Florida Senate - 2025 CS for CS for CS for SB 1240
By the Committee on Rules; the Appropriations Committee on
Health and Human Services; the Committee on Children, Families,
and Elder Affairs; and Senator Calatayud
595-03801-25 20251240c3
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. 394.463, F.S.; providing that
13 a designated facility that has received the transfer
14 of a patient outside a specified timeframe or that
15 does not receive timely notification of a transfer may
16 not release such patient or be ordered by a court to
17 release such patient under specified circumstances;
18 amending s. 394.4655, F.S.; providing a cross
19 reference for specified criteria relating to orders to
20 involuntary outpatient placement; amending s. 394.467,
21 F.S.; revising the definition of the term “court”;
22 providing that orders entered by administrative law
23 judges for continued involuntary placement for
24 patients at certain mental health facilities are final
25 and subject to judicial review; requiring that
26 hearings on petitions for certain continued
27 involuntary services be scheduled immediately;
28 requiring the clerk of the Division of Administrative
29 Hearings to provide copies of petitions and
30 individualized plans for continued services to the
31 Department of Children and Families and other
32 specified individuals; requiring the court or the
33 administrative law judge to make certain
34 determinations before waiving a patient’s attendance
35 at a hearing for continued involuntary placement;
36 authorizing an administrative law judge to issue an
37 order for involuntary services if the patient meets
38 certain criteria; amending s. 394.67, F.S.; defining
39 the term “988 suicide and crisis lifeline call
40 center”; revising the definition of the term “crisis
41 services” to include a 988 suicide and crisis lifeline
42 call center; creating s. 394.9088, F.S.; requiring the
43 department to authorize and provide oversight of the
44 988 suicide and crisis lifeline call centers;
45 authorizing the department to take certain actions for
46 failure to comply with certain provisions; requiring
47 the department to adopt specified rules; amending s.
48 397.427, F.S.; deleting requirements relating to
49 providers of medication-assisted treatment services
50 for opiate addiction; amending s. 916.111, F.S.;
51 revising training requirements for mental health
52 professionals; amending s. 916.115, F.S.; requiring
53 certain court-appointed experts to have completed
54 specified training and continued education; amending
55 s. 916.12, F.S.; providing requirements for an
56 examining expert to determine acceptable treatments
57 available in a community; amending ss. 394.674,
58 394.74, and 397.68141, F.S.; conforming cross
59 references; providing an effective date.
60
61 Be It Enacted by the Legislature of the State of Florida:
62
63 Section 1. Paragraph (d) of subsection (2) of section
64 394.4573, Florida Statutes, is amended to read:
65 394.4573 Coordinated system of care; annual assessment;
66 essential elements; measures of performance; system improvement
67 grants; reports.—On or before December 1 of each year, the
68 department shall submit to the Governor, the President of the
69 Senate, and the Speaker of the House of Representatives an
70 assessment of the behavioral health services in this state. The
71 assessment shall consider, at a minimum, the extent to which
72 designated receiving systems function as no-wrong-door models,
73 the availability of treatment and recovery services that use
74 recovery-oriented and peer-involved approaches, the availability
75 of less-restrictive services, and the use of evidence-informed
76 practices. The assessment shall also consider the availability
77 of and access to coordinated specialty care programs and
78 identify any gaps in the availability of and access to such
79 programs in the state. The department’s assessment shall
80 consider, at a minimum, the needs assessments conducted by the
81 managing entities pursuant to s. 394.9082(5). The department
82 shall compile and include in the report all plans submitted by
83 managing entities pursuant to s. 394.9082(8) and the
84 department’s evaluation of each plan.
85 (2) The essential elements of a coordinated system of care
86 include:
87 (d) Crisis services, including the 988 suicide and crisis
88 lifeline call center, mobile response teams, crisis
89 stabilization units, addiction receiving facilities, and
90 detoxification facilities.
91 Section 2. Subsection (8) of section 394.4598, Florida
92 Statutes, is amended to read:
93 394.4598 Guardian advocate.—
94 (8) The guardian advocate shall be discharged when the
95 patient is discharged from an order for involuntary outpatient
96 services placement or involuntary inpatient placement or when
97 the patient is transferred from involuntary to voluntary status.
98 The court or a hearing officer shall consider the competence of
99 the patient pursuant to subsection (1) and may consider an
100 involuntarily placed patient’s competence to consent to
101 treatment at any hearing. Upon sufficient evidence, the court
102 may restore, or the hearing officer may recommend that the court
103 restore, the patient’s competence. A copy of the order restoring
104 competence or the certificate of discharge containing the
105 restoration of competence shall be provided to the patient and
106 the guardian advocate.
107 Section 3. Subsection (5) of section 394.4625, Florida
108 Statutes, is amended to read:
109 394.4625 Voluntary admissions.—
110 (5) TRANSFER TO INVOLUNTARY STATUS.—When a voluntary
111 patient, or an authorized person on the patient’s behalf, makes
112 a request for discharge, the request for discharge, unless
113 freely and voluntarily rescinded, must be communicated to a
114 physician, a clinical psychologist with at least 3 years of
115 clinical postdoctoral experience in the practice of clinical
116 psychology, or a psychiatrist as quickly as possible, but not
117 later than 12 hours after the request is made. If the patient
118 meets the criteria for involuntary placement, the administrator
119 of the facility must file with the court a petition for
120 involuntary placement, within 2 court working days after the
121 request for discharge is made. If the petition is not filed
122 within 2 court working days, the patient must be discharged.
123 Pending the filing of the petition, the patient may be held and
124 emergency treatment rendered in the least restrictive manner,
125 upon the order of a physician or a psychiatric nurse practicing
126 within the framework of an established protocol with a
127 psychiatrist, if it is determined that such treatment is
128 necessary for the safety of the patient or others.
129 Section 4. Paragraph (i) of subsection (2) of section
130 394.463, Florida Statutes, is amended to read:
131 394.463 Involuntary examination.—
132 (2) INVOLUNTARY EXAMINATION.—
133 (i) One of the following must occur within 12 hours after
134 the patient’s attending physician documents that the patient’s
135 medical condition has stabilized or that an emergency medical
136 condition does not exist:
137 1. The patient must be examined by a facility and released;
138 or
139 2. The patient must be transferred to a designated facility
140 in which appropriate medical treatment is available. However,
141 the facility must be notified of the transfer within 2 hours
142 after the patient’s condition has been stabilized or after
143 determination that an emergency medical condition does not
144 exist. If a physician at the designated facility to which the
145 patient was transferred examines the patient and documents that
146 the patient still poses a threat to himself or herself or to
147 others, the designated facility may not release or be ordered by
148 a court to release the patient based solely on a failure to meet
149 either the 12-hour transfer requirement or the 2-hour notice
150 requirement of this section, unless the patient’s 72-hour
151 examination period has ended.
152 Section 5. Subsection (2) of section 394.4655, Florida
153 Statutes, is amended, and subsection (3) is added to that
154 section, to read:
155 394.4655 Orders to involuntary outpatient placement.—
156 (2) A court or a county court may order an individual to
157 involuntary outpatient placement under s. 394.467. The criteria
158 for ordering a person to involuntary outpatient placement, as
159 well as all of the requirements and processes for placement,
160 including, but not limited to, recommendations for involuntary
161 outpatient placement, petitions, appointment of counsel, and
162 hearings on involuntary outpatient placement, are provided in s.
163 394.467.
164 (3) When recommending an order to involuntary outpatient
165 placement, the petitioner, as defined in s. 394.467(4), shall
166 prepare a services plan for the patient in accordance with s.
167 394.467.
168 Section 6. Paragraph (a) of subsection (1) and subsection
169 (11) of section 394.467, Florida Statutes, are amended to read:
170 394.467 Involuntary inpatient placement and involuntary
171 outpatient services.—
172 (1) DEFINITIONS.—As used in this section, the term:
173 (a) “Court” means a circuit court or, for commitments only
174 to involuntary outpatient services as defined in s. 394.4655, a
175 county court.
176 (11) PROCEDURE FOR CONTINUED INVOLUNTARY SERVICES.—
177 (a) A petition for continued involuntary services must be
178 filed if the patient continues to meet meets the criteria for
179 involuntary services.
180 (b)1. If a patient receiving involuntary outpatient
181 services continues to meet the criteria for involuntary
182 outpatient services, the service provider must file in the court
183 that issued the initial order for involuntary outpatient
184 services a petition for continued involuntary outpatient
185 services.
186 2. If a patient in involuntary inpatient placement
187 continues to meet the criteria for involuntary services and is
188 being treated at a receiving facility, the administrator must,
189 before the expiration of the period the receiving facility is
190 authorized to retain the patient, file in the court that issued
191 the initial order for involuntary inpatient placement, a
192 petition requesting authorization for continued involuntary
193 services. The administrator may petition for inpatient or
194 outpatient services.
195 3. If a patient in involuntary inpatient placement
196 continues to meet the criteria for involuntary services and is
197 being treated at a treatment facility, the administrator must,
198 before expiration of the period the treatment facility is
199 authorized to retain the patient, file a petition requesting
200 authorization for continued involuntary services. The
201 administrator may petition for inpatient or outpatient services.
202 Hearings on petitions for continued involuntary services of an
203 individual placed at any treatment facility are administrative
204 hearings and must be conducted in accordance with s. 120.57(1),
205 except that any order entered by the administrative law judge is
206 final and subject to judicial review in accordance with s.
207 120.68. Orders concerning patients committed after successfully
208 pleading not guilty by reason of insanity are governed by s.
209 916.15.
210 4. The court shall immediately schedule A hearing on the
211 petition shall to be scheduled immediately and held within 15
212 days after the petition is filed.
213 5. The existing involuntary services order shall remain in
214 effect until disposition on the petition for continued
215 involuntary services.
216 (c) The petition must be accompanied by a statement from
217 the patient’s physician, psychiatrist, psychiatric nurse, or
218 clinical psychologist justifying the request, a brief
219 description of the patient’s treatment during the time he or she
220 was receiving involuntary services, and an individualized plan
221 of continued treatment developed in consultation with the
222 patient or the patient’s guardian advocate, if applicable. If
223 the petition is for involuntary outpatient services, it must
224 comply with the requirements of subparagraph (4)(d)3. When the
225 petition has been filed, the clerk of the court or the clerk of
226 the Division of Administrative Hearings, as applicable, shall
227 provide copies of the petition and the individualized plan of
228 continued services to the department, the patient, the patient’s
229 guardian advocate, the state attorney, and the patient’s private
230 counsel or the public defender.
231 (d) The court shall appoint counsel to represent the person
232 who is the subject of the petition for continued involuntary
233 services in accordance with the provisions set forth in
234 subsection (5), unless the person is otherwise represented by
235 counsel or ineligible.
236 (e) Hearings on petitions for continued involuntary
237 outpatient services must be before the court that issued the
238 order for involuntary outpatient services. However, the patient
239 and the patient’s attorney may agree to a period of continued
240 outpatient services without a court hearing.
241 (f) Hearings on petitions for continued involuntary
242 inpatient placement in receiving facilities, or involuntary
243 outpatient services following involuntary inpatient services,
244 must be held in the county or the facility, as appropriate,
245 where the patient is located.
246 (g) The court may appoint a magistrate to preside at the
247 hearing. The procedures for obtaining an order pursuant to this
248 paragraph must meet the requirements of subsection (7).
249 (h) Notice of the hearing must be provided as set forth in
250 s. 394.4599.
251 (i) If a patient’s attendance at the hearing is voluntarily
252 waived, the court or the administrative law judge must determine
253 that the patient knowingly, intelligently, and voluntarily
254 waived his or her right to be present, before waiving the
255 presence of the patient from all or a portion of the hearing.
256 Alternatively, if at the hearing the court or the administrative
257 law judge finds that attendance at the hearing is not consistent
258 with the best interests of the patient, the court or the
259 administrative law judge may waive the presence of the patient
260 from all or any portion of the hearing, unless the patient,
261 through counsel, objects to the waiver of presence. The
262 testimony in the hearing must be under oath, and the proceedings
263 must be recorded.
264 (j) If at a hearing it is shown that the patient continues
265 to meet the criteria for involuntary services, the court or the
266 administrative law judge shall issue an order for continued
267 involuntary outpatient services, involuntary inpatient
268 placement, or a combination of involuntary services for up to 6
269 months. The same procedure shall be repeated before the
270 expiration of each additional period the patient is retained.
271 (k) If the patient has been ordered to undergo involuntary
272 services and has previously been found incompetent to consent to
273 treatment, the court shall consider testimony and evidence
274 regarding the patient’s competence. If the patient’s competency
275 to consent to treatment is restored, the discharge of the
276 guardian advocate is governed by s. 394.4598. If the patient has
277 been ordered to undergo involuntary inpatient placement only and
278 the patient’s competency to consent to treatment is restored,
279 the administrative law judge may issue a recommended order, to
280 the court that found the patient incompetent to consent to
281 treatment, that the patient’s competence be restored and that
282 any guardian advocate previously appointed be discharged.
283 (l) If continued involuntary inpatient placement is
284 necessary for a patient in involuntary inpatient placement who
285 was admitted while serving a criminal sentence, but his or her
286 sentence is about to expire, or for a minor involuntarily
287 placed, but who is about to reach the age of 18, the
288 administrator shall petition the administrative law judge for an
289 order authorizing continued involuntary inpatient placement.
290
291 The procedure required in this subsection must be followed
292 before the expiration of each additional period the patient is
293 involuntarily receiving services.
294 Section 7. Present subsections (1) through (25) of section
295 394.67, Florida Statutes, are redesignated as subsections (2)
296 through (26), respectively, a new subsection (1) is added to
297 that section, and present subsection (4) of that section is
298 amended, to read:
299 394.67 Definitions.—As used in this part, the term:
300 (1) “988 suicide and crisis lifeline call center” means a
301 call center meeting national accreditation and recognized by the
302 department to receive 988 calls, texts, or other forms of
303 communication in this state.
304 (5)(4) “Crisis services” means short-term evaluation,
305 stabilization, and brief intervention services provided to a
306 person who is experiencing an acute mental or emotional crisis,
307 as defined in subsection (19) (18), or an acute substance abuse
308 crisis, as defined in subsection (20) (19), to prevent further
309 deterioration of the person’s mental health. Crisis services are
310 provided in settings such as a crisis stabilization unit, an
311 inpatient unit, a short-term residential treatment program, a
312 detoxification facility, or an addictions receiving facility; at
313 the site of the crisis by a mobile crisis response team; or at a
314 hospital on an outpatient basis; or telephonically by a 988
315 suicide and crisis lifeline call center.
316 Section 8. Section 394.9088, Florida Statutes, is created
317 to read:
318 394.9088 988 suicide and crisis lifeline call center.—
319 (1) The department shall authorize and provide oversight to
320 988 suicide and crisis lifeline call centers. Unless authorized
321 by the department, call centers are not permitted to conduct 988
322 suicide and crisis lifeline services. The department may
323 implement a corrective action plan, suspension, or revocation of
324 authorization for failure to comply with this section and rules
325 adopted under this section.
326 (2) The department shall adopt rules relating to:
327 (a) The process for authorization of 988 suicide and crisis
328 lifeline call centers.
329 (b) Minimum standards for 988 suicide and crisis lifeline
330 call centers to be authorized, including but not limited to,
331 service delivery, quality of care, and performance outcomes.
332 (c) The adequacy and consistency of 988 suicide and crisis
333 lifeline call centers’ personnel certifications, accreditations,
334 quality assurance standards, and minimum training standards.
335 (d) Implementation of a cohesive statewide plan for 988
336 suicide and crisis lifeline call centers to achieve statewide
337 interoperability with the 911 system and to provide individuals
338 with rapid and direct access to the appropriate care.
339 Section 9. Present subsections (3) through (9) of section
340 397.427, Florida Statutes, are redesignated as subsections (2)
341 through (8), respectively, and present subsections (2) and (5)
342 of that section are amended, to read:
343 397.427 Medication-assisted treatment service providers;
344 rehabilitation program; needs assessment and provision of
345 services; persons authorized to issue takeout medication;
346 unlawful operation; penalty.—
347 (2) The department shall determine the need for
348 establishing providers of medication-assisted treatment services
349 for opiate addiction.
350 (a) Providers of medication-assisted treatment services for
351 opiate addiction may be established only in response to the
352 department’s determination and publication of need for
353 additional medication treatment services.
354 (b) If needs assessment is required, the department shall
355 annually conduct the assessment and publish a statement of
356 findings which identifies each substate entity’s need.
357 (c) Notwithstanding paragraphs (a) and (b), the license for
358 medication-assisted treatment programs for opiate addiction
359 licensed before October 1, 1990, may not be revoked solely
360 because of the department’s determination concerning the need
361 for medication-assisted treatment services for opiate addiction.
362 (4)(5) The department shall also determine the need for
363 establishing medication-assisted treatment for substance use
364 disorders other than opiate dependence. Service providers within
365 the publicly funded system shall be funded for provision of
366 these services based on the availability of funds.
367 Section 10. Section 916.111, Florida Statutes, is amended
368 to read:
369 916.111 Training of mental health experts.—The evaluation
370 of defendants for competency to proceed or for sanity at the
371 time of the commission of the offense shall be conducted in such
372 a way as to ensure uniform application of the criteria
373 enumerated in Rules 3.210 and 3.216, Florida Rules of Criminal
374 Procedure. The department shall develop, and may contract with
375 accredited institutions:
376 (1) To provide:
377 (a) A plan for training mental health professionals to
378 perform forensic evaluations and to standardize the criteria and
379 procedures to be used in these evaluations;
380 (b) Clinical protocols and procedures based upon the
381 criteria of Rules 3.210 and 3.216, Florida Rules of Criminal
382 Procedure; and
383 (c) Training for mental health professionals in the
384 application of these protocols and procedures in performing
385 forensic evaluations and providing reports to the courts.
386 Training must include, but not be limited to, information on
387 statutes and rules related to competency restoration, evidence
388 based practices, and least restrictive treatment alternatives
389 and placement options as described in s. 916.12(4)(c); and
390 (2) To compile and maintain the necessary information for
391 evaluating the success of this program, including the number of
392 persons trained, the cost of operating the program, and the
393 effect on the quality of forensic evaluations as measured by
394 appropriateness of admissions to state forensic facilities and
395 to community-based care programs.
396 Section 11. Subsection (1) of section 916.115, Florida
397 Statutes, is amended to read:
398 916.115 Appointment of experts.—
399 (1) The court shall appoint no more than three experts to
400 determine the mental condition of a defendant in a criminal
401 case, including competency to proceed, insanity, involuntary
402 placement, and treatment. The experts may evaluate the defendant
403 in jail or in another appropriate local facility or in a
404 facility of the Department of Corrections.
405 (a) The court-appointed To the extent possible, The
406 appointed experts shall:
407 1. have completed forensic evaluator training approved by
408 the department, and each shall Be a psychiatrist, licensed
409 psychologist, or physician.
410 2. Have completed initial and ongoing forensic evaluator
411 training, provided by the department.
412 3. If performing juvenile evaluations, annually complete
413 juvenile forensic competency evaluation training approved by the
414 department.
415 (b) Existing evaluators shall complete department-provided
416 continuing education training by July 1, 2026, to remain active
417 on the list.
418 (c)(b) The department shall maintain and annually provide
419 the courts with a list of available mental health professionals
420 who have completed the initial and annual approved training as
421 experts.
422 Section 12. Paragraph (d) of subsection (4) of section
423 916.12, Florida Statutes, is amended to read:
424 916.12 Mental competence to proceed.—
425 (4) If an expert finds that the defendant is incompetent to
426 proceed, the expert shall report on any recommended treatment
427 for the defendant to attain competence to proceed. In
428 considering the issues relating to treatment, the examining
429 expert shall specifically report on:
430 (d) The availability of acceptable treatment and, if
431 treatment is available in the community, the expert shall so
432 state in the report. In determining what acceptable treatments
433 are available in the community, the expert shall, at a minimum,
434 use current information or resources on less restrictive
435 treatment alternatives, as described in paragraph (c), and those
436 obtained from training and continuing education approved by the
437 department.
438
439 The examining expert’s report to the court shall include a full
440 and detailed explanation regarding why the alternative treatment
441 options referenced in the evaluation are insufficient to meet
442 the needs of the defendant.
443 Section 13. Paragraph (a) of subsection (1) of section
444 394.674, Florida Statutes, is amended to read:
445 394.674 Eligibility for publicly funded substance abuse and
446 mental health services; fee collection requirements.—
447 (1) To be eligible to receive substance abuse and mental
448 health services funded by the department, an individual must be
449 a member of at least one of the department’s priority
450 populations approved by the Legislature. The priority
451 populations include:
452 (a) For adult mental health services:
453 1. Adults who have severe and persistent mental illness, as
454 designated by the department using criteria that include
455 severity of diagnosis, duration of the mental illness, ability
456 to independently perform activities of daily living, and receipt
457 of disability income for a psychiatric condition. Included
458 within this group are:
459 a. Older adults in crisis.
460 b. Older adults who are at risk of being placed in a more
461 restrictive environment because of their mental illness.
462 c. Persons deemed incompetent to proceed or not guilty by
463 reason of insanity under chapter 916.
464 d. Other persons involved in the criminal justice system.
465 e. Persons diagnosed as having co-occurring mental illness
466 and substance abuse disorders.
467 2. Persons who are experiencing an acute mental or
468 emotional crisis as defined in s. 394.67 s. 394.67(18).
469 Section 14. Subsection (3) of section 394.74, Florida
470 Statutes, is amended to read:
471 394.74 Contracts for provision of local substance abuse and
472 mental health programs.—
473 (3) Contracts shall include, but are not limited to:
474 (a) A provision that, within the limits of available
475 resources, substance abuse and mental health crisis services, as
476 defined in s. 394.67 s. 394.67(4), shall be available to any
477 individual residing or employed within the service area,
478 regardless of ability to pay for such services, current or past
479 health condition, or any other factor;
480 (b) A provision that such services be available with
481 priority of attention being given to individuals who exhibit
482 symptoms of chronic or acute substance abuse or mental illness
483 and who are unable to pay the cost of receiving such services;
484 (c) A provision that every reasonable effort to collect
485 appropriate reimbursement for the cost of providing substance
486 abuse and mental health services to persons able to pay for
487 services, including first-party payments and third-party
488 payments, shall be made by facilities providing services
489 pursuant to this act;
490 (d) A program description and line-item operating budget by
491 program service component for substance abuse and mental health
492 services, provided the entire proposed operating budget for the
493 service provider will be displayed;
494 (e) A provision that client demographic, service, and
495 outcome information required for the department’s Mental Health
496 and Substance Abuse Data System be submitted to the department
497 by a date specified in the contract. The department may not pay
498 the provider unless the required information has been submitted
499 by the specified date; and
500 (f) A requirement that the contractor must conform to
501 department rules and the priorities established thereunder.
502 Section 15. Subsection (3) of section 397.68141, Florida
503 Statutes, is amended to read:
504 397.68141 Contents of petition for involuntary treatment
505 services.—A petition for involuntary services must contain the
506 name of the respondent; the name of the petitioner; the
507 relationship between the respondent and the petitioner; the name
508 of the respondent’s attorney, if known; and the factual
509 allegations presented by the petitioner establishing the need
510 for involuntary services for substance abuse impairment.
511 (3) If there is an emergency, the petition must also
512 describe the respondent’s exigent circumstances and include a
513 request for an ex parte assessment and stabilization order that
514 must be executed pursuant to s. 397.6818 s. 397.68151.
515 Section 16. This act shall take effect July 1, 2025.