Florida Senate - 2024                          SENATOR AMENDMENT
       Bill No. CS/CS/HB 7021, 1st Eng.
       
       
       
       
       
       
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                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                Floor: 1/AE/2R         .            Floor: C            
             03/07/2024 06:16 PM       .      03/08/2024 11:01 AM       
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       Senator Grall moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete lines 804 - 2517
    4  and insert:
    5  and provide copies of such reports to the department, the
    6  President of the Senate, the Speaker of the House of
    7  Representatives, and the minority leaders of the Senate and the
    8  House of Representatives by November 30 of each year.
    9         (f) A patient must shall be examined by a physician or a
   10  clinical psychologist, or by a psychiatric nurse performing
   11  within the framework of an established protocol with a
   12  psychiatrist at a facility without unnecessary delay to
   13  determine if the criteria for involuntary services are met. Such
   14  examination shall include, but not be limited to, consideration
   15  of the patient’s treatment history at the facility and any
   16  information regarding the patient’s condition and behavior
   17  provided by knowledgeable individuals. Evidence that criteria
   18  under subparagraph (1)(b)1. are met may include, but need not be
   19  limited to, repeated admittance for involuntary examination
   20  despite implementation of appropriate discharge plans. For
   21  purposes of this paragraph, the term “repeated admittance” means
   22  three or more admissions into the facility within the
   23  immediately preceding 12 months. An individual’s basic needs
   24  being served while admitted to the facility may not be
   25  considered evidence that criteria under subparagraph (1)(b)1.
   26  are met. Emergency treatment may be provided upon the order of a
   27  physician or a psychiatric nurse practicing within the framework
   28  of an established protocol with a psychiatrist if the physician
   29  or psychiatric nurse determines that such treatment is necessary
   30  for the safety of the patient or others. The patient may not be
   31  released by the receiving facility or its contractor without the
   32  documented approval of a psychiatrist or a clinical psychologist
   33  or, if the receiving facility is owned or operated by a
   34  hospital, health system, or nationally accredited community
   35  mental health center, the release may also be approved by a
   36  psychiatric nurse performing within the framework of an
   37  established protocol with a psychiatrist, or an attending
   38  emergency department physician with experience in the diagnosis
   39  and treatment of mental illness after completion of an
   40  involuntary examination pursuant to this subsection. A
   41  psychiatric nurse may not approve the release of a patient if
   42  the involuntary examination was initiated by a psychiatrist
   43  unless the release is approved by the initiating psychiatrist.
   44  The release may be approved through telehealth.
   45         (g) The examination period must be for up to 72 hours and
   46  begins when a patient arrives at the receiving facility. For a
   47  minor, the examination shall be initiated within 12 hours after
   48  the patient’s arrival at the facility. Within the examination
   49  period, one of the following actions must be taken, based on the
   50  individual needs of the patient:
   51         1. The patient shall be released, unless he or she is
   52  charged with a crime, in which case the patient shall be
   53  returned to the custody of a law enforcement officer;
   54         2. The patient shall be released, subject to subparagraph
   55  1., for voluntary outpatient treatment;
   56         3. The patient, unless he or she is charged with a crime,
   57  shall be asked to give express and informed consent to placement
   58  as a voluntary patient and, if such consent is given, the
   59  patient shall be admitted as a voluntary patient; or
   60         4. A petition for involuntary services shall be filed in
   61  the circuit court if inpatient treatment is deemed necessary or
   62  with the criminal county court, as defined in s. 394.4655(1), as
   63  applicable. When inpatient treatment is deemed necessary, the
   64  least restrictive treatment consistent with the optimum
   65  improvement of the patient’s condition shall be made available.
   66  The When a petition is to be filed for involuntary outpatient
   67  placement, it shall be filed by one of the petitioners specified
   68  in s. 394.467, and the court shall dismiss an untimely filed
   69  petition s. 394.4655(4)(a). A petition for involuntary inpatient
   70  placement shall be filed by the facility administrator. If a
   71  patient’s 72-hour examination period ends on a weekend or
   72  holiday, including the hours before the ordinary business hours
   73  on the morning of the next working day, and the receiving
   74  facility:
   75         a. Intends to file a petition for involuntary services,
   76  such patient may be held at the a receiving facility through the
   77  next working day thereafter and the such petition for
   78  involuntary services must be filed no later than such date. If
   79  the receiving facility fails to file the a petition by for
   80  involuntary services at the ordinary close of business on the
   81  next working day, the patient shall be released from the
   82  receiving facility following approval pursuant to paragraph (f).
   83         b. Does not intend to file a petition for involuntary
   84  services, the a receiving facility may postpone release of a
   85  patient until the next working day thereafter only if a
   86  qualified professional documents that adequate discharge
   87  planning and procedures in accordance with s. 394.468, and
   88  approval pursuant to paragraph (f), are not possible until the
   89  next working day.
   90         (h) A person for whom an involuntary examination has been
   91  initiated who is being evaluated or treated at a hospital for an
   92  emergency medical condition specified in s. 395.002 must be
   93  examined by a facility within the examination period specified
   94  in paragraph (g). The examination period begins when the patient
   95  arrives at the hospital and ceases when the attending physician
   96  documents that the patient has an emergency medical condition.
   97  If the patient is examined at a hospital providing emergency
   98  medical services by a professional qualified to perform an
   99  involuntary examination and is found as a result of that
  100  examination not to meet the criteria for involuntary outpatient
  101  services pursuant to s. 394.467 s. 394.4655(2) or involuntary
  102  inpatient placement pursuant to s. 394.467(1), the patient may
  103  be offered voluntary outpatient or inpatient services or
  104  placement, if appropriate, or released directly from the
  105  hospital providing emergency medical services. The finding by
  106  the professional that the patient has been examined and does not
  107  meet the criteria for involuntary inpatient services or
  108  involuntary outpatient placement must be entered into the
  109  patient’s clinical record. This paragraph is not intended to
  110  prevent a hospital providing emergency medical services from
  111  appropriately transferring a patient to another hospital before
  112  stabilization if the requirements of s. 395.1041(3)(c) have been
  113  met.
  114         (4) DATA ANALYSIS.—
  115         (a)The department shall provide the Using data collected
  116  under paragraph (2)(a) and s. 1006.07(10), and child welfare
  117  data related to involuntary examinations, to the Louis de la
  118  Parte Florida Mental Health Institute established under s.
  119  1004.44. The Agency for Health Care Administration shall provide
  120  Medicaid data to the institute, requested by the institute,
  121  related to involuntary examination of children enrolled in
  122  Medicaid for the purpose of administering the program and
  123  improving service provision for such children. The department
  124  and agency shall enter into any necessary agreements with the
  125  institute to provide such data. The institute shall use such
  126  data to the department shall, at a minimum, analyze data on both
  127  the initiation of involuntary examinations of children and the
  128  initiation of involuntary examinations of students who are
  129  removed from a school; identify any patterns or trends and cases
  130  in which involuntary examinations are repeatedly initiated on
  131  the same child or student; study root causes for such patterns,
  132  trends, or repeated involuntary examinations; and make
  133  recommendations to encourage the use of alternatives to
  134  eliminate inappropriate initiations of such examinations.
  135         (b)The institute shall analyze service data on individuals
  136  who are high utilizers of crisis stabilization services provided
  137  in designated receiving facilities, and shall, at a minimum,
  138  identify any patterns or trends and make recommendations to
  139  decrease avoidable admissions. Recommendations may be addressed
  140  in the department’s contracts with the behavioral health
  141  managing entities and in the contracts between the Agency for
  142  Health Care Administration and the Medicaid managed medical
  143  assistance plans.
  144         (c) The institute department shall publish submit a report
  145  on its findings and recommendations on its website and submit
  146  the report to the Governor, the President of the Senate, and the
  147  Speaker of the House of Representatives, the department, and the
  148  Agency for Health Care Administration by November 1 of each odd
  149  numbered year.
  150         Section 10. Section 394.4655, Florida Statutes, is amended
  151  to read:
  152         394.4655 Orders to involuntary outpatient placement
  153  services.—
  154         (1) DEFINITIONS.—As used in this section, the term
  155  “involuntary outpatient placement” means involuntary outpatient
  156  services as defined in s. 394.467.:
  157         (a)“Court” means a circuit court or a criminal county
  158  court.
  159         (b)“Criminal County court” means a county court exercising
  160  its original jurisdiction in a misdemeanor case under s. 34.01.
  161         (2) A court or a county court may order an individual to
  162  involuntary outpatient placement under s. 394.467. CRITERIA FOR
  163  INVOLUNTARY OUTPATIENT SERVICES.—A person may be ordered to
  164  involuntary outpatient services upon a finding of the court, by
  165  clear and convincing evidence, that the person meets all of the
  166  following criteria:
  167         (a)The person is 18 years of age or older.
  168         (b)The person has a mental illness.
  169         (c)The person is unlikely to survive safely in the
  170  community without supervision, based on a clinical
  171  determination.
  172         (d)The person has a history of lack of compliance with
  173  treatment for mental illness.
  174         (e)The person has:
  175         1.At least twice within the immediately preceding 36
  176  months been involuntarily admitted to a receiving or treatment
  177  facility as defined in s. 394.455, or has received mental health
  178  services in a forensic or correctional facility. The 36-month
  179  period does not include any period during which the person was
  180  admitted or incarcerated; or
  181         2.Engaged in one or more acts of serious violent behavior
  182  toward self or others, or attempts at serious bodily harm to
  183  himself or herself or others, within the preceding 36 months.
  184         (f)The person is, as a result of his or her mental
  185  illness, unlikely to voluntarily participate in the recommended
  186  treatment plan and has refused voluntary services for treatment
  187  after sufficient and conscientious explanation and disclosure of
  188  why the services are necessary or is unable to determine for
  189  himself or herself whether services are necessary.
  190         (g)In view of the person’s treatment history and current
  191  behavior, the person is in need of involuntary outpatient
  192  services in order to prevent a relapse or deterioration that
  193  would be likely to result in serious bodily harm to himself or
  194  herself or others, or a substantial harm to his or her well
  195  being as set forth in s. 394.463(1).
  196         (h)It is likely that the person will benefit from
  197  involuntary outpatient services.
  198         (i)All available, less restrictive alternatives that would
  199  offer an opportunity for improvement of his or her condition
  200  have been judged to be inappropriate or unavailable.
  201         (3)INVOLUNTARY OUTPATIENT SERVICES.—
  202         (a)1.A patient who is being recommended for involuntary
  203  outpatient services by the administrator of the facility where
  204  the patient has been examined may be retained by the facility
  205  after adherence to the notice procedures provided in s.
  206  394.4599. The recommendation must be supported by the opinion of
  207  a psychiatrist and the second opinion of a clinical psychologist
  208  or another psychiatrist, both of whom have personally examined
  209  the patient within the preceding 72 hours, that the criteria for
  210  involuntary outpatient services are met. However, if the
  211  administrator certifies that a psychiatrist or clinical
  212  psychologist is not available to provide the second opinion, the
  213  second opinion may be provided by a licensed physician who has
  214  postgraduate training and experience in diagnosis and treatment
  215  of mental illness, a physician assistant who has at least 3
  216  years’ experience and is supervised by such licensed physician
  217  or a psychiatrist, a clinical social worker, or by a psychiatric
  218  nurse. Any second opinion authorized in this subparagraph may be
  219  conducted through a face-to-face examination, in person or by
  220  electronic means. Such recommendation must be entered on an
  221  involuntary outpatient services certificate that authorizes the
  222  facility to retain the patient pending completion of a hearing.
  223  The certificate must be made a part of the patient’s clinical
  224  record.
  225         2.If the patient has been stabilized and no longer meets
  226  the criteria for involuntary examination pursuant to s.
  227  394.463(1), the patient must be released from the facility while
  228  awaiting the hearing for involuntary outpatient services. Before
  229  filing a petition for involuntary outpatient services, the
  230  administrator of the facility or a designated department
  231  representative must identify the service provider that will have
  232  primary responsibility for service provision under an order for
  233  involuntary outpatient services, unless the person is otherwise
  234  participating in outpatient psychiatric treatment and is not in
  235  need of public financing for that treatment, in which case the
  236  individual, if eligible, may be ordered to involuntary treatment
  237  pursuant to the existing psychiatric treatment relationship.
  238         3.The service provider shall prepare a written proposed
  239  treatment plan in consultation with the patient or the patient’s
  240  guardian advocate, if appointed, for the court’s consideration
  241  for inclusion in the involuntary outpatient services order that
  242  addresses the nature and extent of the mental illness and any
  243  co-occurring substance use disorder that necessitate involuntary
  244  outpatient services. The treatment plan must specify the likely
  245  level of care, including the use of medication, and anticipated
  246  discharge criteria for terminating involuntary outpatient
  247  services. Service providers may select and supervise other
  248  individuals to implement specific aspects of the treatment plan.
  249  The services in the plan must be deemed clinically appropriate
  250  by a physician, clinical psychologist, psychiatric nurse, mental
  251  health counselor, marriage and family therapist, or clinical
  252  social worker who consults with, or is employed or contracted
  253  by, the service provider. The service provider must certify to
  254  the court in the proposed plan whether sufficient services for
  255  improvement and stabilization are currently available and
  256  whether the service provider agrees to provide those services.
  257  If the service provider certifies that the services in the
  258  proposed treatment plan are not available, the petitioner may
  259  not file the petition. The service provider must notify the
  260  managing entity if the requested services are not available. The
  261  managing entity must document such efforts to obtain the
  262  requested services.
  263         (b)If a patient in involuntary inpatient placement meets
  264  the criteria for involuntary outpatient services, the
  265  administrator of the facility may, before the expiration of the
  266  period during which the facility is authorized to retain the
  267  patient, recommend involuntary outpatient services. The
  268  recommendation must be supported by the opinion of a
  269  psychiatrist and the second opinion of a clinical psychologist
  270  or another psychiatrist, both of whom have personally examined
  271  the patient within the preceding 72 hours, that the criteria for
  272  involuntary outpatient services are met. However, if the
  273  administrator certifies that a psychiatrist or clinical
  274  psychologist is not available to provide the second opinion, the
  275  second opinion may be provided by a licensed physician who has
  276  postgraduate training and experience in diagnosis and treatment
  277  of mental illness, a physician assistant who has at least 3
  278  years’ experience and is supervised by such licensed physician
  279  or a psychiatrist, a clinical social worker, or by a psychiatric
  280  nurse. Any second opinion authorized in this subparagraph may be
  281  conducted through a face-to-face examination, in person or by
  282  electronic means. Such recommendation must be entered on an
  283  involuntary outpatient services certificate, and the certificate
  284  must be made a part of the patient’s clinical record.
  285         (c)1.The administrator of the treatment facility shall
  286  provide a copy of the involuntary outpatient services
  287  certificate and a copy of the state mental health discharge form
  288  to the managing entity in the county where the patient will be
  289  residing. For persons who are leaving a state mental health
  290  treatment facility, the petition for involuntary outpatient
  291  services must be filed in the county where the patient will be
  292  residing.
  293         2.The service provider that will have primary
  294  responsibility for service provision shall be identified by the
  295  designated department representative before the order for
  296  involuntary outpatient services and must, before filing a
  297  petition for involuntary outpatient services, certify to the
  298  court whether the services recommended in the patient’s
  299  discharge plan are available and whether the service provider
  300  agrees to provide those services. The service provider must
  301  develop with the patient, or the patient’s guardian advocate, if
  302  appointed, a treatment or service plan that addresses the needs
  303  identified in the discharge plan. The plan must be deemed to be
  304  clinically appropriate by a physician, clinical psychologist,
  305  psychiatric nurse, mental health counselor, marriage and family
  306  therapist, or clinical social worker, as defined in this
  307  chapter, who consults with, or is employed or contracted by, the
  308  service provider.
  309         3.If the service provider certifies that the services in
  310  the proposed treatment or service plan are not available, the
  311  petitioner may not file the petition. The service provider must
  312  notify the managing entity if the requested services are not
  313  available. The managing entity must document such efforts to
  314  obtain the requested services.
  315         (4)PETITION FOR INVOLUNTARY OUTPATIENT SERVICES.—
  316         (a)A petition for involuntary outpatient services may be
  317  filed by:
  318         1.The administrator of a receiving facility; or
  319         2.The administrator of a treatment facility.
  320         (b)Each required criterion for involuntary outpatient
  321  services must be alleged and substantiated in the petition for
  322  involuntary outpatient services. A copy of the certificate
  323  recommending involuntary outpatient services completed by a
  324  qualified professional specified in subsection (3) must be
  325  attached to the petition. A copy of the proposed treatment plan
  326  must be attached to the petition. Before the petition is filed,
  327  the service provider shall certify that the services in the
  328  proposed plan are available. If the necessary services are not
  329  available, the petition may not be filed. The service provider
  330  must notify the managing entity if the requested services are
  331  not available. The managing entity must document such efforts to
  332  obtain the requested services.
  333         (c)The petition for involuntary outpatient services must
  334  be filed in the county where the patient is located, unless the
  335  patient is being placed from a state treatment facility, in
  336  which case the petition must be filed in the county where the
  337  patient will reside. When the petition has been filed, the clerk
  338  of the court shall provide copies of the petition and the
  339  proposed treatment plan to the department, the managing entity,
  340  the patient, the patient’s guardian or representative, the state
  341  attorney, and the public defender or the patient’s private
  342  counsel. A fee may not be charged for filing a petition under
  343  this subsection.
  344         (5)APPOINTMENT OF COUNSEL.—Within 1 court working day
  345  after the filing of a petition for involuntary outpatient
  346  services, the court shall appoint the public defender to
  347  represent the person who is the subject of the petition, unless
  348  the person is otherwise represented by counsel. The clerk of the
  349  court shall immediately notify the public defender of the
  350  appointment. The public defender shall represent the person
  351  until the petition is dismissed, the court order expires, or the
  352  patient is discharged from involuntary outpatient services. An
  353  attorney who represents the patient must be provided access to
  354  the patient, witnesses, and records relevant to the presentation
  355  of the patient’s case and shall represent the interests of the
  356  patient, regardless of the source of payment to the attorney.
  357         (6)CONTINUANCE OF HEARING.—The patient is entitled, with
  358  the concurrence of the patient’s counsel, to at least one
  359  continuance of the hearing. The continuance shall be for a
  360  period of up to 4 weeks.
  361         (7)HEARING ON INVOLUNTARY OUTPATIENT SERVICES.—
  362         (a)1.The court shall hold the hearing on involuntary
  363  outpatient services within 5 working days after the filing of
  364  the petition, unless a continuance is granted. The hearing must
  365  be held in the county where the petition is filed, must be as
  366  convenient to the patient as is consistent with orderly
  367  procedure, and must be conducted in physical settings not likely
  368  to be injurious to the patient’s condition. If the court finds
  369  that the patient’s attendance at the hearing is not consistent
  370  with the best interests of the patient and if the patient’s
  371  counsel does not object, the court may waive the presence of the
  372  patient from all or any portion of the hearing. The state
  373  attorney for the circuit in which the patient is located shall
  374  represent the state, rather than the petitioner, as the real
  375  party in interest in the proceeding.
  376         2.The court may appoint a magistrate to preside at the
  377  hearing. One of the professionals who executed the involuntary
  378  outpatient services certificate shall be a witness. The patient
  379  and the patient’s guardian or representative shall be informed
  380  by the court of the right to an independent expert examination.
  381  If the patient cannot afford such an examination, the court
  382  shall ensure that one is provided, as otherwise provided by law.
  383  The independent expert’s report is confidential and not
  384  discoverable, unless the expert is to be called as a witness for
  385  the patient at the hearing. The court shall allow testimony from
  386  individuals, including family members, deemed by the court to be
  387  relevant under state law, regarding the person’s prior history
  388  and how that prior history relates to the person’s current
  389  condition. The testimony in the hearing must be given under
  390  oath, and the proceedings must be recorded. The patient may
  391  refuse to testify at the hearing.
  392         (b)1.If the court concludes that the patient meets the
  393  criteria for involuntary outpatient services pursuant to
  394  subsection (2), the court shall issue an order for involuntary
  395  outpatient services. The court order shall be for a period of up
  396  to 90 days. The order must specify the nature and extent of the
  397  patient’s mental illness. The order of the court and the
  398  treatment plan must be made part of the patient’s clinical
  399  record. The service provider shall discharge a patient from
  400  involuntary outpatient services when the order expires or any
  401  time the patient no longer meets the criteria for involuntary
  402  placement. Upon discharge, the service provider shall send a
  403  certificate of discharge to the court.
  404         2.The court may not order the department or the service
  405  provider to provide services if the program or service is not
  406  available in the patient’s local community, if there is no space
  407  available in the program or service for the patient, or if
  408  funding is not available for the program or service. The service
  409  provider must notify the managing entity if the requested
  410  services are not available. The managing entity must document
  411  such efforts to obtain the requested services. A copy of the
  412  order must be sent to the managing entity by the service
  413  provider within 1 working day after it is received from the
  414  court. The order may be submitted electronically through
  415  existing data systems. After the order for involuntary services
  416  is issued, the service provider and the patient may modify the
  417  treatment plan. For any material modification of the treatment
  418  plan to which the patient or, if one is appointed, the patient’s
  419  guardian advocate agrees, the service provider shall send notice
  420  of the modification to the court. Any material modifications of
  421  the treatment plan which are contested by the patient or the
  422  patient’s guardian advocate, if applicable, must be approved or
  423  disapproved by the court consistent with subsection (3).
  424         3.If, in the clinical judgment of a physician, the patient
  425  has failed or has refused to comply with the treatment ordered
  426  by the court, and, in the clinical judgment of the physician,
  427  efforts were made to solicit compliance and the patient may meet
  428  the criteria for involuntary examination, a person may be
  429  brought to a receiving facility pursuant to s. 394.463. If,
  430  after examination, the patient does not meet the criteria for
  431  involuntary inpatient placement pursuant to s. 394.467, the
  432  patient must be discharged from the facility. The involuntary
  433  outpatient services order shall remain in effect unless the
  434  service provider determines that the patient no longer meets the
  435  criteria for involuntary outpatient services or until the order
  436  expires. The service provider must determine whether
  437  modifications should be made to the existing treatment plan and
  438  must attempt to continue to engage the patient in treatment. For
  439  any material modification of the treatment plan to which the
  440  patient or the patient’s guardian advocate, if applicable,
  441  agrees, the service provider shall send notice of the
  442  modification to the court. Any material modifications of the
  443  treatment plan which are contested by the patient or the
  444  patient’s guardian advocate, if applicable, must be approved or
  445  disapproved by the court consistent with subsection (3).
  446         (c)If, at any time before the conclusion of the initial
  447  hearing on involuntary outpatient services, it appears to the
  448  court that the person does not meet the criteria for involuntary
  449  outpatient services under this section but, instead, meets the
  450  criteria for involuntary inpatient placement, the court may
  451  order the person admitted for involuntary inpatient examination
  452  under s. 394.463. If the person instead meets the criteria for
  453  involuntary assessment, protective custody, or involuntary
  454  admission pursuant to s. 397.675, the court may order the person
  455  to be admitted for involuntary assessment for a period of 5 days
  456  pursuant to s. 397.6811. Thereafter, all proceedings are
  457  governed by chapter 397.
  458         (d)At the hearing on involuntary outpatient services, the
  459  court shall consider testimony and evidence regarding the
  460  patient’s competence to consent to services. If the court finds
  461  that the patient is incompetent to consent to treatment, it
  462  shall appoint a guardian advocate as provided in s. 394.4598.
  463  The guardian advocate shall be appointed or discharged in
  464  accordance with s. 394.4598.
  465         (e)The administrator of the receiving facility or the
  466  designated department representative shall provide a copy of the
  467  court order and adequate documentation of a patient’s mental
  468  illness to the service provider for involuntary outpatient
  469  services. Such documentation must include any advance directives
  470  made by the patient, a psychiatric evaluation of the patient,
  471  and any evaluations of the patient performed by a psychologist
  472  or a clinical social worker.
  473         (8)PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
  474  SERVICES.—
  475         (a)1.If the person continues to meet the criteria for
  476  involuntary outpatient services, the service provider shall, at
  477  least 10 days before the expiration of the period during which
  478  the treatment is ordered for the person, file in the court that
  479  issued the order for involuntary outpatient services a petition
  480  for continued involuntary outpatient services. The court shall
  481  immediately schedule a hearing on the petition to be held within
  482  15 days after the petition is filed.
  483         2.The existing involuntary outpatient services order
  484  remains in effect until disposition on the petition for
  485  continued involuntary outpatient services.
  486         3.A certificate shall be attached to the petition which
  487  includes a statement from the person’s physician or clinical
  488  psychologist justifying the request, a brief description of the
  489  patient’s treatment during the time he or she was receiving
  490  involuntary services, and an individualized plan of continued
  491  treatment.
  492         4.The service provider shall develop the individualized
  493  plan of continued treatment in consultation with the patient or
  494  the patient’s guardian advocate, if applicable. When the
  495  petition has been filed, the clerk of the court shall provide
  496  copies of the certificate and the individualized plan of
  497  continued services to the department, the patient, the patient’s
  498  guardian advocate, the state attorney, and the patient’s private
  499  counsel or the public defender.
  500         (b)Within 1 court working day after the filing of a
  501  petition for continued involuntary outpatient services, the
  502  court shall appoint the public defender to represent the person
  503  who is the subject of the petition, unless the person is
  504  otherwise represented by counsel. The clerk of the court shall
  505  immediately notify the public defender of such appointment. The
  506  public defender shall represent the person until the petition is
  507  dismissed or the court order expires or the patient is
  508  discharged from involuntary outpatient services. Any attorney
  509  representing the patient shall have access to the patient,
  510  witnesses, and records relevant to the presentation of the
  511  patient’s case and shall represent the interests of the patient,
  512  regardless of the source of payment to the attorney.
  513         (c)Hearings on petitions for continued involuntary
  514  outpatient services must be before the court that issued the
  515  order for involuntary outpatient services. The court may appoint
  516  a magistrate to preside at the hearing. The procedures for
  517  obtaining an order pursuant to this paragraph must meet the
  518  requirements of subsection (7), except that the time period
  519  included in paragraph (2)(e) is not applicable in determining
  520  the appropriateness of additional periods of involuntary
  521  outpatient placement.
  522         (d)Notice of the hearing must be provided as set forth in
  523  s. 394.4599. The patient and the patient’s attorney may agree to
  524  a period of continued outpatient services without a court
  525  hearing.
  526         (e)The same procedure must be repeated before the
  527  expiration of each additional period the patient is placed in
  528  treatment.
  529         (f)If the patient has previously been found incompetent to
  530  consent to treatment, the court shall consider testimony and
  531  evidence regarding the patient’s competence. Section 394.4598
  532  governs the discharge of the guardian advocate if the patient’s
  533  competency to consent to treatment has been restored.
  534         Section 11. Section 394.467, Florida Statutes, is amended
  535  to read:
  536         394.467 Involuntary inpatient placement and involuntary
  537  outpatient services.—
  538         (1)DEFINITIONS.—As used in this section, the term:
  539         (a)“Court” means a circuit court or, for commitments only
  540  to involuntary outpatient services as defined in s. 394.4655, a
  541  county court.
  542         (b)“Involuntary inpatient placement” means placement in a
  543  secure receiving or treatment facility providing stabilization
  544  and treatment services to a person 18 years of age or older who
  545  does not voluntarily consent to services under this chapter, or
  546  a minor who does not voluntarily assent to services under this
  547  chapter.
  548         (c)“Involuntary outpatient services” means services
  549  provided in the community to a person who does not voluntarily
  550  consent to or participate in services under this chapter.
  551         (d)“Services plan” means an individualized plan detailing
  552  the recommended behavioral health services and supports based on
  553  a thorough assessment of the needs of the patient, to safeguard
  554  and enhance the patient’s health and well-being in the
  555  community.
  556         (2)(1) CRITERIA FOR INVOLUNTARY SERVICES.—A person may be
  557  ordered by a court to be provided for involuntary services
  558  inpatient placement for treatment upon a finding of the court,
  559  by clear and convincing evidence, that the person meets the
  560  following criteria:
  561         (a)Involuntary outpatient services.—A person ordered to
  562  involuntary outpatient services must meet the following
  563  criteria:
  564         1.The person has a mental illness and, because of his or
  565  her mental illness:
  566         a.He or she is unlikely to voluntarily participate in a
  567  recommended services plan and has refused voluntary services for
  568  treatment after sufficient and conscientious explanation and
  569  disclosure of why the services are necessary; or
  570         b.Is unable to determine for himself or herself whether
  571  services are necessary.
  572         2.The person is unlikely to survive safely in the
  573  community without supervision, based on a clinical
  574  determination.
  575         3.The person has a history of lack of compliance with
  576  treatment for mental illness.
  577         4.In view of the person’s treatment history and current
  578  behavior, the person is in need of involuntary outpatient
  579  services in order to prevent a relapse or deterioration that
  580  would be likely to result in serious bodily harm to himself or
  581  herself or others, or a substantial harm to his or her well
  582  being as set forth in s. 394.463(1).
  583         5.It is likely that the person will benefit from
  584  involuntary outpatient services.
  585         6.All available less restrictive alternatives that would
  586  offer an opportunity for improvement of the person’s condition
  587  have been deemed to be inappropriate or unavailable.
  588         (b)Involuntary inpatient placement.—A person ordered to
  589  involuntary inpatient placement must meet the following
  590  criteria:
  591         1.(a)The person He or she has a mental illness and,
  592  because of his or her mental illness:
  593         a.1.a. He or she has refused voluntary inpatient placement
  594  for treatment after sufficient and conscientious explanation and
  595  disclosure of the purpose of inpatient placement for treatment;
  596  or
  597         b. He or she Is unable to determine for himself or herself
  598  whether inpatient placement is necessary; and
  599         2.a. He or she is incapable of surviving alone or with the
  600  help of willing, able, and responsible family or friends,
  601  including available alternative services, and, without
  602  treatment, is likely to suffer from neglect or refuse to care
  603  for himself or herself, and such neglect or refusal poses a real
  604  and present threat of substantial harm to his or her well-being;
  605  or
  606         b. Without treatment, there is a substantial likelihood
  607  that in the near future the person he or she will inflict
  608  serious bodily harm on self or others, as evidenced by recent
  609  behavior causing, attempting to cause, or threatening to cause
  610  such harm; and
  611         3.(b) All available less restrictive treatment alternatives
  612  that would offer an opportunity for improvement of the person’s
  613  his or her condition have been deemed judged to be inappropriate
  614  or unavailable.
  615         (3)(2)RECOMMENDATION FOR INVOLUNTARY SERVICES AND
  616  ADMISSION TO A TREATMENT FACILITY.—A patient may be recommended
  617  for involuntary inpatient placement, involuntary outpatient
  618  services, or a combination of both.
  619         (a)A patient may be retained by the a facility that
  620  examined the patient for involuntary services until the
  621  completion of the patient’s court hearing or involuntarily
  622  placed in a treatment facility upon the recommendation of the
  623  administrator of the facility where the patient has been
  624  examined and after adherence to the notice and hearing
  625  procedures provided in s. 394.4599. However, if a patient who is
  626  being recommended for only involuntary outpatient services has
  627  been stabilized and no longer meets the criteria for involuntary
  628  examination pursuant to s. 394.463(1), the patient must be
  629  released from the facility while awaiting the hearing for
  630  involuntary outpatient services.
  631         (b) The recommendation that the involuntary services
  632  criteria reasonably appear to have been met must be supported by
  633  the opinion of a psychiatrist and the second opinion of a
  634  clinical psychologist with at least 3 years of clinical
  635  experience, or another psychiatrist, or a psychiatric nurse
  636  practicing within the framework of an established protocol with
  637  a psychiatrist, who both of whom have personally examined the
  638  patient within the preceding 72 hours, that the criteria for
  639  involuntary inpatient placement are met. For involuntary
  640  inpatient placement, the patient must have been examined within
  641  the preceding 72 hours. For involuntary outpatient services the
  642  patient must have been examined within the preceding 30 days.
  643         (c)If However, if the administrator certifies that a
  644  psychiatrist, a or clinical psychologist with at least 3 years
  645  of clinical experience, or a psychiatric nurse practicing within
  646  the framework of an established protocol with a psychiatrist is
  647  not available to provide a the second opinion, the petitioner
  648  must certify as such and the second opinion may be provided by a
  649  licensed physician who has postgraduate training and experience
  650  in diagnosis and treatment of mental illness, a clinical
  651  psychologist, or by a psychiatric nurse.
  652         (d) Any opinion authorized in this subsection may be
  653  conducted through a face-to-face or in-person examination, in
  654  person, or by electronic means. Recommendations for involuntary
  655  services must be Such recommendation shall be entered on a
  656  petition for involuntary services inpatient placement
  657  certificate, which shall be made a part of the patient’s
  658  clinical record. The filing of the petition that authorizes the
  659  facility to retain the patient pending transfer to a treatment
  660  facility or completion of a hearing.
  661         (4)(3) PETITION FOR INVOLUNTARY SERVICES INPATIENT
  662  PLACEMENT.—
  663         (a)A petition for involuntary services may be filed by:
  664         1. The administrator of a receiving the facility;
  665         2.The administrator of a treatment facility; or
  666         3.A service provider who is treating the person being
  667  petitioned.
  668         (b)A shall file a petition for involuntary inpatient
  669  placement, or inpatient placement followed by outpatient
  670  services, must be filed in the court in the county where the
  671  patient is located.
  672         (c)A petition for involuntary outpatient services must be
  673  filed in the county where the patient is located, unless the
  674  patient is being placed from a state treatment facility, in
  675  which case the petition must be filed in the county where the
  676  patient will reside.
  677         (d)1.The petitioner must state in the petition:
  678         a.Whether the petitioner is recommending inpatient
  679  placement, outpatient services, or both.
  680         b.The length of time recommended for each type of
  681  involuntary services.
  682         c.The reasons for the recommendation.
  683         2.If recommending involuntary outpatient services, or a
  684  combination of involuntary inpatient placement and outpatient
  685  services, the petitioner must identify the service provider that
  686  has agreed to provide services for the person under an order for
  687  involuntary outpatient services, unless he or she is otherwise
  688  participating in outpatient psychiatric treatment and is not in
  689  need of public financing for that treatment, in which case the
  690  individual, if eligible, may be ordered to involuntary treatment
  691  pursuant to the existing psychiatric treatment relationship.
  692         3.When recommending an order to involuntary outpatient
  693  services, the petitioner shall prepare a written proposed
  694  services plan in consultation with the patient or the patient’s
  695  guardian advocate, if appointed, for the court’s consideration
  696  for inclusion in the involuntary outpatient services order that
  697  addresses the nature and extent of the mental illness and any
  698  co-occurring substance use disorder that necessitate involuntary
  699  outpatient services. The services plan must specify the likely
  700  needed level of care, including the use of medication, and
  701  anticipated discharge criteria for terminating involuntary
  702  outpatient services. The services in the plan must be deemed
  703  clinically appropriate by a physician, clinical psychologist,
  704  psychiatric nurse, mental health counselor, marriage and family
  705  therapist, or clinical social worker who consults with, or is
  706  employed or contracted by, the service provider. If the services
  707  in the proposed services plan are not available, the petitioner
  708  may not file the petition. The petitioner must notify the
  709  managing entity if the requested services are not available. The
  710  managing entity must document such efforts to obtain the
  711  requested service. The service provider who accepts the patient
  712  for involuntary outpatient services is responsible for the
  713  development of a comprehensive treatment plan.
  714         (e)Each required criterion for the recommended involuntary
  715  services must be alleged and substantiated in the petition. A
  716  copy of the recommended services plan, if applicable, must be
  717  attached to the petition. The court must accept petitions and
  718  other documentation with electronic signatures.
  719         (f)When the petition has been filed Upon filing, the clerk
  720  of the court shall provide copies of the petition and the
  721  recommended services plan, if applicable, to the department, the
  722  managing entity, the patient, the patient’s guardian or
  723  representative, and the state attorney, and the public defender
  724  or the patient’s private counsel of the judicial circuit in
  725  which the patient is located. A fee may not be charged for the
  726  filing of a petition under this subsection.
  727         (5)(4) APPOINTMENT OF COUNSEL.—Within 1 court working day
  728  after the filing of a petition for involuntary services
  729  inpatient placement, the court shall appoint the public defender
  730  to represent the person who is the subject of the petition,
  731  unless the person is otherwise represented by counsel or
  732  ineligible. The clerk of the court shall immediately notify the
  733  public defender of such appointment. The public defender shall
  734  represent the person until the petition is dismissed, the court
  735  order expires, the patient is discharged from involuntary
  736  services, or the public defender is otherwise discharged by the
  737  court. Any attorney who represents representing the patient
  738  shall be provided have access to the patient, witnesses, and
  739  records relevant to the presentation of the patient’s case and
  740  shall represent the interests of the patient, regardless of the
  741  source of payment to the attorney.
  742         (6)(5) CONTINUANCE OF HEARING.—The patient and the state
  743  are independently is entitled, with the concurrence of the
  744  patient’s counsel, to seek a at least one continuance of the
  745  hearing. The patient shall be granted a request for an initial
  746  continuance for up to 7 calendar days. The patient may request
  747  additional continuances for up to 21 calendar days in total,
  748  which shall only be granted by a showing of good cause and due
  749  diligence by the patient and the patient’s counsel before
  750  requesting the continuance. The state may request one
  751  continuance of up to 7 calendar days, which shall only be
  752  granted by a showing of good cause and due diligence by the
  753  state before requesting the continuance. The state’s failure to
  754  timely review any readily available document or failure to
  755  attempt to contact a known witness does not warrant a
  756  continuance 4 weeks.
  757         (7)(6) HEARING ON INVOLUNTARY SERVICES INPATIENT
  758  PLACEMENT.—
  759         (a)1. The court shall hold a the hearing on the involuntary
  760  services petition inpatient placement within 5 court working
  761  days after the filing of the petition, unless a continuance is
  762  granted.
  763         2. The court must hold any hearing on involuntary
  764  outpatient services in the county where the petition is filed. A
  765  hearing on involuntary inpatient placement, or a combination of
  766  involuntary inpatient placement and involuntary outpatient
  767  services, Except for good cause documented in the court file,
  768  the hearing must be held in the county or the facility, as
  769  appropriate, where the patient is located, except for good cause
  770  documented in the court file.
  771         3.A hearing on involuntary services must be as convenient
  772  to the patient as is consistent with orderly procedure, and
  773  shall be conducted in physical settings not likely to be
  774  injurious to the patient’s condition. If the court finds that
  775  the patient’s attendance at the hearing is not consistent with
  776  the best interests of the patient, or the patient knowingly,
  777  intelligently, and voluntarily waives his or her right to be
  778  present, and if the patient’s counsel does not object, the court
  779  may waive the attendance presence of the patient from all or any
  780  portion of the hearing. The state attorney for the circuit in
  781  which the patient is located shall represent the state, rather
  782  than the petitioner, as the real party in interest in the
  783  proceeding. The facility or service provider shall make the
  784  patient’s clinical records available to the state attorney and
  785  the patient’s attorney so that the state can evaluate and
  786  prepare its case. However, these records shall remain
  787  confidential, and the state attorney may not use any record
  788  obtained under this part for criminal investigation or
  789  prosecution purposes, or for any purpose other than the
  790  patient’s civil commitment under this chapter petitioning
  791  facility administrator, as the real party in interest in the
  792  proceeding.
  793         (b)3. The court may appoint a magistrate to preside at the
  794  hearing. The state attorney and witnesses may remotely attend
  795  and, as appropriate, testify at the hearing under oath via
  796  audio-video teleconference. A witness intending to attend
  797  remotely and testify must provide the parties with all relevant
  798  documents by the close of business on the day before the
  799  hearing. One of the professionals who executed the petition for
  800  involuntary services inpatient placement certificate shall be a
  801  witness. The patient and the patient’s guardian or
  802  representative shall be informed by the court of the right to an
  803  independent expert examination. If the patient cannot afford
  804  such an examination, the court shall ensure that one is
  805  provided, as otherwise provided for by law. The independent
  806  expert’s report is confidential and not discoverable, unless the
  807  expert is to be called as a witness for the patient at the
  808  hearing. The court shall allow testimony from persons, including
  809  family members, deemed by the court to be relevant under state
  810  law, regarding the person’s prior history and how that prior
  811  history relates to the person’s current condition. The testimony
  812  in the hearing must be given under oath, and the proceedings
  813  must be recorded. The patient may refuse to testify at the
  814  hearing.
  815         (c)(b)At the hearing, the court shall consider testimony
  816  and evidence regarding the patient’s competence to consent to
  817  services and treatment. If the court finds that the patient is
  818  incompetent to consent to treatment, it must appoint a guardian
  819  advocate as provided in s. 394.4598.
  820         (8)ORDERS OF THE COURT.—
  821         (a)1. If the court concludes that the patient meets the
  822  criteria for involuntary services, the court may order a patient
  823  to involuntary inpatient placement, involuntary outpatient
  824  services, or a combination of involuntary services depending on
  825  the criteria met and which type of involuntary services best
  826  meet the needs of the patient. However, if the court orders the
  827  patient to involuntary outpatient services, the court may not
  828  order the department or the service provider to provide services
  829  if the program or service is not available in the patient’s
  830  local community, if there is no space available in the program
  831  or service for the patient, or if funding is not available for
  832  the program or service. The petitioner must notify the managing
  833  entity if the requested services are not available. The managing
  834  entity must document such efforts to obtain the requested
  835  services. A copy of the order must be sent to the managing
  836  entity by the service provider within 1 working day after it is
  837  received from the court.
  838         2.The order must specify the nature and extent of the
  839  patient’s mental illness and the reasons the appropriate
  840  involuntary services criteria are satisfied.
  841         3.An order for only involuntary outpatient services,
  842  involuntary inpatient placement, or of a combination of
  843  involuntary services may be for a period of up to 6 months.
  844         4.An order for a combination of involuntary services must
  845  specify the length of time the patient shall be ordered for
  846  involuntary inpatient placement and involuntary outpatient
  847  services.
  848         5.The order of the court and the patient’s services plan,
  849  if applicable, must be made part of the patient’s clinical
  850  record.
  851         (b)If the court orders a patient into involuntary
  852  inpatient placement, the court it may order that the patient be
  853  retained at a receiving facility while awaiting transfer
  854  transferred to a treatment facility, or, if the patient is at a
  855  treatment facility, that the patient be retained there or be
  856  treated at any other appropriate facility, or that the patient
  857  receive services, on an involuntary basis, for up to 90 days.
  858  However, any order for involuntary mental health services in a
  859  treatment facility may be for up to 6 months. The order shall
  860  specify the nature and extent of the patient’s mental illness.
  861  The court may not order an individual with a developmental
  862  disability as defined in s. 393.063 or a traumatic brain injury
  863  or dementia who lacks a co-occurring mental illness to be
  864  involuntarily placed in a state treatment facility. The facility
  865  shall discharge a patient any time the patient no longer meets
  866  the criteria for involuntary inpatient placement, unless the
  867  patient has transferred to voluntary status.
  868         (c) If at any time before the conclusion of a the hearing
  869  on involuntary services, inpatient placement it appears to the
  870  court that the patient person does not meet the criteria for
  871  involuntary inpatient placement under this section, but instead
  872  meets the criteria for involuntary outpatient services, the
  873  court may order the person evaluated for involuntary outpatient
  874  services pursuant to s. 394.4655. The petition and hearing
  875  procedures set forth in s. 394.4655 shall apply. If the person
  876  instead meets the criteria for involuntary assessment,
  877  protective custody, or involuntary admission or treatment
  878  pursuant to s. 397.675, then the court may order the person to
  879  be admitted for involuntary assessment for a period of 5 days
  880  pursuant to s. 397.6757 s. 397.6811. Thereafter, all proceedings
  881  are governed by chapter 397.
  882         (d)At the hearing on involuntary inpatient placement, the
  883  court shall consider testimony and evidence regarding the
  884  patient’s competence to consent to treatment. If the court finds
  885  that the patient is incompetent to consent to treatment, it
  886  shall appoint a guardian advocate as provided in s. 394.4598.
  887         (d)(e) The administrator of the petitioning facility or the
  888  designated department representative shall provide a copy of the
  889  court order and adequate documentation of a patient’s mental
  890  illness to the service provider for involuntary outpatient
  891  services or the administrator of a treatment facility if the
  892  patient is ordered for involuntary inpatient placement, whether
  893  by civil or criminal court. The documentation must include any
  894  advance directives made by the patient, a psychiatric evaluation
  895  of the patient, and any evaluations of the patient performed by
  896  a psychiatric nurse, a clinical psychologist, a marriage and
  897  family therapist, a mental health counselor, or a clinical
  898  social worker. The administrator of a treatment facility may
  899  refuse admission to any patient directed to its facilities on an
  900  involuntary basis, whether by civil or criminal court order, who
  901  is not accompanied by adequate orders and documentation.
  902         (e)In cases resulting in an order for involuntary
  903  outpatient services, the court shall retain jurisdiction over
  904  the case and the parties for entry of further orders as
  905  circumstances may require, including, but not limited to,
  906  monitoring compliance with treatment or ordering inpatient
  907  treatment to stabilize a person who decompensates while under
  908  court-ordered outpatient treatment and meets the commitment
  909  criteria of s. 394.467.
  910         (9)SERVICES PLAN MODIFICATION.—After the order for
  911  involuntary outpatient services is issued, the service provider
  912  and the patient may modify the services plan as provided by
  913  department rule.
  914         (10)NONCOMPLIANCE WITH INVOLUNTARY OUTPATIENT SERVICES.—
  915         (a)If, in the clinical judgment of a physician, a
  916  psychiatrist, a clinical psychologist with at least 3 years of
  917  clinical experience, or a psychiatric nurse practicing within
  918  the framework of an established protocol with a psychiatrist, a
  919  patient receiving involuntary outpatient services has failed or
  920  has refused to comply with the services plan ordered by the
  921  court, and efforts were made to solicit compliance, the service
  922  provider must report such noncompliance to the court. The
  923  involuntary outpatient services order shall remain in effect
  924  unless the service provider determines that the patient no
  925  longer meets the criteria for involuntary outpatient services or
  926  until the order expires. The service provider must determine
  927  whether modifications should be made to the existing services
  928  plan and must attempt to continue to engage the patient in
  929  treatment. For any material modification of the services plan to
  930  which the patient or the patient’s guardian advocate, if
  931  applicable, agrees, the service provider shall send notice of
  932  the modification to the court. Any material modifications of the
  933  services plan which are contested by the patient or the
  934  patient’s guardian advocate, if applicable, must be approved or
  935  disapproved by the court.
  936         (b)A county court may not use incarceration as a sanction
  937  for noncompliance with the services plan, but it may order an
  938  individual evaluated for possible inpatient placement if there
  939  is significant, or are multiple instances of, noncompliance.
  940         (11)(7) PROCEDURE FOR CONTINUED INVOLUNTARY SERVICES
  941  INPATIENT PLACEMENT.—
  942         (a)A petition for continued involuntary services must be
  943  filed if the patient continues to meets the criteria for
  944  involuntary services.
  945         (b)1.If a patient receiving involuntary outpatient
  946  services continues to meet the criteria for involuntary
  947  outpatient services, the service provider must file in the court
  948  that issued the initial order for involuntary outpatient
  949  services a petition for continued involuntary outpatient
  950  services.
  951         2.If a patient in involuntary inpatient placement
  952         (a)Hearings on petitions for continued involuntary
  953  inpatient placement of an individual placed at any treatment
  954  facility are administrative hearings and must be conducted in
  955  accordance with s. 120.57(1), except that any order entered by
  956  the administrative law judge is final and subject to judicial
  957  review in accordance with s. 120.68. Orders concerning patients
  958  committed after successfully pleading not guilty by reason of
  959  insanity are governed by s. 916.15.
  960         (b)If the patient continues to meet the criteria for
  961  involuntary services inpatient placement and is being treated at
  962  a receiving treatment facility, the administrator must shall,
  963  before the expiration of the period the receiving treatment
  964  facility is authorized to retain the patient, file in the court
  965  that issued the initial order for involuntary inpatient
  966  placement, a petition requesting authorization for continued
  967  involuntary services inpatient placement. The administrator may
  968  petition for inpatient or outpatient services.
  969         3.If a patient in inpatient placement continues to meet
  970  the criteria for involuntary services and is being treated at a
  971  treatment facility, the administrator must, before expiration of
  972  the period the treatment facility is authorized to retain the
  973  patient, file a petition requesting authorization for continued
  974  involuntary services. The administrator may petition for
  975  inpatient or outpatient services. Hearings on petitions for
  976  continued involuntary services of an individual placed at any
  977  treatment facility are administrative hearings and must be
  978  conducted in accordance with s. 120.57(1), except that any order
  979  entered by the judge is final and subject to judicial review in
  980  accordance with s. 120.68. Orders concerning patients committed
  981  after successfully pleading not guilty by reason of insanity are
  982  governed by s. 916.15.
  983         4.The court shall immediately schedule a hearing on the
  984  petition to be held within 15 days after the petition is filed.
  985         5.The existing involuntary services order shall remain in
  986  effect until disposition on the petition for continued
  987  involuntary services.
  988         (c) The petition request must be accompanied by a statement
  989  from the patient’s physician, psychiatrist, psychiatric nurse,
  990  or clinical psychologist justifying the request, a brief
  991  description of the patient’s treatment during the time he or she
  992  was receiving involuntary services involuntarily placed, and an
  993  individualized plan of continued treatment developed in
  994  consultation with the patient or the patient’s guardian
  995  advocate, if applicable. If the petition is for involuntary
  996  outpatient services, it must comply with the requirements of
  997  subparagraph (4)(d)3. When the petition has been filed, the
  998  clerk of the court shall provide copies of the petition and the
  999  individualized plan of continued services to the department, the
 1000  patient, the patient’s guardian advocate, the state attorney,
 1001  and the patient’s private counsel or the public defender.
 1002         (d)The court shall appoint counsel to represent the person
 1003  who is the subject of the petition for continued involuntary
 1004  services in accordance to the provisions set forth in subsection
 1005  (5), unless the person is otherwise represented by counsel or
 1006  ineligible.
 1007         (e)Hearings on petitions for continued involuntary
 1008  outpatient services must be before the court that issued the
 1009  order for involuntary outpatient services. However, the patient
 1010  and the patient’s attorney may agree to a period of continued
 1011  outpatient services without a court hearing.
 1012         (f)Hearings on petitions for continued involuntary
 1013  inpatient placement in receiving facilities, or involuntary
 1014  outpatient services following involuntary inpatient services,
 1015  must be held in the county or the facility, as appropriate,
 1016  where the patient is located.
 1017         (g)The court may appoint a magistrate to preside at the
 1018  hearing. The procedures for obtaining an order pursuant to this
 1019  paragraph must meet the requirements of subsection (7).
 1020         (h) Notice of the hearing must be provided as set forth
 1021  provided in s. 394.4599.
 1022         (i) If a patient’s attendance at the hearing is voluntarily
 1023  waived, the administrative law judge must determine that the
 1024  patient knowingly, intelligently, and voluntarily waived his or
 1025  her right to be present, waiver is knowing and voluntary before
 1026  waiving the presence of the patient from all or a portion of the
 1027  hearing. Alternatively, if at the hearing the administrative law
 1028  judge finds that attendance at the hearing is not consistent
 1029  with the best interests of the patient, the administrative law
 1030  judge may waive the presence of the patient from all or any
 1031  portion of the hearing, unless the patient, through counsel,
 1032  objects to the waiver of presence. The testimony in the hearing
 1033  must be under oath, and the proceedings must be recorded.
 1034         (c)Unless the patient is otherwise represented or is
 1035  ineligible, he or she shall be represented at the hearing on the
 1036  petition for continued involuntary inpatient placement by the
 1037  public defender of the circuit in which the facility is located.
 1038         (j)(d) If at a hearing it is shown that the patient
 1039  continues to meet the criteria for involuntary services
 1040  inpatient placement, the court administrative law judge shall
 1041  issue an sign the order for continued involuntary outpatient
 1042  services, inpatient placement for up to 90 days. However, any
 1043  order for involuntary inpatient placement, or mental health
 1044  services in a combination of involuntary services treatment
 1045  facility may be for up to 6 months. The same procedure shall be
 1046  repeated before the expiration of each additional period the
 1047  patient is retained.
 1048         (k)If the patient has been ordered to undergo involuntary
 1049  services and has previously been found incompetent to consent to
 1050  treatment, the court shall consider testimony and evidence
 1051  regarding the patient’s competence. If the patient’s competency
 1052  to consent to treatment is restored, the discharge of the
 1053  guardian advocate is governed by s. 394.4598. If the patient has
 1054  been ordered to undergo involuntary inpatient placement only and
 1055  the patient’s competency to consent to treatment is restored,
 1056  the administrative law judge may issue a recommended order, to
 1057  the court that found the patient incompetent to consent to
 1058  treatment, that the patient’s competence be restored and that
 1059  any guardian advocate previously appointed be discharged.
 1060         (l)(e) If continued involuntary inpatient placement is
 1061  necessary for a patient in involuntary inpatient placement who
 1062  was admitted while serving a criminal sentence, but his or her
 1063  sentence is about to expire, or for a minor involuntarily
 1064  placed, but who is about to reach the age of 18, the
 1065  administrator shall petition the administrative law judge for an
 1066  order authorizing continued involuntary inpatient placement.
 1067  The procedure required in this subsection must be followed
 1068  before the expiration of each additional period the patient is
 1069  involuntarily receiving services.
 1070         (12)(8) RETURN TO FACILITY.—If a patient has been ordered
 1071  to undergo involuntary inpatient placement involuntarily held at
 1072  a receiving or treatment facility under this part and leaves the
 1073  facility without the administrator’s authorization, the
 1074  administrator may authorize a search for the patient and his or
 1075  her return to the facility. The administrator may request the
 1076  assistance of a law enforcement agency in this regard.
 1077         (13)DISCHARGE.—The patient shall be discharged upon
 1078  expiration of the court order or at any time the patient no
 1079  longer meets the criteria for involuntary services, unless the
 1080  patient has transferred to voluntary status. Upon discharge, the
 1081  service provider or facility shall send a certificate of
 1082  discharge to the court.
 1083         Section 12. Subsection (2) of section 394.468, Florida
 1084  Statutes, is amended, and subsection (3) is added to that
 1085  section, to read:
 1086         394.468 Admission and discharge procedures.—
 1087         (2) Discharge planning and procedures for any patient’s
 1088  release from a receiving facility or treatment facility must
 1089  include and document the patient’s needs, and actions to address
 1090  such needs, for consideration of, at a minimum:
 1091         (a) Follow-up behavioral health appointments;
 1092         (b) Information on how to obtain prescribed medications;
 1093  and
 1094         (c) Information pertaining to:
 1095         1. Available living arrangements;
 1096         2. Transportation; and
 1097         (d)Referral to:
 1098         1.Care coordination services. The patient must be referred
 1099  for care coordination services if the patient meets the criteria
 1100  as a member of a priority population as determined by the
 1101  department under s. 394.9082(3)(c) and is in need of such
 1102  services.
 1103         2.3. Recovery support opportunities under s.
 1104  394.4573(2)(l), including, but not limited to, connection to a
 1105  peer specialist.
 1106         (3)During the discharge transition process and while the
 1107  patient is present unless determined inappropriate by a
 1108  physician or psychiatric nurse practicing within the framework
 1109  of an established protocol with a psychiatrist a receiving
 1110  facility shall coordinate, face-to-face or through electronic
 1111  means, discharge plans to a less restrictive community
 1112  behavioral health provider, a peer specialist, a case manager,
 1113  or a care coordination service. The transition process must, at
 1114  a minimum, include all of the following criteria:
 1115         (a)Implementation of policies and procedures outlining
 1116  strategies for how the receiving facility will comprehensively
 1117  address the needs of patients who demonstrate a high use of
 1118  receiving facility services to avoid or reduce future use of
 1119  crisis stabilization services. For any such patient, policies
 1120  and procedures must include, at a minimum, a review of the
 1121  effectiveness of previous discharge plans created by the
 1122  facility for the patient, and the new discharge plan must
 1123  address problems experienced with implementation of previous
 1124  discharge plans.
 1125         (b)Developing and including in discharge paperwork a
 1126  personalized crisis prevention plan that identifies stressors,
 1127  early warning signs or symptoms, and strategies to deal with
 1128  crisis.
 1129         (c)Requiring a staff member to seek to engage a family
 1130  member, legal guardian, legal representative, or natural support
 1131  in discharge planning and meet face to face or through
 1132  electronic means to review the discharge instructions, including
 1133  prescribed medications, follow-up appointments, and any other
 1134  recommended services or follow-up resources, and document the
 1135  outcome of such meeting.
 1136         (d)When the recommended level of care at discharge is not
 1137  immediately available to the patient, the receiving facility
 1138  must, at a minimum, initiate a referral to an appropriate
 1139  provider to meet the needs of the patient to continue care until
 1140  the recommended level of care is available.
 1141         Section 13. Section 394.4915, Florida Statutes, is created
 1142  to read:
 1143         394.4915Office of Children’s Behavioral Health Ombudsman.
 1144  The Office of Children’s Behavioral Health Ombudsman is
 1145  established within the department for the purpose of being a
 1146  central point to receive complaints on behalf of children and
 1147  adolescents with behavioral health disorders receiving state
 1148  funded services and use such information to improve the child
 1149  and adolescent mental health treatment and support system. The
 1150  department and managing entities shall include information about
 1151  and contact information for the office placed prominently on
 1152  their websites on easily accessible web pages related to
 1153  children and adolescent behavioral health services. To the
 1154  extent permitted by available resources, the office shall, at a
 1155  minimum:
 1156         (1)Receive and direct to the appropriate contact within
 1157  the department, the Agency for Health Care Administration, or
 1158  the appropriate organizations providing behavioral health
 1159  services complaints from children and adolescents and their
 1160  families about the child and adolescent mental health treatment
 1161  and support system.
 1162         (2)Maintain records of complaints received and the actions
 1163  taken.
 1164         (3)Be a resource to identify and explain relevant policies
 1165  or procedures to children, adolescents, and their families about
 1166  the child and adolescent mental health treatment and support
 1167  system.
 1168         (4)Provide recommendations to the department to address
 1169  systemic problems within the child and adolescent mental health
 1170  treatment and support system that are leading to complaints. The
 1171  department shall include an analysis of complaints and
 1172  recommendations in the report required under s. 394.4573.
 1173         (5)Engage in functions that may improve the child and
 1174  adolescent mental health treatment and support system.
 1175         Section 14. Subsection (3) of section 394.495, Florida
 1176  Statutes, is amended to read:
 1177         394.495 Child and adolescent mental health system of care;
 1178  programs and services.—
 1179         (3) Assessments must be performed by:
 1180         (a) A clinical psychologist, clinical social worker,
 1181  physician, psychiatric nurse, or psychiatrist, as those terms
 1182  are defined in s. 394.455 professional as defined in s.
 1183  394.455(5), (7), (33), (36), or (37);
 1184         (b) A professional licensed under chapter 491; or
 1185         (c) A person who is under the direct supervision of a
 1186  clinical psychologist, clinical social worker, physician,
 1187  psychiatric nurse, or psychiatrist, as those terms are defined
 1188  in s. 394.455, qualified professional as defined in s.
 1189  394.455(5), (7), (33), (36), or (37) or a professional licensed
 1190  under chapter 491.
 1191         Section 15. Subsection (5) of section 394.496, Florida
 1192  Statutes, is amended to read:
 1193         394.496 Service planning.—
 1194         (5) A clinical psychologist, clinical social worker,
 1195  physician, psychiatric nurse, or psychiatrist, as those terms
 1196  are defined in s. 394.455, professional as defined in s.
 1197  394.455(5), (7), (33), (36), or (37) or a professional licensed
 1198  under chapter 491 must be included among those persons
 1199  developing the services plan.
 1200         Section 16. Paragraph (a) of subsection (2) of section
 1201  394.499, Florida Statutes, is amended to read:
 1202         394.499 Integrated children’s crisis stabilization
 1203  unit/juvenile addictions receiving facility services.—
 1204         (2) Children eligible to receive integrated children’s
 1205  crisis stabilization unit/juvenile addictions receiving facility
 1206  services include:
 1207         (a) A minor whose parent makes person under 18 years of age
 1208  for whom voluntary application based on the parent’s express and
 1209  informed consent, and the requirements of s. 394.4625(1)(a) are
 1210  met is made by his or her guardian, if such person is found to
 1211  show evidence of mental illness and to be suitable for treatment
 1212  pursuant to s. 394.4625. A person under 18 years of age may be
 1213  admitted for integrated facility services only after a hearing
 1214  to verify that the consent to admission is voluntary.
 1215         Section 17. Paragraphs (a) and (d) of subsection (1) of
 1216  section 394.875, Florida Statutes, are amended to read:
 1217         394.875 Crisis stabilization units, residential treatment
 1218  facilities, and residential treatment centers for children and
 1219  adolescents; authorized services; license required.—
 1220         (1)(a) The purpose of a crisis stabilization unit is to
 1221  stabilize and redirect a client to the most appropriate and
 1222  least restrictive community setting available, consistent with
 1223  the client’s needs. Crisis stabilization units may screen,
 1224  assess, and admit for stabilization persons who present
 1225  themselves to the unit and persons who are brought to the unit
 1226  under s. 394.463. Clients may be provided 24-hour observation,
 1227  medication prescribed by a physician, or psychiatrist, or
 1228  psychiatric nurse practicing within the framework of an
 1229  established protocol with a psychiatrist, and other appropriate
 1230  services. Crisis stabilization units shall provide services
 1231  regardless of the client’s ability to pay and shall be limited
 1232  in size to a maximum of 30 beds.
 1233         (d)The department is directed to implement a demonstration
 1234  project in circuit 18 to test the impact of expanding beds
 1235  authorized in crisis stabilization units from 30 to 50 beds.
 1236  Specifically, the department is directed to authorize existing
 1237  public or private crisis stabilization units in circuit 18 to
 1238  expand bed capacity to a maximum of 50 beds and to assess the
 1239  impact such expansion would have on the availability of crisis
 1240  stabilization services to clients.
 1241         Section 18. Section 394.90826, Florida Statutes, is created
 1242  to read:
 1243         394.90826Behavioral Health Interagency Collaboration.—
 1244         (1)The department and the Agency for Health Care
 1245  Administration shall jointly establish behavioral health
 1246  interagency collaboratives throughout the state with the goal of
 1247  identifying and addressing ongoing challenges within the
 1248  behavioral health system at the local level to improve the
 1249  accessibility, availability, and quality of behavioral health
 1250  services. The objectives of the regional collaboratives are to:
 1251         (a)Facilitate enhanced interagency communication and
 1252  collaboration.
 1253         (b)Develop and promote regional strategies tailored to
 1254  address community-level challenges in the behavioral health
 1255  system.
 1256         (2)The regional collaborative membership shall at a
 1257  minimum be composed of representatives from all of the
 1258  following, serving the region:
 1259         (a)Department of Children and Families.
 1260         (b)Agency for Health Care Administration.
 1261         (c)Agency for Persons with Disabilities.
 1262         (d)Department of Elder Affairs.
 1263         (e)Department of Health.
 1264         (f)Department of Education.
 1265         (g)School districts.
 1266         (h)Area agencies on aging.
 1267         (i)Community-based care lead agencies, as defined in s.
 1268  409.986(3)(d).
 1269         (j)Managing entities, as defined in s. 394.9082(2).
 1270         (k)Behavioral health services providers.
 1271         (l)Hospitals.
 1272         (m)Medicaid Managed Medical Assistance Plans.
 1273         (n)Police departments.
 1274         (o)Sheriffs’ offices.
 1275         (3)Each regional collaborative shall define the objectives
 1276  of that collaborative based upon the specific needs of the
 1277  region and local communities located within the region, to
 1278  achieve the specified goals.
 1279         (4)The department shall define the region to be served by
 1280  each collaborative and shall be responsible for facilitating
 1281  meetings.
 1282         (5)All entities represented on the regional collaboratives
 1283  shall provide assistance as appropriate and reasonably necessary
 1284  to fulfill the goals of the regional collaboratives.
 1285         Section 19. Subsection (6) of section 394.9085, Florida
 1286  Statutes, is amended to read:
 1287         394.9085 Behavioral provider liability.—
 1288         (6) For purposes of this section, the terms “detoxification
 1289  services,” “addictions receiving facility,” and “receiving
 1290  facility” have the same meanings as those provided in ss.
 1291  397.311(26)(a)4. 397.311(26)(a)3., 397.311(26)(a)1., and
 1292  394.455(40), respectively.
 1293         Section 20. Subsection (3) of section 397.305, Florida
 1294  Statutes, is amended to read:
 1295         397.305 Legislative findings, intent, and purpose.—
 1296         (3) It is the purpose of this chapter to provide for a
 1297  comprehensive continuum of accessible and quality substance
 1298  abuse prevention, intervention, clinical treatment, and recovery
 1299  support services in the most appropriate and least restrictive
 1300  environment which promotes long-term recovery while protecting
 1301  and respecting the rights of individuals, primarily through
 1302  community-based private not-for-profit providers working with
 1303  local governmental programs involving a wide range of agencies
 1304  from both the public and private sectors.
 1305         Section 21. Subsections (19) and (23) of section 397.311,
 1306  Florida Statutes, are amended to read:
 1307         397.311 Definitions.—As used in this chapter, except part
 1308  VIII, the term:
 1309         (19) “Impaired” or “substance abuse impaired” means having
 1310  a substance use disorder or a condition involving the use of
 1311  alcoholic beverages, illicit or prescription drugs, or any
 1312  psychoactive or mood-altering substance in such a manner as to
 1313  induce mental, emotional, or physical problems or and cause
 1314  socially dysfunctional behavior.
 1315         (23) “Involuntary treatment services” means an array of
 1316  behavioral health services that may be ordered by the court for
 1317  persons with substance abuse impairment or co-occurring
 1318  substance abuse impairment and mental health disorders.
 1319         Section 22. Subsection (6) is added to section 397.401,
 1320  Florida Statutes, to read:
 1321         397.401 License required; penalty; injunction; rules
 1322  waivers.—
 1323         (6)A service provider operating an addictions receiving
 1324  facility or providing detoxification on a nonhospital inpatient
 1325  basis may not exceed its licensed capacity by more than 10
 1326  percent and may not exceed their licensed capacity for more than
 1327  3 consecutive working days or for more than 7 days in 1 month.
 1328         Section 23. Paragraph (i) is added to subsection (1) of
 1329  section 397.4073, Florida Statutes, to read:
 1330         397.4073 Background checks of service provider personnel.—
 1331         (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND
 1332  EXCEPTIONS.—
 1333         (i)Any physician licensed under chapter 458 or chapter 459
 1334  or a nurse licensed under chapter 464 who was required to
 1335  undergo background screening by the Department of Health as part
 1336  of his or her initial licensure or the renewal of licensure, and
 1337  who has an active and unencumbered license, is not subject to
 1338  background screening pursuant to this section.
 1339         Section 24. Subsection (8) of section 397.501, Florida
 1340  Statutes, is amended to read:
 1341         397.501 Rights of individuals.—Individuals receiving
 1342  substance abuse services from any service provider are
 1343  guaranteed protection of the rights specified in this section,
 1344  unless otherwise expressly provided, and service providers must
 1345  ensure the protection of such rights.
 1346         (8) RIGHT TO COUNSEL.—Each individual must be informed that
 1347  he or she has the right to be represented by counsel in any
 1348  judicial involuntary proceeding for involuntary assessment,
 1349  stabilization, or treatment services and that he or she, or if
 1350  the individual is a minor his or her parent, legal guardian, or
 1351  legal custodian, may apply immediately to the court to have an
 1352  attorney appointed if he or she cannot afford one.
 1353         Section 25. Section 397.581, Florida Statutes, is amended
 1354  to read:
 1355         397.581 Unlawful activities relating to assessment and
 1356  treatment; penalties.—
 1357         (1) A person may not knowingly and willfully:
 1358         (a)Furnish furnishing false information for the purpose of
 1359  obtaining emergency or other involuntary admission of another
 1360  person for any person is a misdemeanor of the first degree,
 1361  punishable as provided in s. 775.082 and by a fine not exceeding
 1362  $5,000.
 1363         (b)(2)Cause or otherwise secure, or conspire with or
 1364  assist another to cause or secure Causing or otherwise securing,
 1365  or conspiring with or assisting another to cause or secure,
 1366  without reason for believing a person to be impaired, any
 1367  emergency or other involuntary procedure of another for the
 1368  person under false pretenses is a misdemeanor of the first
 1369  degree, punishable as provided in s. 775.082 and by a fine not
 1370  exceeding $5,000.
 1371         (c)(3)Cause, or conspire with or assist another to cause,
 1372  without lawful justification Causing, or conspiring with or
 1373  assisting another to cause, the denial to any person of any
 1374  right accorded pursuant to this chapter.
 1375         (2)A person who violates subsection (1) commits is a
 1376  misdemeanor of the first degree, punishable as provided in s.
 1377  775.082 and by a fine not exceeding $5,000.
 1378         Section 26. Section 397.675, Florida Statutes, is amended
 1379  to read:
 1380         397.675 Criteria for involuntary admissions, including
 1381  protective custody, emergency admission, and other involuntary
 1382  assessment, involuntary treatment, and alternative involuntary
 1383  assessment for minors, for purposes of assessment and
 1384  stabilization, and for involuntary treatment.—A person meets the
 1385  criteria for involuntary admission if there is good faith reason
 1386  to believe that the person is substance abuse impaired or has a
 1387  substance use disorder and a co-occurring mental health disorder
 1388  and, because of such impairment or disorder:
 1389         (1) Has lost the power of self-control with respect to
 1390  substance abuse; and
 1391         (2)(a) Is in need of substance abuse services and, by
 1392  reason of substance abuse impairment, his or her judgment has
 1393  been so impaired that he or she is incapable of appreciating his
 1394  or her need for such services and of making a rational decision
 1395  in that regard, although mere refusal to receive such services
 1396  does not constitute evidence of lack of judgment with respect to
 1397  his or her need for such services; or
 1398         (b) Without care or treatment, is likely to suffer from
 1399  neglect or refuse to care for himself or herself; that such
 1400  neglect or refusal poses a real and present threat of
 1401  substantial harm to his or her well-being; and that it is not
 1402  apparent that such harm may be avoided through the help of
 1403  willing, able, and responsible family members or friends or the
 1404  provision of other services, or there is substantial likelihood
 1405  that the person has inflicted, or threatened to or attempted to
 1406  inflict, or, unless admitted, is likely to inflict, physical
 1407  harm on himself, herself, or another.
 1408         Section 27. Subsection (1) of section 397.6751, Florida
 1409  Statutes, is amended to read:
 1410         397.6751 Service provider responsibilities regarding
 1411  involuntary admissions.—
 1412         (1) It is the responsibility of the service provider to:
 1413         (a) Ensure that a person who is admitted to a licensed
 1414  service component meets the admission criteria specified in s.
 1415  397.675;
 1416         (b) Ascertain whether the medical and behavioral conditions
 1417  of the person, as presented, are beyond the safe management
 1418  capabilities of the service provider;
 1419         (c) Provide for the admission of the person to the service
 1420  component that represents the most appropriate and least
 1421  restrictive available setting that is responsive to the person’s
 1422  treatment needs;
 1423         (d) Verify that the admission of the person to the service
 1424  component does not result in a census in excess of its licensed
 1425  service capacity;
 1426         (e) Determine whether the cost of services is within the
 1427  financial means of the person or those who are financially
 1428  responsible for the person’s care; and
 1429         (f) Take all necessary measures to ensure that each
 1430  individual in treatment is provided with a safe environment, and
 1431  to ensure that each individual whose medical condition or
 1432  behavioral problem becomes such that he or she cannot be safely
 1433  managed by the service component is discharged and referred to a
 1434  more appropriate setting for care.
 1435         Section 28. Section 397.681, Florida Statutes, is amended
 1436  to read:
 1437         397.681 Involuntary petitions; general provisions; court
 1438  jurisdiction and right to counsel.—
 1439         (1) JURISDICTION.—The courts have jurisdiction of
 1440  involuntary assessment and stabilization petitions and
 1441  involuntary treatment petitions for substance abuse impaired
 1442  persons, and such petitions must be filed with the clerk of the
 1443  court in the county where the person is located. The clerk of
 1444  the court may not charge a fee for the filing of a petition
 1445  under this section. The chief judge may appoint a general or
 1446  special magistrate to preside over all or part of the
 1447  proceedings. The alleged impaired person is named as the
 1448  respondent.
 1449         (2) RIGHT TO COUNSEL.—A respondent has the right to counsel
 1450  at every stage of a judicial proceeding relating to a petition
 1451  for his or her involuntary assessment and a petition for his or
 1452  her involuntary treatment for substance abuse impairment;
 1453  however, the respondent may waive that right if the respondent
 1454  is present and the court finds that such waiver is made
 1455  knowingly, intelligently, and voluntarily. A respondent who
 1456  desires counsel and is unable to afford private counsel has the
 1457  right to court-appointed counsel and to the benefits of s.
 1458  57.081. If the court believes that the respondent needs or
 1459  desires the assistance of counsel, the court shall appoint such
 1460  counsel for the respondent without regard to the respondent’s
 1461  wishes. If the respondent is a minor not otherwise represented
 1462  in the proceeding, the court shall immediately appoint a
 1463  guardian ad litem to act on the minor’s behalf.
 1464         Section 29. Section 397.693, Florida Statutes, is
 1465  renumbered as section 397.68111, Florida Statutes, and amended
 1466  to read:
 1467         397.68111 397.693 Involuntary treatment.—A person may be
 1468  the subject of a petition for court-ordered involuntary
 1469  treatment pursuant to this part, if that person:
 1470         (1)Reasonably appears to meet meets the criteria for
 1471  involuntary admission provided in s. 397.675; and:
 1472         (2)(1) Has been placed under protective custody pursuant to
 1473  s. 397.677 within the previous 10 days;
 1474         (3)(2) Has been subject to an emergency admission pursuant
 1475  to s. 397.679 within the previous 10 days; or
 1476         (4)(3) Has been assessed by a qualified professional within
 1477  30 5 days;
 1478         (4)Has been subject to involuntary assessment and
 1479  stabilization pursuant to s. 397.6818 within the previous 12
 1480  days; or
 1481         (5)Has been subject to alternative involuntary admission
 1482  pursuant to s. 397.6822 within the previous 12 days.
 1483         Section 30. Section 397.695, Florida Statutes, is
 1484  renumbered as section 397.68112, Florida Statutes, and amended
 1485  to read:
 1486         397.68112 397.695 Involuntary services; persons who may
 1487  petition.—
 1488         (1) If the respondent is an adult, a petition for
 1489  involuntary treatment services may be filed by the respondent’s
 1490  spouse or legal guardian, any relative, a service provider, or
 1491  an adult who has direct personal knowledge of the respondent’s
 1492  substance abuse impairment and his or her prior course of
 1493  assessment and treatment.
 1494         (2) If the respondent is a minor, a petition for
 1495  involuntary treatment services may be filed by a parent, legal
 1496  guardian, or service provider.
 1497         (3)The court may prohibit, or a law enforcement agency may
 1498  waive, any service of process fees if a petitioner is determined
 1499  to be indigent.
 1500         Section 31. Section 397.6951, Florida Statutes, is
 1501  renumbered as section 397.68141, Florida Statutes, and amended
 1502  to read:
 1503         397.68141 397.6951 Contents of petition for involuntary
 1504  treatment services.—A petition for involuntary services must
 1505  contain the name of the respondent; the name of the petitioner
 1506  or petitioners; the relationship between the respondent and the
 1507  petitioner; the name of the respondent’s attorney, if known; the
 1508  findings and recommendations of the assessment performed by the
 1509  qualified professional; and the factual allegations presented by
 1510  the petitioner establishing the need for involuntary outpatient
 1511  services for substance abuse impairment. The factual allegations
 1512  must demonstrate:
 1513         (1) The reason for the petitioner’s belief that the
 1514  respondent is substance abuse impaired;
 1515         (2) The reason for the petitioner’s belief that because of
 1516  such impairment the respondent has lost the power of self
 1517  control with respect to substance abuse; and
 1518         (3)(a) The reason the petitioner believes that the
 1519  respondent has inflicted or is likely to inflict physical harm
 1520  on himself or herself or others unless the court orders the
 1521  involuntary services; or
 1522         (b) The reason the petitioner believes that the
 1523  respondent’s refusal to voluntarily receive care is based on
 1524  judgment so impaired by reason of substance abuse that the
 1525  respondent is incapable of appreciating his or her need for care
 1526  and of making a rational decision regarding that need for care.
 1527         (4)The petition may be accompanied by a certificate or
 1528  report of a qualified professional who examined the respondent
 1529  within 30 days before the petition was filed. The certificate or
 1530  report must include the qualified professional’s findings
 1531  relating to his or her assessment of the patient and his or her
 1532  treatment recommendations. If the respondent was not assessed
 1533  before the filing of a treatment petition or refused to submit
 1534  to an evaluation, the lack of assessment or refusal must be
 1535  noted in the petition.
 1536         (5)If there is an emergency, the petition must also
 1537  describe the respondent’s exigent circumstances and include a
 1538  request for an ex parte assessment and stabilization order that
 1539  must be executed pursuant to s. 397.68151.
 1540         Section 32. Section 397.6955, Florida Statutes, is
 1541  renumbered as section 397.68151, Florida Statutes, and amended
 1542  to read:
 1543         397.68151 397.6955 Duties of court upon filing of petition
 1544  for involuntary services.—
 1545         (1) Upon the filing of a petition for involuntary services
 1546  for a substance abuse impaired person with the clerk of the
 1547  court, the court shall immediately determine whether the
 1548  respondent is represented by an attorney or whether the
 1549  appointment of counsel for the respondent is appropriate. If the
 1550  court appoints counsel for the person, the clerk of the court
 1551  shall immediately notify the office of criminal conflict and
 1552  civil regional counsel, created pursuant to s. 27.511, of the
 1553  appointment. The office of criminal conflict and civil regional
 1554  counsel shall represent the person until the petition is
 1555  dismissed, the court order expires, or the person is discharged
 1556  from involuntary treatment services, or the office is otherwise
 1557  discharged by the court. An attorney that represents the person
 1558  named in the petition shall have access to the person,
 1559  witnesses, and records relevant to the presentation of the
 1560  person’s case and shall represent the interests of the person,
 1561  regardless of the source of payment to the attorney.
 1562         (2) The court shall schedule a hearing to be held on the
 1563  petition within 10 court working 5 days unless a continuance is
 1564  granted. The court may appoint a magistrate to preside at the
 1565  hearing.
 1566         (3) A copy of the petition and notice of the hearing must
 1567  be provided to the respondent; the respondent’s parent,
 1568  guardian, or legal custodian, in the case of a minor; the
 1569  respondent’s attorney, if known; the petitioner; the
 1570  respondent’s spouse or guardian, if applicable; and such other
 1571  persons as the court may direct. If the respondent is a minor, a
 1572  copy of the petition and notice of the hearing must be
 1573  personally delivered to the respondent. The clerk court shall
 1574  also issue a summons to the person whose admission is sought and
 1575  unless a circuit court’s chief judge authorizes disinterested
 1576  private process servers to serve parties under this chapter, a
 1577  law enforcement agency must effect such service on the person
 1578  whose admission is sought for the initial treatment hearing.
 1579         Section 33. Section 397.6818, Florida Statutes, is amended
 1580  to read:
 1581         397.6818 Court determination.—
 1582         (1)When the petitioner asserts that emergency
 1583  circumstances exist, or when upon review of the petition the
 1584  court determines that an emergency exists, the court may rely
 1585  solely on the contents of the petition and, without the
 1586  appointment of an attorney, enter an ex parte order for the
 1587  respondent’s involuntary assessment and stabilization which must
 1588  be executed during the period when the hearing on the petition
 1589  for treatment is pending.
 1590         (2)The court may further order a law enforcement officer
 1591  or another designated agent of the court to:
 1592         (a)Take the respondent into custody and deliver him or her
 1593  for evaluation to either the nearest appropriate licensed
 1594  service provider or a licensed service provider designated by
 1595  the court.
 1596         (b)Serve the respondent with the notice of hearing and a
 1597  copy of the petition.
 1598         (3)The service provider may not hold the respondent for
 1599  longer than 72 hours of observation, unless:
 1600         (a)The service provider seeks additional time under s.
 1601  397.6957(1)(c) and the court, after a hearing, grants that
 1602  motion;
 1603         (b)The respondent shows signs of withdrawal, or a need to
 1604  be either detoxified or treated for a medical condition, which
 1605  shall extend the amount of time the respondent may be held for
 1606  observation until the issue is resolved but no later than the
 1607  scheduled hearing date, absent a court-approved extension; or
 1608         (c)The original or extended observation period ends on a
 1609  weekend or holiday, including the hours before the ordinary
 1610  business hours of the following workday morning, in which case
 1611  the provider may hold the respondent until the next court
 1612  working day.
 1613         (4)If the ex parte order was not executed by the initial
 1614  hearing date, it is deemed void. However, if the respondent does
 1615  not appear at the hearing for any reason, including lack of
 1616  service, and upon reviewing the petition, testimony, and
 1617  evidence presented, the court reasonably believes the respondent
 1618  meets this chapter’s commitment criteria and that a substance
 1619  abuse emergency exists, the court may issue or reissue an ex
 1620  parte assessment and stabilization order that is valid for 90
 1621  days. If the respondent’s location is known at the time of the
 1622  hearing, the court:
 1623         (a)Must continue the case for no more than 10 court
 1624  working days; and
 1625         (b)May order a law enforcement officer or another
 1626  designated agent of the court to:
 1627         1.Take the respondent into custody and deliver him or her
 1628  for evaluation to either the nearest appropriate licensed
 1629  service provider or a licensed service provider designated by
 1630  the court; and
 1631         2.If a hearing date is set, serve the respondent with
 1632  notice of the rescheduled hearing and a copy of the involuntary
 1633  treatment petition if the respondent has not already been
 1634  served.
 1635  
 1636  Otherwise, the petitioner must inform the court that the
 1637  respondent has been assessed so that the court may schedule a
 1638  hearing as soon as is practicable. However, if the respondent
 1639  has not been assessed within 90 days, the court must dismiss the
 1640  case. At the hearing initiated in accordance with s.
 1641  397.6811(1), the court shall hear all relevant testimony. The
 1642  respondent must be present unless the court has reason to
 1643  believe that his or her presence is likely to be injurious to
 1644  him or her, in which event the court shall appoint a guardian
 1645  advocate to represent the respondent. The respondent has the
 1646  right to examination by a court-appointed qualified
 1647  professional. After hearing all the evidence, the court shall
 1648  determine whether there is a reasonable basis to believe the
 1649  respondent meets the involuntary admission criteria of s.
 1650  397.675.
 1651         (1)Based on its determination, the court shall either
 1652  dismiss the petition or immediately enter an order authorizing
 1653  the involuntary assessment and stabilization of the respondent;
 1654  or, if in the course of the hearing the court has reason to
 1655  believe that the respondent, due to mental illness other than or
 1656  in addition to substance abuse impairment, is likely to injure
 1657  himself or herself or another if allowed to remain at liberty,
 1658  the court may initiate involuntary proceedings under the
 1659  provisions of part I of chapter 394.
 1660         (2)If the court enters an order authorizing involuntary
 1661  assessment and stabilization, the order shall include the
 1662  court’s findings with respect to the availability and
 1663  appropriateness of the least restrictive alternatives and the
 1664  need for the appointment of an attorney to represent the
 1665  respondent, and may designate the specific licensed service
 1666  provider to perform the involuntary assessment and stabilization
 1667  of the respondent. The respondent may choose the licensed
 1668  service provider to deliver the involuntary assessment where
 1669  possible and appropriate.
 1670         (3)If the court finds it necessary, it may order the
 1671  sheriff to take the respondent into custody and deliver him or
 1672  her to the licensed service provider specified in the court
 1673  order or, if none is specified, to the nearest appropriate
 1674  licensed service provider for involuntary assessment.
 1675         (4)The order is valid only for the period specified in the
 1676  order or, if a period is not specified, for 7 days after the
 1677  order is signed.
 1678         Section 34. Section 397.6957, Florida Statutes, is amended
 1679  to read:
 1680         397.6957 Hearing on petition for involuntary treatment
 1681  services.—
 1682         (1)(a)The respondent must be present at a hearing on a
 1683  petition for involuntary treatment services, unless the court
 1684  finds that he or she knowingly, intelligently, and voluntarily
 1685  waives his or her right to be present or, upon receiving proof
 1686  of service and evaluating the circumstances of the case, that
 1687  his or her presence is inconsistent with his or her best
 1688  interests or is likely to be injurious to self or others. The
 1689  court shall hear and review all relevant evidence, including
 1690  testimony from individuals such as family members familiar with
 1691  the respondent’s prior history and how it relates to his or her
 1692  current condition, and the review of results of the assessment
 1693  completed by the qualified professional in connection with this
 1694  chapter. The court may also order drug tests. Witnesses may
 1695  remotely attend and, as appropriate, testify
 1696  
 1697  ================= T I T L E  A M E N D M E N T ================
 1698  And the title is amended as follows:
 1699         Delete line 89
 1700  and insert:
 1701         hearing in certain circumstances through specified
 1702         means; providing