Florida Senate - 2025                             CS for SB 1240
       
       
        
       By the Committee on Children, Families, and Elder Affairs; and
       Senator Calatayud
       
       
       
       
       586-02608-25                                          20251240c1
    1                        A bill to be entitled                      
    2         An act relating to substance abuse and mental health
    3         care; amending s. 394.4573, F.S.; expanding mental
    4         health crisis services to include the 988 suicide and
    5         crisis lifeline call center; amending s. 394.4598,
    6         F.S.; authorizing the guardian advocate to be
    7         discharged when a patient is discharged from
    8         involuntary outpatient services; amending s. 394.4625,
    9         F.S.; requiring clinical psychologists who make
   10         determinations of involuntary placement at certain
   11         mental health facilities to have specified clinical
   12         experience; amending s. 394.4655, F.S.; providing
   13         cross-reference for specified criteria relating to
   14         orders to involuntary outpatient placement; amending
   15         s. 394.467, F.S.; providing that orders entered by
   16         administrative law judges for continued involuntary
   17         placement for patients at certain mental health
   18         facilities are final and subject to judicial review;
   19         requiring hearings to be scheduled immediately;
   20         requiring the clerk of the Division of Administrative
   21         Hearings to provide copies of petitions and
   22         individualized plans for continued services to the
   23         Department of Children and Families and other
   24         specified individuals; requiring the court or the
   25         administrative law judge to make certain
   26         determinations before waiving a patient’s attendance
   27         at a hearing for continued involuntary placement;
   28         authorizing an administrative law judge to issue an
   29         order for involuntary services if the patient meets
   30         certain criteria; amending s. 394.67, F.S.; revising
   31         the definition of “crisis services” to include a 988
   32         suicide and crisis lifeline call center and defining
   33         the term “988 suicide and crisis lifeline call
   34         center”; creating s. 394.9088, F.S.; requiring the
   35         Department of Children and Families to authorize and
   36         provide oversight of the 988 suicide and crisis
   37         lifeline call centers and adopt specified rules;
   38         amending s. 397.427, F.S.; removing requirements
   39         relating to providers of medication-assisted treatment
   40         services for opiate addiction; amending s. 916.111,
   41         F.S.; revising training requirements for mental health
   42         professionals; amending s. 916.115, F.S.; requiring
   43         court appointed experts to have completed specified
   44         training and continued education; amending s. 916.12,
   45         F.S.; providing requirements for an expert to
   46         determine acceptable treatments available in a
   47         community; amending ss. 394.674, 394.74, and 397.68141
   48         F.S.; conforming cross-references; providing an
   49         effective date.
   50          
   51  Be It Enacted by the Legislature of the State of Florida:
   52  
   53         Section 1. Paragraph (d) of subsection (2) of section
   54  394.4573, Florida Statutes, is amended to read:
   55         394.4573 Coordinated system of care; annual assessment;
   56  essential elements; measures of performance; system improvement
   57  grants; reports.—On or before December 1 of each year, the
   58  department shall submit to the Governor, the President of the
   59  Senate, and the Speaker of the House of Representatives an
   60  assessment of the behavioral health services in this state. The
   61  assessment shall consider, at a minimum, the extent to which
   62  designated receiving systems function as no-wrong-door models,
   63  the availability of treatment and recovery services that use
   64  recovery-oriented and peer-involved approaches, the availability
   65  of less-restrictive services, and the use of evidence-informed
   66  practices. The assessment shall also consider the availability
   67  of and access to coordinated specialty care programs and
   68  identify any gaps in the availability of and access to such
   69  programs in the state. The department’s assessment shall
   70  consider, at a minimum, the needs assessments conducted by the
   71  managing entities pursuant to s. 394.9082(5). The department
   72  shall compile and include in the report all plans submitted by
   73  managing entities pursuant to s. 394.9082(8) and the
   74  department’s evaluation of each plan.
   75         (2) The essential elements of a coordinated system of care
   76  include:
   77         (d) Crisis services, including the 988 suicide and crisis
   78  lifeline call center, mobile response teams, crisis
   79  stabilization units, addiction receiving facilities, and
   80  detoxification facilities.
   81         Section 2. Subsection (8) of section 394.4598, Florida
   82  Statutes, are amended to read:
   83         394.4598 Guardian advocate.—
   84         (8) The guardian advocate shall be discharged when the
   85  patient is discharged from an order for involuntary outpatient
   86  services placement or involuntary inpatient placement or when
   87  the patient is transferred from involuntary to voluntary status.
   88  The court or a hearing officer shall consider the competence of
   89  the patient pursuant to subsection (1) and may consider an
   90  involuntarily placed patient’s competence to consent to
   91  treatment at any hearing. Upon sufficient evidence, the court
   92  may restore, or the hearing officer may recommend that the court
   93  restore, the patient’s competence. A copy of the order restoring
   94  competence or the certificate of discharge containing the
   95  restoration of competence shall be provided to the patient and
   96  the guardian advocate.
   97         Section 3. Subsection (5) of section 394.4625, Florida
   98  Statutes, is amended to read:
   99         394.4625 Voluntary admissions.—
  100         (5) TRANSFER TO INVOLUNTARY STATUS.—When a voluntary
  101  patient, or an authorized person on the patient’s behalf, makes
  102  a request for discharge, the request for discharge, unless
  103  freely and voluntarily rescinded, must be communicated to a
  104  physician, a clinical psychologist with at least 3 years of
  105  clinical postdoctoral experience in the practice of clinical
  106  psychology, or a psychiatrist as quickly as possible, but not
  107  later than 12 hours after the request is made. If the patient
  108  meets the criteria for involuntary placement, the administrator
  109  of the facility must file with the court a petition for
  110  involuntary placement, within 2 court working days after the
  111  request for discharge is made. If the petition is not filed
  112  within 2 court working days, the patient must be discharged.
  113  Pending the filing of the petition, the patient may be held and
  114  emergency treatment rendered in the least restrictive manner,
  115  upon the order of a physician or a psychiatric nurse practicing
  116  within the framework of an established protocol with a
  117  psychiatrist, if it is determined that such treatment is
  118  necessary for the safety of the patient or others.
  119         Section 4. Subsection (2) of section 394.4655, Florida
  120  Statutes, is amended to read:
  121         394.4655 Orders to involuntary outpatient placement.—
  122         (2) A court or a county court may order an individual to
  123  involuntary outpatient placement under s. 394.467. The criteria
  124  for ordering a person to involuntary outpatient placement, as
  125  well as all of the requirements and processes for placement,
  126  including, but not limited to, recommendations for involuntary
  127  outpatient placement, petitions, appointment of counsel, and
  128  hearings on involuntary outpatient placement are provided in s.
  129  394.467.
  130         (3)When recommending an order to involuntary outpatient
  131  placement, the petitioner, as defined in s. 394.467(4), shall
  132  prepare a services plan for the patient in accordance with s.
  133  394.467.
  134         Section 5. Paragraph (a) of subsection (1) and subsection
  135  (11) of section 394.467, Florida Statutes, are amended to read:
  136         394.467 Involuntary inpatient placement and involuntary
  137  outpatient services.—
  138         (1) DEFINITIONS.—As used in this section, the term:
  139         (a) “Court” means a circuit court or, for commitments only
  140  to involuntary outpatient services as defined in s. 394.4655, a
  141  county court.
  142         (11) PROCEDURE FOR CONTINUED INVOLUNTARY SERVICES.—
  143         (a) A petition for continued involuntary services must be
  144  filed if the patient continues to meet meets the criteria for
  145  involuntary services.
  146         (b)1. If a patient receiving involuntary outpatient
  147  services continues to meet the criteria for involuntary
  148  outpatient services, the service provider must file in the court
  149  that issued the initial order for involuntary outpatient
  150  services a petition for continued involuntary outpatient
  151  services.
  152         2. If a patient in involuntary inpatient placement
  153  continues to meet the criteria for involuntary services and is
  154  being treated at a receiving facility, the administrator must,
  155  before the expiration of the period the receiving facility is
  156  authorized to retain the patient, file in the court that issued
  157  the initial order for involuntary inpatient placement, a
  158  petition requesting authorization for continued involuntary
  159  services. The administrator may petition for inpatient or
  160  outpatient services.
  161         3. If a patient in involuntary inpatient placement
  162  continues to meet the criteria for involuntary services and is
  163  being treated at a treatment facility, the administrator must,
  164  before expiration of the period the treatment facility is
  165  authorized to retain the patient, file a petition requesting
  166  authorization for continued involuntary services. The
  167  administrator may petition for inpatient or outpatient services.
  168  Hearings on petitions for continued involuntary services of an
  169  individual placed at any treatment facility are administrative
  170  hearings and must be conducted in accordance with s. 120.57(1),
  171  except that any order entered by the administrative law judge is
  172  final and subject to judicial review in accordance with s.
  173  120.68. Orders concerning patients committed after successfully
  174  pleading not guilty by reason of insanity are governed by s.
  175  916.15.
  176         4. The court shall immediately schedule A hearing on the
  177  petition shall to be scheduled immediately and held within 15
  178  days after the petition is filed.
  179         5. The existing involuntary services order shall remain in
  180  effect until disposition on the petition for continued
  181  involuntary services.
  182         (c) The petition must be accompanied by a statement from
  183  the patient’s physician, psychiatrist, psychiatric nurse, or
  184  clinical psychologist justifying the request, a brief
  185  description of the patient’s treatment during the time he or she
  186  was receiving involuntary services, and an individualized plan
  187  of continued treatment developed in consultation with the
  188  patient or the patient’s guardian advocate, if applicable. If
  189  the petition is for involuntary outpatient services, it must
  190  comply with the requirements of subparagraph (4)(d)3. When the
  191  petition has been filed, the clerk of the court or the clerk of
  192  the Division of Administrative Hearings, as applicable, shall
  193  provide copies of the petition and the individualized plan of
  194  continued services to the department, the patient, the patient’s
  195  guardian advocate, the state attorney, and the patient’s private
  196  counsel or the public defender.
  197         (d) The court shall appoint counsel to represent the person
  198  who is the subject of the petition for continued involuntary
  199  services in accordance with the provisions set forth in
  200  subsection (5), unless the person is otherwise represented by
  201  counsel or ineligible.
  202         (e) Hearings on petitions for continued involuntary
  203  outpatient services must be before the court that issued the
  204  order for involuntary outpatient services. However, the patient
  205  and the patient’s attorney may agree to a period of continued
  206  outpatient services without a court hearing.
  207         (f) Hearings on petitions for continued involuntary
  208  inpatient placement in receiving facilities, or involuntary
  209  outpatient services following involuntary inpatient services,
  210  must be held in the county or the facility, as appropriate,
  211  where the patient is located.
  212         (g) The court may appoint a magistrate to preside at the
  213  hearing. The procedures for obtaining an order pursuant to this
  214  paragraph must meet the requirements of subsection (7).
  215         (h) Notice of the hearing must be provided as set forth in
  216  s. 394.4599.
  217         (i) If a patient’s attendance at the hearing is voluntarily
  218  waived, the court or the administrative law judge must determine
  219  that the patient knowingly, intelligently, and voluntarily
  220  waived his or her right to be present, before waiving the
  221  presence of the patient from all or a portion of the hearing.
  222  Alternatively, if at the hearing the court or the administrative
  223  law judge finds that attendance at the hearing is not consistent
  224  with the best interests of the patient, the court or the
  225  administrative law judge may waive the presence of the patient
  226  from all or any portion of the hearing, unless the patient,
  227  through counsel, objects to the waiver of presence. The
  228  testimony in the hearing must be under oath, and the proceedings
  229  must be recorded.
  230         (j) If at a hearing it is shown that the patient continues
  231  to meet the criteria for involuntary services, the court or the
  232  administrative law shall issue an order for continued
  233  involuntary outpatient services, involuntary inpatient
  234  placement, or a combination of involuntary services for up to 6
  235  months. The same procedure shall be repeated before the
  236  expiration of each additional period the patient is retained.
  237         (k) If the patient has been ordered to undergo involuntary
  238  services and has previously been found incompetent to consent to
  239  treatment, the court shall consider testimony and evidence
  240  regarding the patient’s competence. If the patient’s competency
  241  to consent to treatment is restored, the discharge of the
  242  guardian advocate is governed by s. 394.4598. If the patient has
  243  been ordered to undergo involuntary inpatient placement only and
  244  the patient’s competency to consent to treatment is restored,
  245  the administrative law judge may issue a recommended order, to
  246  the court that found the patient incompetent to consent to
  247  treatment, that the patient’s competence be restored and that
  248  any guardian advocate previously appointed be discharged.
  249         (l) If continued involuntary inpatient placement is
  250  necessary for a patient in involuntary inpatient placement who
  251  was admitted while serving a criminal sentence, but his or her
  252  sentence is about to expire, or for a minor involuntarily
  253  placed, but who is about to reach the age of 18, the
  254  administrator shall petition the administrative law judge for an
  255  order authorizing continued involuntary inpatient placement.
  256  
  257  The procedure required in this subsection must be followed
  258  before the expiration of each additional period the patient is
  259  involuntarily receiving services.
  260         Section 6. Present subsections (1) through (25) of section
  261  394.67, Florida Statutes, are redesignated as subsections (2)
  262  through (26), respectively, subsection (4) is amended, and a new
  263  subsection (1) is added to that section, to read:
  264         394.67 Definitions.—As used in this part, the term:
  265         (1)“988 suicide and crisis lifeline call center” means a
  266  call center meeting national accreditation and recognized by the
  267  department to receive 988 calls, texts, or other forms of
  268  communication in this state.
  269         (4) “Crisis services” means short-term evaluation,
  270  stabilization, and brief intervention services provided to a
  271  person who is experiencing an acute mental or emotional crisis,
  272  as defined in subsection (19) (18), or an acute substance abuse
  273  crisis, as defined in subsection (20) (19), to prevent further
  274  deterioration of the person’s mental health. Crisis services are
  275  provided in settings such as a crisis stabilization unit, an
  276  inpatient unit, a short-term residential treatment program, a
  277  detoxification facility, or an addictions receiving facility; at
  278  the site of the crisis by a mobile crisis response team; or at a
  279  hospital on an outpatient basis; or telephonically by a 988
  280  suicide and crisis lifeline call center.
  281         Section 7. Section 394.9088, Florida Statutes, is created
  282  to read:
  283         394.9088988 suicide and crisis lifeline call center.—
  284         (1)The department shall authorize and provide oversight to
  285  988 suicide and crisis lifeline call centers. Unless authorized
  286  by the department, call centers are not permitted to conduct 988
  287  suicide and crisis lifeline services. The department may
  288  implement a corrective action plan, suspension, or revocation of
  289  authorization for failure to comply with this section and rules
  290  adopted under this section.
  291         (2)The department shall adopt rules relating to:
  292         (a)The process for authorization of 988 suicide and crisis
  293  lifeline call centers.
  294         (b)Minimum standards for 988 suicide and crisis lifeline
  295  call centers to be authorized, including but not limited to,
  296  service delivery, quality of care, and performance outcomes.
  297         (c)The adequacy and consistency of 988 suicide and crisis
  298  lifeline call centers’ personnel certifications, accreditations,
  299  quality assurance standards, and minimum training standards.
  300         (d)Implementation of a cohesive statewide plan for 988
  301  suicide and crisis lifeline call centers to achieve statewide
  302  interoperability with the 911 system and to provide individuals
  303  with rapid and direct access to the appropriate care.
  304         Section 8. Present subsections (3) through (9) of section
  305  397.427, Florida Statutes, are redesignated as subsections (2)
  306  through (8), respectively, and present subsections (2) and (5)
  307  of that section are amended, to read:
  308         397.427 Medication-assisted treatment service providers;
  309  rehabilitation program; needs assessment and provision of
  310  services; persons authorized to issue takeout medication;
  311  unlawful operation; penalty.—
  312         (2)The department shall determine the need for
  313  establishing providers of medication-assisted treatment services
  314  for opiate addiction.
  315         (a)Providers of medication-assisted treatment services for
  316  opiate addiction may be established only in response to the
  317  department’s determination and publication of need for
  318  additional medication treatment services.
  319         (b)If needs assessment is required, the department shall
  320  annually conduct the assessment and publish a statement of
  321  findings which identifies each substate entity’s need.
  322         (c)Notwithstanding paragraphs (a) and (b), the license for
  323  medication-assisted treatment programs for opiate addiction
  324  licensed before October 1, 1990, may not be revoked solely
  325  because of the department’s determination concerning the need
  326  for medication-assisted treatment services for opiate addiction.
  327         (4)(5)The department shall also determine the need for
  328  establishing medication-assisted treatment for substance use
  329  disorders other than opiate dependence. Service providers within
  330  the publicly funded system shall be funded for provision of
  331  these services based on the availability of funds.
  332         Section 9. Subsection (3) of section 397.68141, Florida
  333  Statutes, is amended to read:
  334         397.68141 Contents of petition for involuntary treatment
  335  services.—A petition for involuntary services must contain the
  336  name of the respondent; the name of the petitioner; the
  337  relationship between the respondent and the petitioner; the name
  338  of the respondent’s attorney, if known; and the factual
  339  allegations presented by the petitioner establishing the need
  340  for involuntary services for substance abuse impairment.
  341         (3) If there is an emergency, the petition must also
  342  describe the respondent’s exigent circumstances and include a
  343  request for an ex parte assessment and stabilization order that
  344  must be executed pursuant to s. 397.6818 s. 397.68151.
  345         Section 10. Section 916.111, Florida Statutes, is amended
  346  to read:
  347         916.111 Training of mental health experts.—The evaluation
  348  of defendants for competency to proceed or for sanity at the
  349  time of the commission of the offense shall be conducted in such
  350  a way as to ensure uniform application of the criteria
  351  enumerated in Rules 3.210 and 3.216, Florida Rules of Criminal
  352  Procedure. The department shall develop, and may contract with
  353  accredited institutions:
  354         (1) To provide:
  355         (a) A plan for training mental health professionals to
  356  perform forensic evaluations and to standardize the criteria and
  357  procedures to be used in these evaluations;
  358         (b) Clinical protocols and procedures based upon the
  359  criteria of Rules 3.210 and 3.216, Florida Rules of Criminal
  360  Procedure; and
  361         (c) Training for mental health professionals in the
  362  application of these protocols and procedures in performing
  363  forensic evaluations and providing reports to the courts.
  364  Training must include, but is not limited to, information on
  365  statutes and rules related to competency restoration, evidence
  366  based practices, least restrictive treatment alternatives and
  367  placement options as described in s. 916.12(4)(c); and
  368         (2) To compile and maintain the necessary information for
  369  evaluating the success of this program, including the number of
  370  persons trained, the cost of operating the program, and the
  371  effect on the quality of forensic evaluations as measured by
  372  appropriateness of admissions to state forensic facilities and
  373  to community-based care programs.
  374         Section 11. Subsection (1) of section 916.115, Florida
  375  Statutes, is amended to read:
  376         916.115 Appointment of experts.—
  377         (1) The court shall appoint no more than three experts to
  378  determine the mental condition of a defendant in a criminal
  379  case, including competency to proceed, insanity, involuntary
  380  placement, and treatment. The experts may evaluate the defendant
  381  in jail or in another appropriate local facility or in a
  382  facility of the Department of Corrections.
  383         (a) The court To the extent possible, The appointed experts
  384  shall:
  385         1.have completed forensic evaluator training approved by
  386  the department, and each shall Be a psychiatrist, licensed
  387  psychologist, or physician.
  388         2.Have completed initial and ongoing forensic evaluator
  389  training, provided by the department.
  390         3.If performing juvenile evaluations, complete annually,
  391  juvenile forensic competency evaluation training approved by the
  392  department.
  393         (b)Existing evaluators shall complete department-provided
  394  continuing education training by July 1, 2026, to remain active
  395  on the list.
  396         (c)(b) The department shall maintain and annually provide
  397  the courts with a list of available mental health professionals
  398  who have completed the initial and annual approved training as
  399  experts.
  400         Section 12. Paragraph (d) of subsection (4) of section
  401  916.12, Florida Statutes, is amended to read:
  402         916.12 Mental competence to proceed.—
  403         (4) If an expert finds that the defendant is incompetent to
  404  proceed, the expert shall report on any recommended treatment
  405  for the defendant to attain competence to proceed. In
  406  considering the issues relating to treatment, the examining
  407  expert shall specifically report on:
  408         (d) The availability of acceptable treatment and, if
  409  treatment is available in the community, the expert shall so
  410  state in the report. In determining what acceptable treatments
  411  are available in the community, the expert shall, at a minimum,
  412  use current information or resources on less restrictive
  413  treatment alternatives, as described in paragraph (c) and those
  414  obtained from training and continuing education approved by the
  415  department.
  416  
  417  The examining expert’s report to the court shall include a full
  418  and detailed explanation regarding why the alternative treatment
  419  options referenced in the evaluation are insufficient to meet
  420  the needs of the defendant.
  421         Section 13. Paragraph (a) of subsection (1) of section
  422  394.674, Florida Statutes, is amended to read:
  423         394.674 Eligibility for publicly funded substance abuse and
  424  mental health services; fee collection requirements.—
  425         (1) To be eligible to receive substance abuse and mental
  426  health services funded by the department, an individual must be
  427  a member of at least one of the department’s priority
  428  populations approved by the Legislature. The priority
  429  populations include:
  430         (a) For adult mental health services:
  431         1. Adults who have severe and persistent mental illness, as
  432  designated by the department using criteria that include
  433  severity of diagnosis, duration of the mental illness, ability
  434  to independently perform activities of daily living, and receipt
  435  of disability income for a psychiatric condition. Included
  436  within this group are:
  437         a. Older adults in crisis.
  438         b. Older adults who are at risk of being placed in a more
  439  restrictive environment because of their mental illness.
  440         c. Persons deemed incompetent to proceed or not guilty by
  441  reason of insanity under chapter 916.
  442         d. Other persons involved in the criminal justice system.
  443         e. Persons diagnosed as having co-occurring mental illness
  444  and substance abuse disorders.
  445         2. Persons who are experiencing an acute mental or
  446  emotional crisis as defined in s. 394.67 s. 394.67(18).
  447         Section 14. Paragraph (a) of subsection (3) of section
  448  394.74, Florida Statutes, is amended to read:
  449         394.74 Contracts for provision of local substance abuse and
  450  mental health programs.—
  451         (3) Contracts shall include, but are not limited to:
  452         (a) A provision that, within the limits of available
  453  resources, substance abuse and mental health crisis services, as
  454  defined in s. 394.67 s. 394.67(4), shall be available to any
  455  individual residing or employed within the service area,
  456  regardless of ability to pay for such services, current or past
  457  health condition, or any other factor;
  458         Section 15. This act shall take effect July 1, 2025.