HB 1459 2022
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to the mental health of minors; 2
amending s. 394.462, F.S.; requiring that 3
transportation plans include options for transporting 4
minors which do not involve marked police vehicles or 5
uniformed law enforcement officers; creating s. 6
394.4635, F.S.; defining the terms "immediately" and 7
"serious bodily harm"; specifying the conditions that 8
must be met for a minor to be taken to a receiving 9
facility for involuntary examination; specifying 10
requirements for initiating a minor's involuntary 11
examination and his or her transportation; specifying 12
requirements for receiving facilities relating to such 13
minors; requiring that court orders for involuntary 14
examinations be made a part of the minor's clinical 15
record; prohibiting a fee from being charged for 16
filing such orders; requiring facilities receiving 17
minors for involuntary examination to provide certain 18
orders and reports to the Department of Children and 19
Families; providing for the validity of such orders; 20
providing requirements for law enforcement offic ers 21
initiating involuntary examinations of minors or 22
transporting minors to such examinations; prohibiting 23
minors undergoing involuntary examinations initiated 24
by law enforcement officers from being held at 25
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receiving facilities for longer than a specified 26
period; providing an exception; requiring law 27
enforcement officers who initiate an involuntary 28
examination for a minor to execute a written report 29
containing specified information; requiring facilities 30
to send such reports to the department; requiring the 31
law enforcement officer's agency to retain such report 32
and to provide a copy of the report to a minor's 33
parent or guardian upon request; requiring that 34
certain reports and certificates be made part of a 35
minor's clinical record; requiring facilities 36
receiving minors for involuntary examinations to 37
create specified records; requiring facilities to 38
submit such records and copies of certain reports to 39
the department in a sworn report; authorizing the 40
department to adopt rules; requiring facilities to 41
notify minors and their parents or guardians of the 42
minor's right to counsel and to provide minors with 43
the opportunity to immediately consult and be 44
represented by counsel; providing requirements for the 45
transportation of minors to facilities for involuntary 46
examination; requiring specified examinations of 47
minors admitted to a receiving facility after an 48
involuntary examination is initiated by certain 49
persons; requiring minors to be released from 50
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receiving facilities as soon as a specified 51
determination is made; req uiring facilities to have at 52
least one staff member with the authority to make such 53
determinations at the facility at all times; 54
authorizing emergency treatment of minors under 55
certain circumstances; requiring minors to be 56
immediately released if a parent or guardian revokes 57
consent for the minor's admission; prohibiting an 58
examination period from lasting longer than a 59
specified amount of time; requiring that certain 60
actions be taken within the examination period; 61
prohibiting students from being removed fro m schools 62
and transported to a receiving facility for 63
involuntary examination unless certain requirements 64
are met; requiring facilities to contact schools for 65
specified information under certain circumstances; 66
requiring facilities to notify the department if 67
schools fail to provide such information; requiring 68
the department, in consultation with the Department of 69
Education, to take certain actions relating to such 70
schools; prohibiting minors receiving treatment for 71
mental illness from being deprived of spec ified 72
privacy rights; providing construction; requiring 73
minors to be provided with parental or guardian 74
contact; providing an exception; providing 75
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construction; requiring receiving facility staff to 76
consult with certain persons to ensure continuity of 77
care and prevent disruption to existing medication 78
regimens; requiring that certain conditions be met 79
before giving or prescribing a minor certain 80
psychotropic medication; providing remedies for minors 81
for specified violations; providing immunity for 82
certain persons acting in good faith; providing an 83
exception; requiring facilities examining minors on a 84
voluntary basis to provide the department with a 85
report containing specified information and copies of 86
certain other reports within a specified timeframe; 87
requiring the department to annually publish specified 88
data relating to such reports; providing construction; 89
requiring the department to contract with a 90
consultancy on crisis services to review the provision 91
of crisis services for minors; providing requirement s 92
for such review; providing construction; amending s. 93
394.467, F.S.; revising requirements for minors to be 94
ordered for involuntary inpatient placement; defining 95
the term "serious bodily harm"; conforming provisions 96
to changes made by the act; amending s. 409.996, F.S.; 97
revising duties of the department relating to 98
evaluations of lead agencies and monitoring out -of-99
home placements; amending s. 1001.212, F.S.; revising 100
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data that must be provided by the Office of Safe 101
Schools to support the evaluation of spe cified mental 102
health services; defining the term "mandatory mental 103
health treatment"; requiring school districts, charter 104
school sponsors, and other entities operating a public 105
school to develop, implement, and submit to the office 106
specified policies and p rocedures; requiring the 107
office to monitor the effectiveness of such policies 108
and procedures; requiring the Department of Education 109
to adopt rules implementing the most effective 110
policies and procedures on a statewide basis; creating 111
the Telehealth Pilot P rogram within the Department of 112
Children and Families; providing a purpose for the 113
program; requiring certain persons transporting minors 114
to receiving facilities to first obtain specified 115
advice through telehealth services; prohibiting the 116
telehealth services from being provided by an entity 117
that provides involuntary examination services; 118
requiring the department to analyze and compare 119
specified data and prepare a report summarizing the 120
impact of the program; requiring the department to 121
submit the report to the Governor and the Legislature 122
by a specified date; requiring the Legislature to 123
appropriate funds necessary for the creation and 124
administration of the pilot program; requiring the 125
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department to adopt rules; providing for future 126
expiration; amending s. 394.463, F.S.; conforming 127
provisions to changes made by the act; providing 128
effective dates. 129
130
Be It Enacted by the Legislature of the State of Florida: 131
132
Section 1. Subsection (4) is added to section 394.462, 133
Florida Statutes, to read: 134
394.462 Transportation.—A transportation plan shall be 135
developed and implemented by each county in collaboration with 136
the managing entity in accordance with this section. A county 137
may enter into a memorandum of understanding with the governing 138
boards of nearby countie s to establish a shared transportation 139
plan. When multiple counties enter into a memorandum of 140
understanding for this purpose, the counties shall notify the 141
managing entity and provide it with a copy of the agreement. The 142
transportation plan shall describe methods of transport to a 143
facility within the designated receiving system for individuals 144
subject to involuntary examination under s. 394.463 or 145
involuntary admission under s. 397.6772, s. 397.679, s. 146
397.6798, or s. 397.6811, and may identify responsibil ity for 147
other transportation to a participating facility when necessary 148
and agreed to by the facility. The plan may rely on emergency 149
medical transport services or private transport companies, as 150
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appropriate. The plan shall comply with the transportation 151
provisions of this section and ss. 397.6772, 397.6795, 397.6822, 152
and 397.697. 153
(4) TRANSPORTING MINORS. —The transportation plan must 154
include options for transporting minors which do not involve 155
marked police vehicles or uniformed law enforcement officers. 156
Section 2. Section 394.4635, Florida Statutes, is created 157
to read: 158
394.4635 Involuntary examination of a minor. — 159
(1) DEFINITIONS.—For the purposes of this section, the 160
term: 161
(a) "Immediately" means without unnecessary delay. 162
(b) "Serious bodily harm" means a physical condition that 163
creates a substantial risk of death, protracted and obvious 164
disfigurement, or protracted loss or impairment of a bodily 165
member or of an organ's function. 166
(2) CRITERIA FOR INVOLUNTARY EXAMINATION. —A minor may only 167
be taken to a receiving facility for involuntary examination if 168
all of the following conditions are met: 169
(a) It is likely that the minor has a mental illness and, 170
because of his or her mental illness and as evidenced by recent 171
behavior, there is a substant ial likelihood that the minor will 172
imminently cause death or serious bodily harm to himself or 173
herself or to others if the minor is not immediately examined. 174
(b) Involuntary examination is the least restrictive means 175
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of preventing the minor from imminent ly causing serious bodily 176
harm to himself or herself or others. 177
(c)1. The minor's parent or guardian with the authority to 178
consent to medical treatment, after being informed of the 179
specific circumstances giving rise to the recommendation to do 180
so, provides his or her express and informed voluntary consent 181
for the minor's examination at a receiving facility; 182
2. The parent's or guardian's consent cannot be obtained 183
under subparagraph 1. because the minor's parent or guardian 184
cannot be located after exhausting all reasonable efforts to 185
contact each of them; or 186
3. There is recent and affirmative evidence, including, 187
but not limited to, evidence provided by the minor, that 188
contacting the minor's parent or guardian would cause an 189
imminent risk of death , serious bodily harm, or physical or 190
sexual abuse of the minor. 191
(3) INITIATION OF INVOLUNTARY EXAMINATION. —An involuntary 192
examination of a minor may be initiated by any one of the 193
following means: 194
(a) A circuit or county court may enter an ex parte or der 195
stating that the minor appears to meet the criteria for 196
involuntary examination of minors under this section and 197
specifying the findings on which that conclusion is based. The 198
ex parte order for involuntary examination must be based on 199
written or oral sworn testimony that includes actual knowledge 200
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of specific facts that support the findings. If other less 201
restrictive means are not available, such as voluntary 202
appearance for outpatient evaluation, a law enforcement officer, 203
a parent or guardian, the pare nt's or guardian's designee, a 204
medical provider, or any other designated agent of the court 205
must take the minor into custody and transport the minor to an 206
appropriate, or the nearest, facility within the designated 207
receiving system pursuant to s. 394.462 f or involuntary 208
examination. Immediately after a minor's arrival at a receiving 209
facility, the facility staff shall verbally explain to the 210
minor, and, if present, the minor's parent or guardian, the 211
rights of patients under s. 394.459 using language and 212
terminology the minor understands and shall provide a copy of 213
the rights or physically show the minor where the notice of 214
rights of patients is posted in the facility as required under 215
s. 394.459(12). If the minor's parent or guardian is not present 216
at the time of the minor's arrival, the facility must attempt to 217
notify the parent or guardian pursuant to s. 394.4599(2)(c)2. 218
The order of the court must be made a part of the minor's 219
clinical record. A fee may not be charged for the filing of an 220
order under this paragraph. A facility accepting the patient 221
based on such order must send a copy of the order to the 222
department within 5 working days. The order may be submitted 223
electronically through existing data systems, if applicable. The 224
order is valid only until the minor is delivered to the facility 225
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or for the period specified in the order itself, whichever 226
occurs first. If a period is not specified in the order, the 227
order is valid for 7 days after the date the order was signed. 228
(b)1. A law enforcement officer may take a minor who 229
appears to meet the criteria for involuntary examination of 230
minors under this section into custody and, consistent with 231
subsection (6), deliver the minor or have him or her delivered 232
by another person to an appropriate, or the nearest, fa cility 233
within the designated receiving system pursuant to s. 394.462 234
for a determination of whether the minor meets the criteria for 235
involuntary examination. Whenever possible, an officer 236
considering such transportation must use telehealth resources or 237
other means to obtain the advice of a medical professional 238
authorized to initiate involuntary examinations as to whether 239
the minor meets the criteria for involuntary examination before 240
transporting him or her to a receiving facility. An officer who 241
uses such services or means and is advised that a minor does not 242
meet the criteria for involuntary examination may not take the 243
minor into custody or have the minor transported to a facility. 244
2. Once a minor arrives at a receiving facility for 245
involuntary examinat ion initiated by a law enforcement officer, 246
the minor may not be held involuntarily for more than 2 hours 247
unless a physician, clinical psychologist, psychiatric nurse, 248
school psychologist, mental health counselor, marriage and 249
family therapist, or clinical social worker provides written 250
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certification stating that he or she has examined the minor and 251
finds that the minor appears to meet the criteria for 252
involuntary examination of minors and stating the observations 253
upon which the finding is based. Upon the r equest of the minor's 254
parent or guardian, the parent or guardian must be allowed to 255
remain with the minor at any time between the minor's arrival at 256
the facility and when the examination occurs unless there is 257
recent and affirmative evidence, including, bu t not limited to, 258
evidence provided by the minor, that allowing the minor's parent 259
or guardian to remain with the minor would cause an imminent 260
risk of death, serious bodily harm, or physical or sexual abuse 261
of the minor. Immediately after a minor's arriva l at a receiving 262
facility, the facility staff shall verbally explain to the 263
minor, and, if present, the minor's parent or guardian, the 264
rights of patients under s. 394.459 using language and 265
terminology the minor understands and shall provide a copy of 266
the rights or physically show the minor where the notice of 267
rights of patients is posted in the facility as required under 268
s. 394.459(12). If the minor's parent or guardian is not present 269
at the time of the minor's arrival, the facility must attempt to 270
notify the parent or guardian as required by s. 394.4599(2)(c)2. 271
and seek his or her consent for further examination of the 272
minor, except to the extent such consent is not required under 273
subparagraph (2)(c)3. 274
3. Regardless of whether a facility receives writte n 275
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certification that the minor meets the criteria for involuntary 276
examination under subparagraph 2., the law enforcement officer 277
who took the minor into custody must execute a written report 278
detailing the circumstances under which the minor was taken into 279
custody, and the report must be made a part of the minor's 280
clinical record. The facility shall send a copy of the report to 281
the department within 5 working days, regardless of whether the 282
minor is admitted. The law enforcement officer's law enforcement 283
agency shall retain a copy of the report pursuant to the 284
agency's policy and provide it to the minor's parent or guardian 285
at his or her request. The report must state the reasons the 286
examination was initiated; specify whether the minor was taken 287
into custody at a school and, if so, provide the name and 288
address of the school; and specify which criteria were met under 289
paragraph (2)(c). If the criterion under subparagraph (2)(c)1. 290
was met, the report must include the parent's or guardian's name 291
and contact information. If the criterion under subparagraph 292
(2)(c)2. was met, the report must state the means by which the 293
law enforcement officer attempted to locate each parent or 294
guardian. If the criterion under subparagraph (2)(c)3. was met, 295
the report must include the recent and affirmative evidence that 296
led to a conclusion that contacting the parent or guardian would 297
pose an imminent risk of death, serious bodily harm, or physical 298
or sexual abuse of the minor. 299
(c)1. A physician, clinical psychologist, psychiatric 300
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nurse, school psychologist, mental health counselor, marriage 301
and family therapist, or clinical social worker may provide 302
written certification stating that he or she has examined a 303
minor, either in person or through telehealth, within the 304
preceding 48 hours and finds that the minor appears to meet the 305
criteria for involuntary examination and stating the 306
observations upon which that conclusion is based. 307
2. If other less restrictive means, such as voluntary 308
appearance for outpatient evaluation, are not avail able, a 309
parent or guardian, the parent's or guardian's designee, a 310
family member, a friend, a medical provider, a school counselor, 311
a school administrator, or a law enforcement officer must take 312
the minor named in the certification into custody and deliver 313
him or her to the appropriate, or nearest, facility within the 314
designated receiving system pursuant to s. 394.462 for 315
involuntary examination. Upon the minor's arrival, the facility 316
staff shall verbally explain to the minor, and, if present, the 317
minor's parent or guardian, the rights of patients under s. 318
394.459 using language and terminology the minor understands and 319
shall provide a copy of the rights or physically show the minor 320
where the notice of rights of patients is posted in the facility 321
as required under s. 394.459(12). If the minor's parent or 322
guardian is not present at the time of the minor's arrival, the 323
facility must attempt to notify the parent or guardian pursuant 324
to s. 394.4599(2)(c)2. and seek his or her consent for further 325
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examination of the minor, except to the extent such consent is 326
not required under subparagraph (2)(c)3. The minor must be 327
transported consistent with the requirements under subsection 328
(6). If the person transporting the minor is a law enforcement 329
officer, the officer must also execute a written report 330
detailing the circumstances under which the minor was taken into 331
custody. The report must state the reasons the examination was 332
initiated; specify whether the minor was taken into custody at a 333
school and, if so, provide the na me and address of the school; 334
and specify which criteria were met under paragraph (2)(c). If 335
the criterion under subparagraph (2)(c)1. was met, the report 336
must include the parent's or guardian's name and contact 337
information. If the criterion under subparag raph (2)(c)2. was 338
met, the report must state the means by which the law 339
enforcement officer attempted to locate each parent or guardian. 340
If the criterion under subparagraph (2)(c)3. was met, the report 341
must include the recent and affirmative evidence that led to a 342
conclusion that contacting the parent or guardian would pose an 343
imminent risk of death, serious bodily harm, or physical or 344
sexual abuse of the minor. 345
3. The report and certificate must be made a part of the 346
minor's clinical record. Any facility accepting the minor based 347
on the certificate must send a copy of the certificate to the 348
department within 5 working days, regardless of whether the 349
minor is not admitted or is admitted on a voluntary or 350
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involuntary basis. The document may be submitted ele ctronically 351
through existing data systems, if applicable. A full and 352
complete copy of the minor's clinical record or any portion of 353
it, including the report and certificate, must be provided to 354
the minor's parent or guardian upon his or her request. 355
(4) REQUIRED FACILITY REPORTS. — 356
(a)1. At the time the minor arrives at the receiving 357
facility, the facility shall record whether the minor meets the 358
criteria for involuntary services at that time; whether the 359
minor meets the criteria because of risk of death or serious 360
bodily harm to himself or herself or others; the means by which 361
the minor arrived at the facility, including whether he or she 362
was transported there by law enforcement; whether the area's 363
mobile crisis response team was contacted before the adm ission; 364
the time and date the minor arrived at the facility; whether the 365
minor has Medicaid, Medicare, private health insurance, or no 366
health insurance; the minor's age, name, race, gender, national 367
origin, disability status, including whether the minor ha s a 368
developmental disability, and social security number; what 369
actions were taken after the initial examination, including 370
whether the minor was released or examined further; and any 371
other information the department requires by rule. 372
2. At the conclusion of the period specified in subsection 373
(8), the facility shall record the time and date the minor left 374
the facility or a petition for involuntary services was 375
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initiated pursuant to paragraph (8)(d); whether psychotropic 376
medication was administered while the minor was in the facility; 377
if the minor left the facility, a description of the followup 378
services provided; and any other information the department 379
requires by rule. 380
(b) A receiving facility shall submit the records created 381
in paragraph (a) to the department in a sworn written report 382
that also includes copies of any reports prepared by law 383
enforcement or school personnel required under this section. The 384
information in the report shall also be made a part of the 385
minor's clinical rec ord. The department may adopt rules 386
governing such reports. 387
(5) RIGHT TO COUNSEL. —Upon a minor's arrival at a 388
receiving facility, the facility shall notify the minor and his 389
or her parent or guardian of the minor's right to counsel and 390
shall provide the minor the opportunity to immediately consult 391
with and be represented by a public defender or the minor's 392
attorney. 393
(6) TRANSPORTATION. —All persons initiating the involuntary 394
examination of a minor shall make every effort to avoid 395
transporting minors in v ehicles ordinarily used for law 396
enforcement purposes. When law enforcement officers initiate or 397
participate in the transportation of a minor for involuntary 398
examination, officers must use the least restrictive means for 399
transporting the minor and must use unmarked vehicles or 400
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ambulances if available. Law enforcement officers must allow a 401
minor's parent or guardian or the parent's or guardian's 402
designee, if available, to transport the minor to the receiving 403
facility unless there is compelling evidence that d oing so would 404
endanger the minor. If the parent or guardian of a minor, or the 405
parent's or guardian's designee, is unavailable to transport the 406
minor, law enforcement officers must allow other appropriate and 407
willing persons to transport the minor, if avai lable, including 408
a school counselor, school administrator, family member, friend, 409
or medical provider, unless there is compelling evidence that 410
doing so would endanger the minor. If a minor is transported by 411
a law enforcement officer, the officer must also allow the 412
minor's parent or guardian to ride in the same vehicle with the 413
minor unless there is compelling evidence that doing so would 414
endanger the minor. Law enforcement officers may not use 415
restraints on a minor being transported for involuntary 416
examination, including handcuffs, hobbles, and zip ties, except 417
in a situation where there is no other available means to 418
prevent imminent serious bodily harm to the minor or others. A 419
department or agency policy requiring that all persons 420
transported in police cars be restrained may not be used to 421
justify the use of restraints on minors transported pursuant to 422
this section. 423
(7) MINIMAL DETENTION. —When a minor is admitted to a 424
receiving facility after an involuntary examination is initiated 425
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by someone other tha n a physician, a clinical psychologist, or a 426
psychiatric nurse performing within the framework of an 427
established protocol with a psychiatrist at a facility, a 428
physician, a clinical psychologist, or a psychiatric nurse must 429
examine the minor immediately upo n admission to determine if the 430
criteria for involuntary services are met. A minor shall be 431
released from a receiving facility as soon as a physician, a 432
clinical psychologist, a psychiatric nurse, an advanced practice 433
registered nurse registered under s. 4 64.0123, a mental health 434
counselor, a marriage and family therapist, or a clinical social 435
worker at the facility determines the minor no longer meets the 436
criteria for involuntary examination of minors. Facilities may 437
establish procedures to designate one o r more employees to make 438
such determination, but the facility must have at least one 439
staff member with the authority to make such determination at 440
the facility at all times. Emergency treatment may be provided 441
to a minor upon the order of a physician if th e physician 442
determines that such treatment is necessary for the safety of 443
the minor or others. A minor must be immediately released if the 444
minor's parent or guardian revokes consent for his or her 445
admission to a facility. 446
(8) DURATION AND CONCLUSION OF I NVOLUNTARY EXAMINATION. —447
The examination period for a minor may not last longer than 72 448
hours. Within the examination period, one of the following 449
actions must be taken based on the individual needs of the 450
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minor: 451
(a) The minor must be released pursuant to subsection (7). 452
(b) The minor must be released for voluntary outpatient 453
treatment. 454
(c) If the minor and the minor's parent or guardian have 455
given express and informed written consent to placement as a 456
voluntary patient, the minor must be admitted as a voluntary 457
patient. 458
(d) A petition for involuntary services must be filed in 459
the circuit court if inpatient treatment is deemed necessary or 460
with the criminal county court, as defined in s. 394.4655(1), as 461
applicable. If inpatient treatment is deemed nec essary, the 462
least restrictive treatment consistent with the optimum 463
improvement of the minor's condition must be made available. A 464
petition for involuntary inpatient placement must state, under 465
penalty of perjury, that the receiving facility administrator 466
believes the minor meets the criteria for involuntary placement 467
and the facility intends to pursue such placement. The petition 468
must be filed by the facility administrator. 469
(9) REMOVAL FROM SCHOOLS. — 470
(a) A student may not be removed from any school as 471
defined in s. 1003.01(2) and transported to a receiving facility 472
for involuntary examination unless the school principal, the 473
school counselor, the school psychologist, or any other school 474
official who has the most knowledge about the circumstances of 475
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the student's removal submits a written report to the department 476
containing all of the following information: 477
1. The school name and address. 478
2. The time and date of the removal. 479
3. The student's name, age, grade, race, gender, and 480
national origin. 481
4. Whether the student has a disability, including whether 482
he or she has a Section 504 plan or an individual education plan 483
(IEP), and the basis for such classification or receipt of 484
services, including the nature of the disability or medical 485
diagnosis. 486
5. Whether the student is experiencing homelessness as 487
defined in s. 1003.01(12). 488
6. Whether the student has limited English proficiency as 489
defined in s. 1003.56(2)(a). 490
7. The circumstances leading to the involuntary 491
examination, including whether the beh avior leading to the 492
involuntary examination was observed by a law enforcement 493
officer directly or relayed to law enforcement indirectly and 494
whether the basis for the removal was for danger to self or 495
others. 496
8. If the involuntary examination was initiat ed because of 497
danger to self, whether the school used a suicide screening 498
instrument approved under s. 1012.583. 499
9. Whether a physician, clinical psychologist, psychiatric 500
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nurse, school psychologist, mental health counselor, marriage 501
and family therapist , clinical social worker, or mobile crisis 502
team, and, if the student has a disability, an exceptional 503
student education director or a member of the student's IEP 504
team, was present on the school campus at the time of the 505
decision to remove the student or to contact law enforcement to 506
do so. 507
10. Whether a physician, clinical psychologist, 508
psychiatric nurse, school psychologist, mental health counselor, 509
marriage and family therapist, clinical social worker, or mobile 510
crisis team, and, if the student has a di sability, an 511
exceptional student education director or a member of the 512
student's IEP team, was consulted before the decision to remove 513
the student from the school for involuntary examination. 514
11. If the student is a minor, whether a parent or 515
guardian was contacted before the student's removal and, if so, 516
whether the parent or guardian consented to the removal and 517
whether he or she was given the opportunity to remove the 518
student from school. 519
12. Any other information the department determines is 520
appropriate. 521
(b) If a receiving facility receives a student for 522
involuntary examination and the report of the law enforcement 523
officer made pursuant to subsection (3) indicates that the 524
student was removed from a school but the student is not 525
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accompanied by the school's report required under paragraph (a) 526
or the report is incomplete, the facility must contact the 527
school by the end of the next working day and obtain a completed 528
copy of the report. If the school fails to provide the report, 529
the facility must notify the department by certified mail or by 530
e-mail, if available, by the next working day. The department 531
shall keep records of all such notifications and take all 532
appropriate steps, in consultation with the Department of 533
Education, to ensure that any failures to notify do not reoccur. 534
(c) The department may adopt rules governing such reports. 535
(10) PRIVACY.—A minor receiving treatment for mental 536
illness may not be deprived of his or her right to privacy under 537
state and federal law, the United States Constit ution, or the 538
State Constitution, including the right to keep the fact of such 539
treatment confidential and not disclose the information except 540
to those individuals who provide medical services or collect 541
data on the use of involuntary and voluntary examinat ion. This 542
subsection may not be construed to limit any other rights minors 543
may have under this chapter or other law, including, but not 544
limited to, s. 394.459. Each entity sharing, collecting, or 545
maintaining data or information under this section is requir ed 546
to meet the standards set forth in the National Institute of 547
Standards and Technology Cybersecurity Framework Version 1.1. 548
(11) ACCESS TO PARENTS OR GUARDIANS. —A minor shall be 549
provided as much contact with his or her parent or guardian as 550
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he or she desires and is practicable unless the treating 551
psychiatrist executes a written certificate under penalty of 552
perjury indicating that doing so would pose a risk of serious 553
psychological harm. At a minimum, such contact must include 554
daily in-person visiting hours and unlimited use of a telephone 555
for the minor to contact his or her parent or guardian and, to 556
the extent practicable, allow a minor's parent or guardian to 557
stay with the minor overnight in the receiving facility. This 558
subsection may not be construed to limit any other rights minors 559
may have under this chapter or other law, including, but not 560
limited to, s. 394.459. 561
(12) CONTINUITY OF CARE. —Receiving facility staff shall 562
consult with the parent or guardian of a minor and any medical 563
professionals treating the minor to ensure continuity of care 564
and prevent disruption to the minor's existing medication 565
regimen. Psychotropic medication that a minor is not prescribed 566
at the time of evaluation or treatment must be given or 567
prescribed to a minor only after every reasonable effort has 568
been made to consult with the minor's existing medical and 569
psychiatric providers. 570
(13) VIOLATIONS.—Any minor whose rights under this chapter 571
have been violated may file suit through his or her legal 572
representative against any person, agency, municipality, 573
district, or other entity in any court of this state having 574
jurisdiction. A minor who files suit may seek declaratory 575
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relief, injunctive relief, and damages. Any person who acts in 576
good faith in compliance with this part is im mune from civil or 577
criminal liability for his or her actions in connection with the 578
admission, diagnosis, treatment, or discharge of a minor from a 579
receiving facility, or the decision not to admit the minor or 580
initiate an examination. However, this section does not relieve 581
any person from liability if such person is negligent. 582
(14) REPORTING ON VOLUNTARY EXAMINATION. — 583
(a) For each minor examined on a voluntary basis by a 584
receiving facility, the facility shall compile all of the 585
following information in a written report to the department: 586
1. The means by which the minor arrived at the facility, 587
including whether he or she was transported by law enforcement. 588
2. Whether the area's mobile crisis response team was 589
contacted. 590
3. Whether the minor is a st udent at a school as defined 591
in s. 1003.01(2) or at a private school as defined in s. 592
1002.01(2), whether the minor was transported to the facility 593
from that school, and, if so, the name of the school. 594
4. The time and date the minor arrived at the facili ty. 595
5. Whether the facility recommended that the minor 596
voluntarily consent to admission. 597
6. Whether the minor has Medicaid, Medicare, private 598
health insurance, or no health insurance. 599
7. Whether the minor has a developmental disability. 600
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8. The minor's age, name, race, gender, and national 601
origin. 602
9. The time and date the minor left the facility and a 603
description of the followup services provided, if applicable. 604
10. Any other information the department deems 605
appropriate. 606
(b) For any minor exami ned or admitted on a voluntary 607
basis, the receiving facility must send a copy of the report to 608
the department within 5 working days after the examination, and 609
the facility must attach copies of any reports provided by law 610
enforcement and schools pursuant t o this section to the report. 611
The department shall publish aggregated data, broken down by 612
demographics, for each category of information listed in 613
subparagraphs (a)1.-10. for every receiving facility on an 614
annual basis no later than 6 months after the con clusion of the 615
fiscal year during which the data was collected. 616
(c) This subsection may not be construed to alter or 617
expand the authority of any person to examine a minor on a 618
voluntary basis under s. 394.4625. 619
(15) OUTSIDE REVIEW. —The department shall contract with a 620
nationally recognized consultancy on crisis services for minors 621
which is based outside this state to review this state's 622
provision of crisis services for minors. Such review must 623
include examining the clinical records of a random sample of 624
minors involuntarily examined and determining if they meet with 625
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national best practices. The consultancy must make 626
recommendations for improvement of crisis services for minors. 627
The review must also provide an est imate of the per-minor cost 628
of involuntary examination compared with other methods of 629
addressing minors in crisis. 630
(16) CONSTRUCTION.—The provisions of this section take 631
precedence over any provision of this chapter which is 632
inconsistent with this sectio n. 633
Section 3. Subsection (1) of section 394.467, Florida 634
Statutes, is amended to read: 635
394.467 Involuntary inpatient placement. — 636
(1) CRITERIA.— 637
(a) A person 18 years of age or older may be ordered for 638
involuntary inpatient placement for treatment upon a finding of 639
the court by clear and convincing evidence that: 640
1.(a) He or she has a mental illness and because of his or 641
her mental illness: 642
a.(I)1.a. He or she has refused voluntary inpatient 643
placement for treatment after sufficient and conscien tious 644
explanation and disclosure of the purpose of inpatient placement 645
for treatment; or 646
(II)b. He or she is unable to determine for himself or 647
herself whether inpatient placement is necessary; and 648
b.(I)2.a. He or she is incapable of surviving alone or 649
with the help of willing and responsible family or friends, 650
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including available alternative services, and, without 651
treatment, is likely to suffer from neglect or refuse to care 652
for himself or herself, and such neglect or refusal poses a real 653
and present threat of substantial harm to his or her well -being; 654
or 655
(II)b. There is substantial likelihood that in the near 656
future he or she will inflict serious bodily harm on self or 657
others, as evidenced by recent behavior causing, attempting, or 658
threatening such harm; and 659
2.(b) All available less restrictive treatment 660
alternatives that would offer an opportunity for improvement of 661
his or her condition have been judged to be inappropriate. 662
(b) A minor may be ordered for involuntary inpatient 663
placement for treatment if a court finds by clear and convincing 664
evidence that all of the following conditions are met: 665
1. The minor has a mental illness. 666
2. Because of his or her mental illness, it is likely that 667
the minor will, if not ordered for involuntary inpat ient 668
placement, imminently cause death or serious bodily harm to 669
himself or herself or to others, as evidenced by recent behavior 670
causing, attempting, or threatening such harm. 671
3. Involuntary inpatient placement is the least 672
restrictive means of preventi ng the minor from imminently 673
causing serious bodily harm to himself or herself or others. 674
4.a. The minor's parent or guardian with the authority to 675
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consent to medical treatment, after being informed of the 676
specific circumstances giving rise to the recomm endation to do 677
so, provides his or her express and informed voluntary consent 678
for the minor's examination at a receiving facility; 679
b. The parent's or guardian's consent cannot be obtained 680
under sub-subparagraph a. because the minor's parent or guardian 681
cannot be located after exhausting all reasonable efforts to 682
contact each of them; or 683
c. There is recent and affirmative evidence, including, 684
but not limited to, evidence provided by the minor, that 685
contacting the minor's parent or guardian would cause an 686
imminent risk of death, serious bodily harm, or physical or 687
sexual abuse of the minor. 688
689
As used in this paragraph, the term "serious bodily harm" means 690
a physical condition that creates a substantial risk of death, 691
protracted and obvious disfigurement, or protracted loss or 692
impairment of a bodily member or of an organ's function. 693
Section 4. Paragraphs (a) and (b) of subsection (21) of 694
section 409.996, Florida Statutes, are amended to read: 695
409.996 Duties of the Department of Children and 696
Families.—The department shall contract for the delivery, 697
administration, or management of care for children in the child 698
protection and child welfare system. In doing so, the department 699
retains responsibility for the quality of contracted services 700
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and programs and shall ensure that, at a minimum, services are 701
delivered in accordance with applicable federal and state 702
statutes and regulations and the performance standards and 703
metrics specified in the strategic plan created under s. 704
20.19(1). 705
(21) The department, in co nsultation with lead agencies, 706
shall establish a quality assurance program for contracted 707
services to dependent children. The quality assurance program 708
shall, at a minimum, be based on standards established by 709
federal and state law, national accrediting or ganizations, and 710
the Office of Quality established under s. 402.715, and must be 711
consistent with the child welfare results -oriented 712
accountability system required by s. 409.997. 713
(a) The department must evaluate each lead agency under 714
contract at least an nually. These evaluations shall cover the 715
programmatic, operational, and fiscal operations of the lead 716
agency and must be consistent with the child welfare results -717
oriented accountability system required under s. 409.997 . The 718
department must consult with d ependency judges in the circuit or 719
circuits served by the lead agency on the performance of the 720
lead agency. 721
(b) The department and each lead agency shall monitor out -722
of-home placements, including the extent to which sibling groups 723
are placed together or provisions to provide visitation and 724
other contacts if siblings are separated and a record of each 725
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time a minor with an open case is examined under chapter 394, 726
including whether the minor was voluntarily or involuntarily 727
examined under s. 394.4625 or s. 394.4635, and the number of 728
days spent in a receiving facility . The data must shall identify 729
reasons for sibling separation and examination under chapter 730
394. Information related to sibling placement and examination 731
under chapter 394 must shall be incorporated into the results -732
oriented accountability system required under s. 409.997 and 733
into the evaluation of the outcome specified in s. 734
409.986(2)(e). The information related to sibling placement must 735
shall also be made available to the institute established under 736
s. 1004.615 for use in assessing the performance of child 737
welfare services in relation to the outcome specified in s. 738
409.986(2)(e). 739
Section 5. Subsection (7) of section 1001.212, Florida 740
Statutes, is amended to read: 741
1001.212 Office of Safe Schools.—There is created in the 742
Department of Education the Office of Safe Schools. The office 743
is fully accountable to the Commissioner of Education. The 744
office shall serve as a central repository for best practices, 745
training standards, and compliance ove rsight in all matters 746
regarding school safety and security, including prevention 747
efforts, intervention efforts, and emergency preparedness 748
planning. The office shall: 749
(7) Provide data to support the evaluation of mental 750
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health services pursuant to s. 100 4.44. 751
(a) Such data must include, for each school, the number of 752
involuntary examinations as defined in s. 394.455 which are 753
initiated at the school, on school transportation, or at a 754
school-sponsored activity and the number of children for whom an 755
examination is initiated. 756
1. The following information for each student must also be 757
included with such data: 758
a. The student's name, age, grade, race, gender, and 759
national origin; 760
b. The student's disability status, including whether he 761
or she has or is eligible for a Section 504 plan or an 762
individual education plan (IEP), and whether the reason for such 763
services or eligibility is a developmental disability; 764
c. Whether the student is experiencing homelessness as 765
described in s. 1003.01(12); 766
d. Whether the student has limited English proficiency as 767
defined in s. 1003.56(2)(a); 768
e. The number of school days that passed after the 769
involuntary examination and before the day the student next 770
attended school; 771
f. Whether the student involuntarily examined has been 772
previously examined and, if so, the number of times the student 773
has been examined; 774
g. Whether a mobile crisis response team was contacted 775
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before the examination, and, if so, whether the team conducted 776
an examination of the child and the team's r ecommendations; 777
h. Whether the student's parent or guardian was contacted 778
before the decision to initiate the involuntary examination and 779
whether the parent or guardian consented; and 780
i. Any other information the department determines is 781
appropriate. 782
2. The information required under subparagraph 1. must be 783
updated monthly, and data on total incidents of involuntary 784
examination, disaggregated by sub -subparagraphs 1.a.-d., must be 785
made publicly accessible on the department's website, including 786
on the K-12 data portal, annually within 90 days after the last 787
day of each school year and in compliance with applicable 788
privacy laws. Data aggregated by a school district for sub -789
subparagraph 1.f. must also be made publicly accessible on the 790
department's website annually and in compliance with applicable 791
privacy laws. School districts shall notify all parents of the 792
availability of this data before any deadlines for applications 793
to transfer between schools or school districts. The department 794
shall adopt rules set ting minimum standards for documenting, 795
reporting, and monitoring the use of involuntary examination of 796
students under s. 394.463. The department must provide school 797
districts with such standards before August 1, 2023. 798
(b) Such data must also include, fo r each school, the 799
number of incidents of mandatory mental health treatment and the 800
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number of children provided such treatment. For the purposes of 801
this paragraph, the term "mandatory mental health treatment" 802
means any time a student is required to undergo mental health 803
treatment or examination as a condition of attendance at school 804
or participation in any school activity. The term includes, but 805
is not limited to: 806
1. Mental health treatment as a condition of admittance to 807
or transfer to or from a school; 808
2. Mental health treatment as a condition of avoiding or 809
modifying the severity of suspension, expulsion, transfer to 810
another school, or discipline of any kind; 811
3. Requiring a parent or guardian to take a student to a 812
receiving facility for involuntary examination under s. 394.4635 813
or voluntary examination under s. 394.4625; 814
4. Involuntary examination initiated on a school campus or 815
otherwise reported pursuant this section; or 816
5. Mental health treatment or examination required as part 817
of determining a student's eligibility for, or as an element of, 818
exceptional student instruction. 819
(c)1. Each school district, charter school sponsor, or 820
other entity operating a public school shall develop and submit 821
to the office, no later than August 1, 2022, polici es and 822
procedures that are consistent with this subsection and that 823
govern all of the following: 824
a. Compliance with paragraphs (a) and (b). 825
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b. Monitoring and reporting of data collected. 826
c. Notification to all parents and guardians at the 827
beginning of a school year of their rights under ss. 828
1002.20(3)(l) and 1002.33(9)(q). 829
d. Training programs relating to involuntary examinations 830
and mandatory mental health treatment. 831
e. The entity's plan for selecting personnel to be 832
trained. 833
f. The entity's plan for eliminating the inappropriate use 834
of involuntary examinations and other inappropriate mandatory 835
mental health treatment. The plan must include a goal for 836
reducing the necessity for involuntary examination and mandatory 837
mental health treatment and mu st include activities, skills, and 838
resources required to achieve that goal. 839
2. The office shall monitor the effectiveness of the 840
policies and procedures submitted pursuant to subparagraph 1., 841
and the department shall adopt rules to implement the most 842
effective policies and procedures on a statewide basis. 843
Section 6. (1) Effective September 1, 2022, a Telehealth 844
Pilot Program is created within the Department of Children and 845
Families to provide services to Hillsborough, Leon, and Miami -846
Dade Counties for 1 year. The purpose of this pilot program is 847
to assess whether the use of involuntary examination of a minor 848
is appropriate before the minor is transported for an 849
involuntary examination. 850
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(2) In each of the counties participating in the pilot 851
program, before transporting a minor to a receiving facility for 852
involuntary examination pursuant to s. 394.4635(3), Florida 853
Statutes, the person transporting the minor must use telehealth 854
services to obtain the advice of a medical professional 855
authorized to initiate involuntary examinations as to whether 856
the minor meets the criteria for involuntary examination. The 857
telehealth services may not be provided by an entity that 858
provides involuntary examination services. 859
(3) The Department of Children and Families sha ll analyze 860
and compare data on the use of involuntary examinations of 861
minors before and after implementation of the pilot program and 862
shall prepare a report summarizing the impact of the pilot 863
program and submit the report to the Governor, the President of 864
the Senate, and the Speaker of the House of Representatives 865
within 90 days after September 1, 2023. 866
(4) The Legislature shall appropriate funds necessary for 867
the creation and administration of the pilot program. 868
(5) The Department of Children and Fami lies shall adopt 869
rules to administer the pilot program. 870
(6) This section expires January 1, 2024. 871
Section 7. Subsection (1) and paragraphs (a), (f), and (g) 872
of subsection (2) of section 394.463, Florida Statutes, are 873
amended to read: 874
394.463 Involuntary examination.— 875
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(1) CRITERIA.—A person 18 years of age or older may be 876
taken to a receiving facility for involuntary examination if 877
there is reason to believe that the person has a mental illness 878
and because of his or her mental illness: 879
(a)1. The person has refused voluntary examination after 880
conscientious explanation and disclosure of the purpose of the 881
examination; or 882
2. The person is unable to determine for himself or 883
herself whether examination is necessary; and 884
(b)1. Without care or treatm ent, the person is likely to 885
suffer from neglect or refuse to care for himself or herself; 886
such neglect or refusal poses a real and present threat of 887
substantial harm to his or her well -being; and it is not 888
apparent that such harm may be avoided through th e help of 889
willing family members or friends or the provision of other 890
services; or 891
2. There is a substantial likelihood that without care or 892
treatment the person will cause serious bodily harm to himself 893
or herself or others in the near future, as eviden ced by recent 894
behavior. 895
(2) INVOLUNTARY EXAMINATION. — 896
(a) An involuntary examination may be initiated on a 897
person 18 years of age or older by any one of the following 898
means: 899
1. A circuit or county court may enter an ex parte order 900
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stating that a person appears to meet the criteria for 901
involuntary examination and specifying the findings on which 902
that conclusion is based. The ex parte order for involuntary 903
examination must be based on written or oral sworn testimony 904
that includes specific facts that sup port the findings. If other 905
less restrictive means are not available, such as voluntary 906
appearance for outpatient evaluation, a law enforcement officer, 907
or other designated agent of the court, shall take the person 908
into custody and deliver him or her to an appropriate, or the 909
nearest, facility within the designated receiving system 910
pursuant to s. 394.462 for involuntary examination. The order of 911
the court shall be made a part of the patient's clinical record. 912
A fee may not be charged for the filing of an or der under this 913
subsection. A facility accepting the patient based on this order 914
must send a copy of the order to the department within 5 working 915
days. The order may be submitted electronically through existing 916
data systems, if available. The order shall be valid only until 917
the person is delivered to the facility or for the period 918
specified in the order itself, whichever comes first. If a time 919
limit is not specified in the order, the order is valid for 7 920
days after the date that the order was signed. 921
2. A law enforcement officer shall take a person who 922
appears to meet the criteria for involuntary examination into 923
custody and deliver the person or have him or her delivered to 924
an appropriate, or the nearest, facility within the designated 925
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receiving system pur suant to s. 394.462 for examination. The 926
officer shall execute a written report detailing the 927
circumstances under which the person was taken into custody, 928
which must be made a part of the patient's clinical record. Any 929
facility accepting the patient based on this report must send a 930
copy of the report to the department within 5 working days. 931
3. A physician, a physician assistant, a clinical 932
psychologist, a psychiatric nurse, an advanced practice 933
registered nurse registered under s. 464.0123, a mental healt h 934
counselor, a marriage and family therapist, or a clinical social 935
worker may execute a certificate stating that he or she has 936
examined a person within the preceding 48 hours and finds that 937
the person appears to meet the criteria for involuntary 938
examination and stating the observations upon which that 939
conclusion is based. If other less restrictive means, such as 940
voluntary appearance for outpatient evaluation, are not 941
available, a law enforcement officer shall take into custody the 942
person named in the certif icate and deliver him or her to the 943
appropriate, or nearest, facility within the designated 944
receiving system pursuant to s. 394.462 for involuntary 945
examination. The law enforcement officer shall execute a written 946
report detailing the circumstances under wh ich the person was 947
taken into custody. The report and certificate shall be made a 948
part of the patient's clinical record. Any facility accepting 949
the patient based on this certificate must send a copy of the 950
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certificate to the department within 5 working day s. The 951
document may be submitted electronically through existing data 952
systems, if applicable. 953
954
When sending the order, report, or certificate to the 955
department, a facility shall, at a minimum, provide information 956
about which action was taken regarding the patient under 957
paragraph (g), which information shall also be made a part of 958
the patient's clinical record. 959
(f) A patient 18 years of age or older shall be examined 960
by a physician or a clinical psychologist, or by a psychiatric 961
nurse performing within the framework of an established protocol 962
with a psychiatrist at a facility without unnecessary delay to 963
determine if the criteria for involuntary services are met. 964
Emergency treatment may be provided upon the order of a 965
physician if the physician determines t hat such treatment is 966
necessary for the safety of the patient or others. The patient 967
may not be released by the receiving facility or its contractor 968
without the documented approval of a psychiatrist or a clinical 969
psychologist or, if the receiving facility is owned or operated 970
by a hospital or health system, the release may also be approved 971
by a psychiatric nurse performing within the framework of an 972
established protocol with a psychiatrist, or an attending 973
emergency department physician with experience in t he diagnosis 974
and treatment of mental illness after completion of an 975
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involuntary examination pursuant to this subsection. A 976
psychiatric nurse may not approve the release of a patient if 977
the involuntary examination was initiated by a psychiatrist 978
unless the release is approved by the initiating psychiatrist. 979
(g) The examination period must be for up to 72 hours. For 980
a minor, the examination shall be initiated within 12 hours 981
after the patient's arrival at the facility. Within the 982
examination period or, if t he examination period ends on a 983
weekend or holiday, no later than the next working day 984
thereafter, one of the following actions must be taken, based on 985
the individual needs of the patient: 986
1. The patient shall be released, unless he or she is 987
charged with a crime, in which case the patient shall be 988
returned to the custody of a law enforcement officer; 989
2. The patient shall be released, subject to subparagraph 990
1., for voluntary outpatient treatment; 991
3. The patient, unless he or she is charged with a cri me, 992
shall be asked to give express and informed consent to placement 993
as a voluntary patient and, if such consent is given, the 994
patient shall be admitted as a voluntary patient; or 995
4. A petition for involuntary services shall be filed in 996
the circuit court if inpatient treatment is deemed necessary or 997
with the criminal county court, as defined in s. 394.4655(1), as 998
applicable. When inpatient treatment is deemed necessary, the 999
least restrictive treatment consistent with the optimum 1000
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improvement of the patient 's condition shall be made available. 1001
When a petition is to be filed for involuntary outpatient 1002
placement, it shall be filed by one of the petitioners specified 1003
in s. 394.4655(4)(a). A petition for involuntary inpatient 1004
placement shall be filed by the faci lity administrator. 1005
Section 8. Except as otherwise expressly provided in this 1006
act, this act shall take effect July 1, 2022. 1007