364  respondent’s attorney, if known; the petitioner; the
 2365  respondent’s spouse or guardian, if applicable; and such other
 2366  persons as the court may direct. If the respondent is a minor, a
 2367  copy of the petition and notice of the hearing must be
 2368  personally delivered to the respondent. The clerk court shall
 2369  also issue a summons to the person whose admission is sought and
 2370  unless a circuit court’s chief judge authorizes disinterested
 2371  private process servers to serve parties under this chapter, a
 2372  law enforcement agency must effect such service on the person
 2373  whose admission is sought for the initial treatment hearing.
 2374         Section 34. Section 397.6818, Florida Statutes, is amended
 2375  to read:
 2376         397.6818 Court determination.—
 2377         (1)When the petitioner asserts that emergency
 2378  circumstances exist, or when upon review of the petition the
 2379  court determines that an emergency exists, the court may rely
 2380  solely on the contents of the petition and, without the
 2381  appointment of an attorney, enter an ex parte order for the
 2382  respondent’s involuntary assessment and stabilization which must
 2383  be executed during the period when the hearing on the petition
 2384  for treatment is pending.
 2385         (2)The court may further order a law enforcement officer
 2386  or another designated agent of the court to:
 2387         (a)Take the respondent into custody and deliver him or her
 2388  for evaluation to either the nearest appropriate licensed
 2389  service provider or a licensed service provider designated by
 2390  the court.
 2391         (b)Serve the respondent with the notice of hearing and a
 2392  copy of the petition.
 2393         (3)The service provider may not hold the respondent for
 2394  longer than 72 hours of observation, unless:
 2395         (a)The service provider seeks additional time under s.
 2396  397.6957(1)(c) and the court, after a hearing, grants that
 2397  motion;
 2398         (b)The respondent shows signs of withdrawal, or a need to
 2399  be either detoxified or treated for a medical condition, which
 2400  shall extend the amount of time the respondent may be held for
 2401  observation until the issue is resolved but no later than the
 2402  scheduled hearing date, absent a court-approved extension; or
 2403         (c)The original or extended observation period ends on a
 2404  weekend or holiday, including the hours before the ordinary
 2405  business hours of the following workday morning, in which case
 2406  the provider may hold the respondent until the next court
 2407  working day.
 2408         (4)If the ex parte order was not executed by the initial
 2409  hearing date, it shall be deemed void. However, should the
 2410  respondent not appear at the hearing for any reason, including
 2411  lack of service, and upon reviewing the petition, testimony, and
 2412  evidence presented, the court reasonably believes the respondent
 2413  meets this chapter’s commitment criteria and that a substance
 2414  abuse emergency exists, the court may issue or reissue an ex
 2415  parte assessment and stabilization order that is valid for 90
 2416  days. If the respondent’s location is known at the time of the
 2417  hearing, the court:
 2418         (a)Shall continue the case for no more than 10 court
 2419  working days; and
 2420         (b)May order a law enforcement officer or another
 2421  designated agent of the court to:
 2422         1.Take the respondent into custody and deliver him or her
 2423  for evaluation to either the nearest appropriate licensed
 2424  service provider or a licensed service provider designated by
 2425  the court; and
 2426         2.If a hearing date is set, serve the respondent with
 2427  notice of the rescheduled hearing and a copy of the involuntary
 2428  treatment petition if the respondent has not already been
 2429  served.
 2430  
 2431  Otherwise, the petitioner must inform the court that the
 2432  respondent has been assessed so that the court may schedule a
 2433  hearing as soon as is practicable. However, if the respondent
 2434  has not been assessed within 90 days, the court must dismiss the
 2435  case. At the hearing initiated in accordance with s.
 2436  397.6811(1), the court shall hear all relevant testimony. The
 2437  respondent must be present unless the court has reason to
 2438  believe that his or her presence is likely to be injurious to
 2439  him or her, in which event the court shall appoint a guardian
 2440  advocate to represent the respondent. The respondent has the
 2441  right to examination by a court-appointed qualified
 2442  professional. After hearing all the evidence, the court shall
 2443  determine whether there is a reasonable basis to believe the
 2444  respondent meets the involuntary admission criteria of s.
 2445  397.675.
 2446         (1)Based on its determination, the court shall either
 2447  dismiss the petition or immediately enter an order authorizing
 2448  the involuntary assessment and stabilization of the respondent;
 2449  or, if in the course of the hearing the court has reason to
 2450  believe that the respondent, due to mental illness other than or
 2451  in addition to substance abuse impairment, is likely to injure
 2452  himself or herself or another if allowed to remain at liberty,
 2453  the court may initiate involuntary proceedings under the
 2454  provisions of part I of chapter 394.
 2455         (2)If the court enters an order authorizing involuntary
 2456  assessment and stabilization, the order shall include the
 2457  court’s findings with respect to the availability and
 2458  appropriateness of the least restrictive alternatives and the
 2459  need for the appointment of an attorney to represent the
 2460  respondent, and may designate the specific licensed service
 2461  provider to perform the involuntary assessment and stabilization
 2462  of the respondent. The respondent may choose the licensed
 2463  service provider to deliver the involuntary assessment where
 2464  possible and appropriate.
 2465         (3)If the court finds it necessary, it may order the
 2466  sheriff to take the respondent into custody and deliver him or
 2467  her to the licensed service provider specified in the court
 2468  order or, if none is specified, to the nearest appropriate
 2469  licensed service provider for involuntary assessment.
 2470         (4)The order is valid only for the period specified in the
 2471  order or, if a period is not specified, for 7 days after the
 2472  order is signed.
 2473         Section 35. Section 397.6957, Florida Statutes, is amended
 2474  to read:
 2475         397.6957 Hearing on petition for involuntary treatment
 2476  services.—
 2477         (1)(a)The respondent must be present at a hearing on a
 2478  petition for involuntary treatment services unless the court
 2479  finds that he or she knowingly, intelligently, and voluntarily
 2480  waives his or her right to be present or, upon receiving proof
 2481  of service and evaluating the circumstances of the case, that
 2482  his or her presence is inconsistent with his or her best
 2483  interests or is likely to be injurious to self or others., The
 2484  court shall hear and review all relevant evidence, including
 2485  testimony from individuals such as family members familiar with
 2486  the respondent’s prior history and how it relates to his or her
 2487  current condition, and the review of results of the assessment
 2488  completed by the qualified professional in connection with this
 2489  chapter. The court may also order drug tests. Upon a finding of
 2490  good cause, the court may permit all witnesses, including, but
 2491  not limited to, medical professionals who are or have been
 2492  involved with the respondent’s treatment, to remotely attend and
 2493  testify at the hearing under oath via audio-video
 2494  teleconference. A witness intending to remotely attend and
 2495  testify must provide the parties with all relevant documents by
 2496  the close of business on the day before the hearing the
 2497  respondent’s protective custody, emergency admission,
 2498  involuntary assessment, or alternative involuntary admission.
 2499  The respondent must be present unless the court finds that his
 2500  or her presence is likely to be injurious to himself or herself
 2501  or others, in which event the court must appoint a guardian
 2502  advocate to act in behalf of the respondent throughout the
 2503  proceedings.
 2504         (b)A respondent may not be involuntarily ordered into
 2505  treatment under this chapter without a clinical assessment being
 2506  performed, unless he or she is present in court and expressly
 2507  waives the assessment. In nonemergency situations, if the
 2508  respondent was not, or had previously refused to be, assessed by
 2509  a qualified professional and, based on the petition, testimony,
 2510  and evidence presented, it reasonably appears that the
 2511  respondent qualifies for involuntary treatment services, the
 2512  court must issue an involuntary assessment and stabilization
 2513  order to determine the appropriate level of treatment the
 2514  respondent requires. Additionally, in cases where an assessment
 2515  was attached to the petition, the respondent may request, or the
 2516  court on its own motion may order, an independent assessment by
 2517  a court-appointed or otherwise agreed upon qualified
 2518  professional. If an assessment order is issued, it is valid for
 2519  90 days, and if the respondent is present or there is either
 2520  proof of service or his or her location is known, the
 2521  involuntary treatment hearing shall be continued for no more
 2522  than 10 court working days. Otherwise, the petitioner must
 2523  inform the court that the respondent has been assessed so that
 2524  the court may schedule a hearing as soon as is practicable. The
 2525  assessment must occur before the new hearing date, and if there
 2526  is evidence indicating that the respondent will not voluntarily
 2527  appear at the forthcoming hearing or is a danger to self or
 2528  others, the court may enter a preliminary order committing the
 2529  respondent to an appropriate treatment facility for further
 2530  evaluation until the date of the rescheduled hearing. However,
 2531  if after 90 days the respondent remains unassessed, the court
 2532  must dismiss the case.
 2533         (c)1.The respondent’s assessment by a qualified
 2534  professional must occur within 72 hours after his or her arrival
 2535  at a licensed service provider unless the respondent shows signs
 2536  of withdrawal or a need to be either detoxified or treated for a
 2537  medical condition, which shall extend the amount of time the
 2538  respondent may be held for observation until such issue is
 2539  resolved but no later than the scheduled hearing date, absent a
 2540  court-approved extension. If the respondent is a minor, such
 2541  assessment must be initiated within the first 12 hours of the
 2542  minor’s admission to the facility. The service provider may also
 2543  move to extend the 72 hours of observation by petitioning the
 2544  court in writing for additional time. The service provider must
 2545  furnish copies of such motion to all parties in accordance with
 2546  applicable confidentiality requirements, and after a hearing,
 2547  the court may grant additional time. If the court grants the
 2548  service provider’s petition, the service provider may continue
 2549  to hold the respondent, and if the original or extended
 2550  observation period ends on a weekend or holiday, including the
 2551  hours before the ordinary business hours of the following
 2552  workday morning, the provider may hold the respondent until the
 2553  next court working day.
 2554         2.No later than the ordinary close of business on the day
 2555  before the hearing, the qualified professional shall transmit,
 2556  in accordance with any applicable confidentiality requirements,
 2557  his or her clinical assessment to the clerk of the court, who
 2558  shall enter it into the court file. The report must contain a
 2559  recommendation on the level of substance abuse treatment the
 2560  respondent requires, if any, and the relevant information on
 2561  which the qualified professional’s findings are based. This
 2562  document must further note whether the respondent has any co
 2563  occurring mental health or other treatment needs. For adults
 2564  subject to an involuntary assessment, the report’s filing with
 2565  the court satisfies s. 397.6758 if it also contains the
 2566  respondent’s admission and discharge information. The qualified
 2567  professional’s failure to include a treatment recommendation,
 2568  much like a recommendation of no treatment, shall result in the
 2569  petition’s dismissal.
 2570         (2) The petitioner has the burden of proving by clear and
 2571  convincing evidence that:
 2572         (a) The respondent is substance abuse impaired and has a
 2573  history of lack of compliance with treatment for substance
 2574  abuse; and
 2575         (b) Because of such impairment the respondent is unlikely
 2576  to voluntarily participate in the recommended services or is
 2577  unable to determine for himself or herself whether services are
 2578  necessary and:
 2579         1. Without services, the respondent is likely to suffer
 2580  from neglect or refuse to care for himself or herself; that such
 2581  neglect or refusal poses a real and present threat of
 2582  substantial harm to his or her well-being; and that there is a
 2583  substantial likelihood that without services the respondent will
 2584  cause serious bodily harm to himself, herself, or another in the
 2585  near future, as evidenced by recent behavior; or
 2586         2. The respondent’s refusal to voluntarily receive care is
 2587  based on judgment so impaired by reason of substance abuse that
 2588  the respondent is incapable of appreciating his or her need for
 2589  care and of making a rational decision regarding that need for
 2590  care.
 2591         (3) One of the qualified professionals who executed the
 2592  involuntary services certificate must be a witness. The court
 2593  shall allow testimony from individuals, including family
 2594  members, deemed by the court to be relevant under state law,
 2595  regarding the respondent’s prior history and how that prior
 2596  history relates to the person’s current condition. The Testimony
 2597  in the hearing must be taken under oath, and the proceedings
 2598  must be recorded. The respondent patient may refuse to testify
 2599  at the hearing.
 2600         (4)If at any point during the hearing the court has reason
 2601  to believe that the respondent, due to mental illness other than
 2602  or in addition to substance abuse impairment, meets the
 2603  involuntary commitment provisions of part I of chapter 394, the
 2604  court may initiate involuntary examination proceedings under
 2605  such provisions.
 2606         (5)(4) At the conclusion of the hearing the court shall
 2607  either dismiss the petition or order the respondent to receive
 2608  involuntary treatment services from his or her chosen licensed
 2609  service provider if possible and appropriate. Any treatment
 2610  order must include findings regarding the respondent’s need for
 2611  treatment and the appropriateness of other less restrictive
 2612  alternatives.
 2613         Section 36. Section 397.697, Florida Statutes, is amended
 2614  to read:
 2615         397.697 Court determination; effect of court order for
 2616  involuntary services.—
 2617         (1)(a) When the court finds that the conditions for
 2618  involuntary treatment services have been proved by clear and
 2619  convincing evidence, it may order the respondent to receive
 2620  involuntary treatment services from a publicly funded licensed
 2621  service provider for a period not to exceed 90 days. The court
 2622  may also order a respondent to undergo treatment through a
 2623  privately funded licensed service provider if the respondent has
 2624  the ability to pay for the treatment, or if any person on the
 2625  respondent’s behalf voluntarily demonstrates a willingness and
 2626  an ability to pay for the treatment. If the court finds it
 2627  necessary, it may direct the sheriff to take the respondent into
 2628  custody and deliver him or her to the licensed service provider
 2629  specified in the court order, or to the nearest appropriate
 2630  licensed service provider, for involuntary treatment services.
 2631  When the conditions justifying involuntary treatment services no
 2632  longer exist, the individual must be released as provided in s.
 2633  397.6971. When the conditions justifying involuntary treatment
 2634  services are expected to exist after 90 days of treatment
 2635  services, a renewal of the involuntary services order may be
 2636  requested pursuant to s. 397.6975 before the end of the 90-day
 2637  period.
 2638         (b)To qualify for involuntary outpatient treatment, an
 2639  individual must be supported by a social worker or case manager
 2640  of a licensed service provider, or a willing, able, and
 2641  responsible individual appointed by the court who shall inform
 2642  the court and parties if the respondent fails to comply with his
 2643  or her outpatient program. In addition, unless the respondent
 2644  has been involuntarily ordered into inpatient treatment under
 2645  this chapter at least twice during the last 36 months, or
 2646  demonstrates the ability to substantially comply with the
 2647  outpatient treatment while waiting for residential placement to
 2648  become available, he or she must receive an assessment from a
 2649  qualified professional or licensed physician expressly
 2650  recommending outpatient services, such services must be
 2651  available in the county in which the respondent is located, and
 2652  it must appear likely that the respondent will follow a
 2653  prescribed outpatient care plan.
 2654         (2) In all cases resulting in an order for involuntary
 2655  treatment services, the court shall retain jurisdiction over the
 2656  case and the parties for the entry of such further orders as the
 2657  circumstances may require, including, but not limited to,
 2658  monitoring compliance with treatment, changing the treatment
 2659  modality, or initiating contempt of court proceedings for
 2660  violating any valid order issued pursuant to this chapter.
 2661  Hearings under this section may be set by motion of the parties
 2662  or under the court’s own authority, and the motion and notice of
 2663  hearing for these ancillary proceedings, which include, but are
 2664  not limited to, civil contempt, must be served in accordance
 2665  with relevant court procedural rules. The court’s requirements
 2666  for notification of proposed release must be included in the
 2667  original order.
 2668         (3) An involuntary treatment services order also authorizes
 2669  the licensed service provider to require the individual to
 2670  receive treatment services that will benefit him or her,
 2671  including treatment services at any licensable service component
 2672  of a licensed service provider.
 2673         (4) If the court orders involuntary treatment services, a
 2674  copy of the order must be sent to the managing entity within 1
 2675  working day after it is received from the court. Documents may
 2676  be submitted electronically through though existing data
 2677  systems, if applicable. The institute established under s.
 2678  1004.44 shall also receive and maintain copies of the
 2679  involuntary assessment and treatment orders issued pursuant to
 2680  ss. 397.68151, 397.6818, and 397.6957; the qualified
 2681  professional assessments; the professional certificates; and the
 2682  law enforcement officers’ protective custody reports. The
 2683  institute established under s. 1004.44 shall use such documents
 2684  to prepare annual reports analyzing the data the documents
 2685  contain, without including patients’ personal identifying
 2686  information, and the institute shall post such reports on its
 2687  website and provide copies of the reports to the department, the
 2688  President of the Senate, and the Speaker of the House of
 2689  Representatives by December 31 of each year.
 2690         Section 37. Section 397.6971, Florida Statutes, is amended
 2691  to read:
 2692         397.6971 Early release from involuntary services.—
 2693         (1) At any time before the end of the 90-day involuntary
 2694  treatment services period, or before the end of any extension
 2695  granted pursuant to s. 397.6975, an individual receiving
 2696  involuntary treatment services may be determined eligible for
 2697  discharge to the most appropriate referral or disposition for
 2698  the individual when any of the following apply:
 2699         (a) The individual no longer meets the criteria for
 2700  involuntary admission and has given his or her informed consent
 2701  to be transferred to voluntary treatment status.
 2702         (b) If the individual was admitted on the grounds of
 2703  likelihood of infliction of physical harm upon himself or
 2704  herself or others, such likelihood no longer exists.
 2705         (c) If the individual was admitted on the grounds of need
 2706  for assessment and stabilization or treatment, accompanied by
 2707  inability to make a determination respecting such need:
 2708         1. Such inability no longer exists; or
 2709         2. It is evident that further treatment will not bring
 2710  about further significant improvements in the individual’s
 2711  condition.
 2712         (d) The individual is no longer needs treatment in need of
 2713  services.
 2714         (e) The director of the service provider determines that
 2715  the individual is beyond the safe management capabilities of the
 2716  provider.
 2717         (2) Whenever a qualified professional determines that an
 2718  individual admitted for involuntary treatment services qualifies
 2719  for early release under subsection (1), the service provider
 2720  shall immediately discharge the individual and must notify all
 2721  persons specified by the court in the original treatment order.
 2722         Section 38. Section 397.6975, Florida Statutes, is amended
 2723  to read:
 2724         397.6975 Extension of involuntary treatment services
 2725  period.—
 2726         (1) Whenever a service provider believes that an individual
 2727  who is nearing the scheduled date of his or her release from
 2728  involuntary treatment services continues to meet the criteria
 2729  for involuntary services in s. 397.68111 or s. 397.6957 s.
 2730  397.693, a petition for renewal of the involuntary treatment
 2731  services order must may be filed with the court at least 10 days
 2732  before the expiration of the court-ordered services period. The
 2733  petition may be filed by the service provider or by the person
 2734  who filed the petition for the initial treatment order if the
 2735  petition is accompanied by supporting documentation from the
 2736  service provider. The court shall immediately schedule a hearing
 2737  within 10 court working days to be held not more than 15 days
 2738  after filing of the petition, and. the court shall provide the
 2739  copy of the petition for renewal and the notice of the hearing
 2740  to all parties and counsel to the proceeding. The hearing is
 2741  conducted pursuant to ss. 397.6957 and 397.697 and must be held
 2742  before the circuit court unless referred to a magistrate s.
 2743  397.6957.
 2744         (2) If the court finds that the petition for renewal of the
 2745  involuntary treatment services order should be granted, it may
 2746  order the respondent to receive involuntary treatment services
 2747  for a period not to exceed an additional 90 days. When the
 2748  conditions justifying involuntary treatment services no longer
 2749  exist, the individual must be released as provided in s.
 2750  397.6971. When the conditions justifying involuntary services
 2751  continue to exist after an additional 90 days of service, a new
 2752  petition requesting renewal of the involuntary treatment
 2753  services order may be filed pursuant to this section.
 2754         (3)Within 1 court working day after the filing of a
 2755  petition for continued involuntary services, the court shall
 2756  appoint the office of criminal conflict and civil regional
 2757  counsel to represent the respondent, unless the respondent is
 2758  otherwise represented by counsel. The clerk of the court shall
 2759  immediately notify the office of criminal conflict and civil
 2760  regional counsel of such appointment. The office of criminal
 2761  conflict and civil regional counsel shall represent the
 2762  respondent until the petition is dismissed or the court order
 2763  expires or the respondent is discharged from involuntary
 2764  services. Any attorney representing the respondent shall have
 2765  access to the respondent, witnesses, and records relevant to the
 2766  presentation of the respondent’s case and shall represent the
 2767  interests of the respondent, regardless of the source of payment
 2768  to the attorney.
 2769         (4)Hearings on petitions for continued involuntary
 2770  services shall be before the circuit court. The court may
 2771  appoint a magistrate to preside at the hearing. The procedures
 2772  for obtaining an order pursuant to this section shall be in
 2773  accordance with s. 397.697.
 2774         (5)Notice of hearing shall be provided to the respondent
 2775  or his or her counsel. The respondent and the respondent’s
 2776  counsel may agree to a period of continued involuntary services
 2777  without a court hearing.
 2778         (6)The same procedure shall be repeated before the
 2779  expiration of each additional period of involuntary services.
 2780         (7)If the respondent has previously been found incompetent
 2781  to consent to treatment, the court shall consider testimony and
 2782  evidence regarding the respondent’s competence.
 2783         Section 39. Section 397.6977, Florida Statutes, is amended
 2784  to read:
 2785         397.6977 Disposition of individual upon completion of
 2786  involuntary services.—
 2787         (1) At the conclusion of the 90-day period of court-ordered
 2788  involuntary services, the respondent is automatically discharged
 2789  unless a motion for renewal of the involuntary services order
 2790  has been filed with the court pursuant to s. 397.6975.
 2791         (2)Discharge planning and procedures for any respondent’s
 2792  release from involuntary treatment services must include and
 2793  document the respondent’s needs, and actions to address such
 2794  needs, for, at a minimum:
 2795         (a)Follow-up behavioral health appointments.
 2796         (b)Information on how to obtain prescribed medications.
 2797         (c)Information pertaining to available living arrangements
 2798  and transportation.
 2799         (d)Referral to recovery support opportunities, including,
 2800  but not limited to, connection to a peer specialist.
 2801         Section 40. Section 397.6811, Florida Statutes, is
 2802  repealed.
 2803         Section 41. Section 397.6814, Florida Statutes, is
 2804  repealed.
 2805         Section 42. Section 397.6815, Florida Statutes, is
 2806  repealed.
 2807         Section 43. Section 397.6819, Florida Statutes, is
 2808  repealed.
 2809         Section 44. Section 397.6821, Florida Statutes, is
 2810  repealed.
 2811         Section 45. Section 397.6822, Florida Statutes, is
 2812  repealed.
 2813         Section 46. Section 397.6978, Florida Statutes, is
 2814  repealed.
 2815         Section 47. Subsection (2) of section 916.13, Florida
 2816  Statutes, is amended to read:
 2817         916.13 Involuntary commitment of defendant adjudicated
 2818  incompetent.—
 2819         (2) A defendant who has been charged with a felony and who
 2820  has been adjudicated incompetent to proceed due to mental
 2821  illness, and who meets the criteria for involuntary commitment
 2822  under this chapter, may be committed to the department, and the
 2823  department shall retain and treat the defendant.
 2824         (a) Immediately after receipt of a completed copy of the
 2825  court commitment order containing all documentation required by
 2826  the applicable Florida Rules of Criminal Procedure, the
 2827  department shall request all medical information relating to the
 2828  defendant from the jail. The jail shall provide the department
 2829  with all medical information relating to the defendant within 3
 2830  business days after receipt of the department’s request or at
 2831  the time the defendant enters the physical custody of the
 2832  department, whichever is earlier.
 2833         (b) Within 60 days after the date of admission and at the
 2834  end of any period of extended commitment, or at any time the
 2835  administrator or his or her designee determines that the
 2836  defendant has regained competency to proceed or no longer meets
 2837  the criteria for continued commitment, the administrator or
 2838  designee shall file a report with the court pursuant to the
 2839  applicable Florida Rules of Criminal Procedure.
 2840         (c)1.If the department determines at any time that a
 2841  defendant will not or is unlikely to regain competency to
 2842  proceed, the department must, within 30 days after the
 2843  determination, complete and submit a competency evaluation
 2844  report to the circuit court to determine if the defendant meets
 2845  the criteria for involuntary civil commitment under s. 394.467.
 2846  A qualified professional, as defined in s. 394.455, must sign
 2847  the competency evaluation report for the circuit court under
 2848  penalty of perjury. A copy of the report must, at a minimum, be
 2849  provided to the court, state attorney, and counsel for the
 2850  defendant before initiating any transfer of the defendant back
 2851  to the committing jurisdiction.
 2852         2.For purposes of this paragraph, the term “competency
 2853  evaluation report to the circuit court” means a report by the
 2854  department regarding a defendant’s incompetence to proceed in a
 2855  criminal proceeding due to mental illness as set forth in this
 2856  section. The report must, at a minimum, include the following
 2857  regarding the defendant:
 2858         a.A description of mental, emotional, and behavioral
 2859  disturbances.
 2860         b.An explanation to support the opinion of incompetence to
 2861  proceed.
 2862         c.The rationale to support why the defendant is unlikely
 2863  to gain competence to proceed in the foreseeable future.
 2864         d.A clinical opinion regarding whether the defendant no
 2865  longer meets the criteria for involuntary forensic commitment
 2866  pursuant to this section.
 2867         e.A recommendation on whether the defendant meets the
 2868  criteria for involuntary services pursuant to s. 394.467.
 2869         (d)(c) The defendant must be transported, in accordance
 2870  with s. 916.107, to the committing court’s jurisdiction within 7
 2871  days after of notification that the defendant is competent to
 2872  proceed or no longer meets the criteria for continued
 2873  commitment. A determination on the issue of competency must be
 2874  made at a hearing within 30 days of the notification. If the
 2875  defendant is receiving psychotropic medication at a mental
 2876  health facility at the time he or she is discharged and
 2877  transferred to the jail, the administering of such medication
 2878  must continue unless the jail physician documents the need to
 2879  change or discontinue it. To ensure continuity of care, the
 2880  referring mental health facility must transfer the patient with
 2881  up to 30 days of medications and assist in discharge planning
 2882  with medical teams at the receiving county jail. The jail and
 2883  department physicians shall collaborate to ensure that
 2884  medication changes do not adversely affect the defendant’s
 2885  mental health status or his or her ability to continue with
 2886  court proceedings; however, the final authority regarding the
 2887  administering of medication to an inmate in jail rests with the
 2888  jail physician. Notwithstanding this paragraph, a defendant who
 2889  meets the criteria for involuntary examination pursuant to s.
 2890  394.463, as determined by an independent clinical opinion, shall
 2891  appear remotely for the hearing. Court witnesses may appear
 2892  remotely.
 2893         Section 48. Subsection (6) of section 40.29, Florida
 2894  Statutes, is amended to read:
 2895         40.29 Payment of due-process costs; reimbursement for
 2896  petitions and orders.—
 2897         (6) Subject to legislative appropriation, the clerk of the
 2898  circuit court may, on a quarterly basis, submit to the Justice
 2899  Administrative Commission a certified request for reimbursement
 2900  for petitions and orders filed under ss. 394.459, 394.463,
 2901  394.467, and 394.917, and 397.6814, at the rate of $40 per
 2902  petition or order. Such request for reimbursement shall be
 2903  submitted in the form and manner prescribed by the Justice
 2904  Administrative Commission pursuant to s. 28.35(2)(i).
 2905         Section 49. Subsections (5) and (6) of section 394.492,
 2906  Florida Statutes, are amended to read:
 2907         394.492 Definitions.—As used in ss. 394.490-394.497, the
 2908  term:
 2909         (5) “Child or adolescent who has an emotional disturbance”
 2910  means a person under 18 years of age who is diagnosed with a
 2911  mental, emotional, or behavioral disorder of sufficient duration
 2912  to meet one of the diagnostic categories specified in the most
 2913  recent edition of the Diagnostic and Statistical Manual of the
 2914  American Psychiatric Association, but who does not exhibit
 2915  behaviors that substantially interfere with or limit his or her
 2916  role or ability to function in the family, school, or community.
 2917  The emotional disturbance must not be considered to be a
 2918  temporary response to a stressful situation. The term does not
 2919  include a child or adolescent who meets the criteria for
 2920  involuntary placement under s. 394.497(2) s. 394.467(1).
 2921         (6) “Child or adolescent who has a serious emotional
 2922  disturbance or mental illness” means a person under 18 years of
 2923  age who:
 2924         (a) Is diagnosed as having a mental, emotional, or
 2925  behavioral disorder that meets one of the diagnostic categories
 2926  specified in the most recent edition of the Diagnostic and
 2927  Statistical Manual of Mental Disorders of the American
 2928  Psychiatric Association; and
 2929         (b) Exhibits behaviors that substantially interfere with or
 2930  limit his or her role or ability to function in the family,
 2931  school, or community, which behaviors are not considered to be a
 2932  temporary response to a stressful situation.
 2933  
 2934  The term includes a child or adolescent who meets the criteria
 2935  for involuntary placement under s. 394.467(2) s. 394.467(1).
 2936         Section 50. Paragraph (b) of subsection (1) of section
 2937  409.972, Florida Statutes, is amended to read:
 2938         409.972 Mandatory and voluntary enrollment.—
 2939         (1) The following Medicaid-eligible persons are exempt from
 2940  mandatory managed care enrollment required by s. 409.965, and
 2941  may voluntarily choose to participate in the managed medical
 2942  assistance program:
 2943         (b) Medicaid recipients residing in residential commitment
 2944  facilities operated through the Department of Juvenile Justice
 2945  or a treatment facility as defined in s. 394.455 s. 394.455(49).
 2946         Section 51. Subsection (7) of section 744.2007, Florida
 2947  Statutes, is amended to read:
 2948         744.2007 Powers and duties.—
 2949         (7) A public guardian may not commit a ward to a treatment
 2950  facility, as defined in s. 394.455 s. 394.455(49), without an
 2951  involuntary placement proceeding as provided by law.
 2952         Section 52. Subsection (3) of section 916.107, Florida
 2953  Statutes, is amended to read:
 2954         916.107 Rights of forensic clients.—
 2955         (3) RIGHT TO EXPRESS AND INFORMED CONSENT.—
 2956         (a) A forensic client shall be asked to give express and
 2957  informed written consent for treatment. If a client refuses such
 2958  treatment as is deemed necessary and essential by the client’s
 2959  multidisciplinary treatment team for the appropriate care of the
 2960  client, such treatment may be provided under the following
 2961  circumstances:
 2962         1. In an emergency situation in which there is immediate
 2963  danger to the safety of the client or others, such treatment may
 2964  be provided upon the written order of a physician for up to 48
 2965  hours, excluding weekends and legal holidays. If, after the 48
 2966  hour period, the client has not given express and informed
 2967  consent to the treatment initially refused, the administrator or
 2968  designee of the civil or forensic facility shall, within 48
 2969  hours, excluding weekends and legal holidays, petition the
 2970  committing court or the circuit court serving the county in
 2971  which the facility is located, at the option of the facility
 2972  administrator or designee, for an order authorizing the
 2973  continued treatment of the client. In the interim, the need for
 2974  treatment shall be reviewed every 48 hours and may be continued
 2975  without the consent of the client upon the continued written
 2976  order of a physician who has determined that the emergency
 2977  situation continues to present a danger to the safety of the
 2978  client or others.
 2979         2. In a situation other than an emergency situation, the
 2980  administrator or designee of the facility shall petition the
 2981  court for an order authorizing necessary and essential treatment
 2982  for the client.
 2983         a. If the client has been receiving psychotropic medication
 2984  at the jail at the time of transfer to the forensic or civil
 2985  facility and lacks the capacity to make an informed decision
 2986  regarding mental health treatment at the time of admission, the
 2987  admitting physician shall order continued administration of
 2988  psychotropic medication if, in the clinical judgment of the
 2989  physician, abrupt cessation of that psychotropic medication
 2990  could pose a risk to the health or safety of the client while a
 2991  court order to medicate is pursued. The administrator or
 2992  designee of the forensic or civil facility shall, within 5 days
 2993  after a client’s admission, excluding weekends and legal
 2994  holidays, petition the committing court or the circuit court
 2995  serving the county in which the facility is located, at the
 2996  option of the facility administrator or designee, for an order
 2997  authorizing the continued treatment of a client with
 2998  psychotropic medication. The jail physician shall provide a
 2999  current psychotropic medication order at the time of transfer to
 3000  the forensic or civil facility or upon request of the admitting
 3001  physician after the client is evaluated.
 3002         b. The court order shall allow such treatment for up to 90
 3003  days after the date that the order was entered. Unless the court
 3004  is notified in writing that the client has provided express and
 3005  informed written consent or that the client has been discharged
 3006  by the committing court, the administrator or designee of the
 3007  facility shall, before the expiration of the initial 90-day
 3008  order, petition the court for an order authorizing the
 3009  continuation of treatment for an additional 90 days. This
 3010  procedure shall be repeated until the client provides consent or
 3011  is discharged by the committing court.
 3012         3. At the hearing on the issue of whether the court should
 3013  enter an order authorizing treatment for which a client was
 3014  unable to or refused to give express and informed consent, the
 3015  court shall determine by clear and convincing evidence that the
 3016  client has mental illness, intellectual disability, or autism,
 3017  that the treatment not consented to is essential to the care of
 3018  the client, and that the treatment not consented to is not
 3019  experimental and does not present an unreasonable risk of
 3020  serious, hazardous, or irreversible side effects. In arriving at
 3021  the substitute judgment decision, the court must consider at
 3022  least the following factors:
 3023         a. The client’s expressed preference regarding treatment;
 3024         b. The probability of adverse side effects;
 3025         c. The prognosis without treatment; and
 3026         d. The prognosis with treatment.
 3027  
 3028  The hearing shall be as convenient to the client as may be
 3029  consistent with orderly procedure and shall be conducted in
 3030  physical settings not likely to be injurious to the client’s
 3031  condition. The court may appoint a general or special magistrate
 3032  to preside at the hearing. The client or the client’s guardian,
 3033  and the representative, shall be provided with a copy of the
 3034  petition and the date, time, and location of the hearing. The
 3035  client has the right to have an attorney represent him or her at
 3036  the hearing, and, if the client is indigent, the court shall
 3037  appoint the office of the public defender to represent the
 3038  client at the hearing. The client may testify or not, as he or
 3039  she chooses, and has the right to cross-examine witnesses and
 3040  may present his or her own witnesses.
 3041         (b) In addition to the provisions of paragraph (a), in the
 3042  case of surgical procedures requiring the use of a general
 3043  anesthetic or electroconvulsive treatment or nonpsychiatric
 3044  medical procedures, and prior to performing the procedure,
 3045  written permission shall be obtained from the client, if the
 3046  client is legally competent, from the parent or guardian of a
 3047  minor client, or from the guardian of an incompetent client. The
 3048  administrator or designee of the forensic facility or a
 3049  designated representative may, with the concurrence of the
 3050  client’s attending physician, authorize emergency surgical or
 3051  nonpsychiatric medical treatment if such treatment is deemed
 3052  lifesaving or for a situation threatening serious bodily harm to
 3053  the client and permission of the client or the client’s guardian
 3054  could not be obtained before provision of the needed treatment.
 3055         Section 53. For the 2024-2025 fiscal year, the sum of $50
 3056  million of recurring funds from the General Revenue Fund is
 3057  appropriated to the Department of Children and Families to
 3058  implement the provisions of this act.
 3059         Section 54. This act shall take effect July 1, 2024.