Florida Senate - 2022 SB 1510 By Senator Powell 30-00740A-22 20221510__ 1 A bill to be entitled 2 An act relating to the mental health of minors; 3 amending s. 394.462, F.S.; requiring that 4 transportation plans include options for transporting 5 minors which do not involve marked police vehicles or 6 uniformed law enforcement officers; creating s. 7 394.4635, F.S.; defining the terms immediately and 8 serious bodily harm; specifying the conditions that 9 must be met for a minor to be taken to a receiving 10 facility for involuntary examination; specifying 11 requirements for initiating a minors involuntary 12 examination and his or her transportation; specifying 13 requirements for receiving facilities relating to such 14 minors; requiring that court orders for involuntary 15 examinations be made a part of the minors clinical 16 record; prohibiting a fee from being charged for 17 filing such orders; requiring facilities receiving 18 minors for involuntary examination to provide certain 19 orders and reports to the Department of Children and 20 Families; providing for the validity of such orders; 21 providing requirements for law enforcement officers 22 initiating involuntary examinations of minors or 23 transporting minors to such examinations; prohibiting 24 minors undergoing involuntary examinations initiated 25 by law enforcement officers from being held at medical 26 facilities for longer than a specified period; 27 providing an exception; requiring law enforcement 28 officers who initiate an involuntary examination for a 29 minor to execute a written report containing specified 30 information; requiring facilities to send such reports 31 to the department; requiring the law enforcement 32 officers agency to retain such report and to provide 33 a copy of the report to a minors parent or guardian 34 upon request; requiring that certain reports and 35 certificates be made part of a minors clinical 36 records; requiring facilities receiving minors for 37 involuntary examinations to create specified records; 38 requiring facilities to submit such records and copies 39 of certain reports to the department in a sworn 40 report; authorizing the department to adopt rules; 41 requiring facilities to notify minors and their 42 parents or guardians of the minors right to counsel 43 and to provide minors with the opportunity to 44 immediately consult and be represented by counsel; 45 providing requirements for the transportation of 46 minors to facilities for involuntary examination; 47 requiring specified examinations of minors admitted to 48 a receiving facility after an involuntary examination 49 is initiated by certain persons; requiring minors to 50 be released from receiving facilities as soon as a 51 specified determination is made; requiring facilities 52 to have at least one staff member with the authority 53 to make such determinations at the facility at all 54 times; 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 minors 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 requiring that a petition for involuntary services be 62 filed in specified circumstances; prohibiting students 63 from being removed from schools and transported to a 64 receiving facility for involuntary examination unless 65 certain requirements are met; requiring facilities to 66 contact schools for specified information under 67 certain circumstances; requiring facilities to notify 68 the department if schools fail to provide such 69 information; requiring the department, in consultation 70 with the Department of Education, to take certain 71 actions relating to such schools; prohibiting minors 72 receiving treatment for mental illness from being 73 deprived of specified privacy rights; providing 74 construction; requiring minors to be provided with 75 parental or guardian contact; providing an exception; 76 providing construction; requiring receiving facility 77 staff to consult with certain persons to ensure 78 continuity of care and prevent disruption to existing 79 medication regimens; requiring that certain conditions 80 be met before giving or prescribing a minor certain 81 psychotropic medication; providing remedies for minors 82 for specified violations; providing immunity for 83 certain persons acting in good faith; providing an 84 exception; requiring facilities examining minors on a 85 voluntary basis to provide the department with a 86 report containing specified information and copies of 87 certain other reports within a specified timeframe; 88 requiring the department to annually publish specified 89 data relating to such reports; providing construction; 90 requiring the department to contract with a 91 consultancy on crisis services to review the provision 92 of crisis services for minors; providing requirements 93 for such review; providing construction; amending s. 94 394.467, F.S.; revising requirements for minors to be 95 ordered for involuntary inpatient placement; defining 96 the term serious bodily harm; conforming provisions 97 to changes made by the act; amending s. 409.996, F.S.; 98 revising duties of the department relating to 99 evaluations of lead agencies and monitoring out-of 100 home placements; amending s. 1001.212, F.S.; revising 101 data that must be provided by the Office of Safe 102 Schools to support the evaluation of specified mental 103 health services; requiring the department to adopt 104 certain rules and provide school districts with 105 certain standards before a specified date; defining 106 the term mandatory mental health treatment; 107 requiring school districts, charter school sponsors, 108 and other entities operating a public school to 109 develop, implement, and submit to the office specified 110 policies and procedures by a specified date; requiring 111 the office to monitor the effectiveness of such 112 policies and procedures; requiring the department to 113 adopt rules implementing the most effective policies 114 and procedures on a statewide basis; creating the 115 Telehealth Pilot Program within the Department of 116 Children and Families; providing a purpose for the 117 program; requiring certain persons transporting minors 118 to receiving facilities to first obtain specified 119 advice through telehealth services; prohibiting the 120 telehealth services from being provided by an entity 121 that provides involuntary examination services; 122 requiring the department to analyze and compare 123 specified data and prepare a report summarizing the 124 impact of the program; requiring the department to 125 submit the report to the Governor and the Legislature 126 by a specified date; requiring the Legislature to 127 appropriate funds necessary for the creation and 128 administration of the pilot program; requiring the 129 department to adopt rules; providing for future 130 expiration; amending s. 394.463, F.S.; conforming 131 provisions to changes made by the act; providing 132 effective dates. 133 134 Be It Enacted by the Legislature of the State of Florida: 135 136 Section 1.Subsection (4) is added to section 394.462, 137 Florida Statutes, to read: 138 394.462Transportation.A transportation plan shall be 139 developed and implemented by each county in collaboration with 140 the managing entity in accordance with this section. A county 141 may enter into a memorandum of understanding with the governing 142 boards of nearby counties to establish a shared transportation 143 plan. When multiple counties enter into a memorandum of 144 understanding for this purpose, the counties shall notify the 145 managing entity and provide it with a copy of the agreement. The 146 transportation plan shall describe methods of transport to a 147 facility within the designated receiving system for individuals 148 subject to involuntary examination under s. 394.463 or 149 involuntary admission under s. 397.6772, s. 397.679, s. 150 397.6798, or s. 397.6811, and may identify responsibility for 151 other transportation to a participating facility when necessary 152 and agreed to by the facility. The plan may rely on emergency 153 medical transport services or private transport companies, as 154 appropriate. The plan shall comply with the transportation 155 provisions of this section and ss. 397.6772, 397.6795, 397.6822, 156 and 397.697. 157 (4)TRANSPORTING MINORS.The transportation plan must 158 include options for transporting minors which do not involve 159 marked police vehicles or uniformed law enforcement officers. 160 Section 2.Section 394.4635, Florida Statutes, is created 161 to read: 162 394.4635Involuntary examination of a minor. 163 (1)DEFINITION.For the purposes of this section, the term: 164 (a)Immediately means without unnecessary delay. 165 (b)Serious bodily harm means a physical condition that 166 creates a substantial risk of death, protracted and obvious 167 disfigurement, or protracted loss or impairment of a bodily 168 member or of an organs function. 169 (2)CRITERIA FOR INVOLUNTARY EXAMINATION.A minor may only 170 be taken to a receiving facility for involuntary examination if 171 all of the following conditions are met: 172 (a)It is likely that the minor has a mental illness and, 173 because of his or her mental illness and as evidenced by recent 174 behavior, there is a substantial likelihood that the minor will 175 imminently cause death or serious bodily harm to himself or 176 herself or to others if the minor is not immediately examined. 177 (b)Involuntary examination is the least restrictive means 178 of preventing the minor from imminently causing serious bodily 179 harm to himself or herself or others. 180 (c)1.The minors parent or guardian with the authority to 181 consent to medical treatment, after being informed of the 182 specific circumstances giving rise to the recommendation to do 183 so, provides his or her express and informed voluntary consent 184 for the minors examination at a receiving facility; 185 2.The parents or guardians consent cannot be obtained 186 under subparagraph 1. because none of the minors parents or 187 guardians can be located after exhausting all reasonable efforts 188 to contact each of them; or 189 3.There is recent and affirmative evidence, including, but 190 not limited to, evidence provided by the minor, that contacting 191 the minors parent or guardian would cause an imminent risk of 192 death, serious bodily harm, or physical or sexual abuse of the 193 minor. 194 (3)INITIATION OF INVOLUNTARY EXAMINATION.An involuntary 195 examination of a minor may be initiated by any one of the 196 following means: 197 (a)A circuit or county court may enter an ex parte order 198 stating that the minor appears to meet the criteria for 199 involuntary examination of minors under this section and 200 specifying the findings on which that conclusion is based. The 201 ex parte order for involuntary examination must be based on 202 written or oral sworn testimony that includes actual knowledge 203 of specific facts that support the findings. If other less 204 restrictive means are not available, such as voluntary 205 appearance for outpatient evaluation, a law enforcement officer, 206 a parent or guardian, the parents or guardians designee, a 207 medical provider, or any other designated agent of the court 208 must take the minor into custody and transport the minor to an 209 appropriate, or the nearest, facility within the designated 210 receiving system pursuant to s. 394.462 for involuntary 211 examination. Immediately after a minors arrival at a receiving 212 facility, the facility staff shall verbally explain to the 213 minor, and, if present, the minors parent or guardian, the 214 rights of patients under s. 394.459 using language and 215 terminology the minor understands and shall provide a copy of 216 the rights or physically show the minor where the notice of 217 rights of patients is posted in the facility as required under 218 s. 394.459(12). If the minors parent or guardian is not present 219 at the time of the minors arrival, the facility must attempt to 220 notify the parent or guardian pursuant to s. 394.4599(2)(c)2. 221 The order of the court must be made a part of the minors 222 clinical record. A fee may not be charged for the filing of an 223 order under this paragraph. A facility accepting the patient 224 based on such order must send a copy of the order to the 225 department within 5 working days. The order may be submitted 226 electronically through existing data systems, if applicable. The 227 order is valid only until the minor is delivered to the facility 228 or for the period specified in the order itself, whichever 229 occurs first. If a period is not specified in the order, the 230 order is valid for 7 days after the date the order was signed. 231 (b)1.A law enforcement officer may take a minor who 232 appears to meet the criteria for involuntary examination of 233 minors under this section into custody and, consistent with 234 subsection (6), deliver the minor or have him or her delivered 235 by another person to an appropriate, or the nearest, facility 236 within the designated receiving system pursuant to s. 394.462 237 for a determination of whether the minor meets the criteria for 238 involuntary examination. Whenever possible, an officer 239 considering such transportation must use telehealth resources or 240 other means to obtain the advice of a medical professional 241 authorized to initiate involuntary examinations as to whether 242 the minor meets the criteria for involuntary examination before 243 transporting him or her to a receiving facility. An officer who 244 uses such services or means and is advised that a minor does not 245 meet the criteria for involuntary examination may not take the 246 minor into custody or have the minor transported to a facility. 247 2.Once a minor arrives at a receiving facility for 248 involuntary examination initiated by a law enforcement officer, 249 the minor may not be held involuntarily for more than 2 hours 250 unless a physician, clinical psychologist, psychiatric nurse, 251 school psychologist, mental health counselor, marriage and 252 family therapist, or clinical social worker provides written 253 certification stating that he or she has examined the minor and 254 finds that the minor appears to meet the criteria for 255 involuntary examination of minors and stating the observations 256 upon which the finding is based. Upon the request of the minors 257 parent or guardian, the parent or guardian must be allowed to 258 remain with the minor at any time between the minors arrival at 259 the facility and when the examination occurs unless there is 260 recent and affirmative evidence, including, but not limited to, 261 evidence provided by the minor, that allowing the minors parent 262 or guardian to remain with the minor would cause an imminent 263 risk of death, serious bodily harm, or physical or sexual abuse 264 of the minor. Immediately after a minors arrival at a receiving 265 facility, the facility staff shall verbally explain to the 266 minor, and, if present, the minors parent or guardian, the 267 rights of patients under s. 394.459 using language and 268 terminology the minor understands and shall provide a copy of 269 the rights or physically show the minor where the notice of 270 rights of patients is posted in the facility as required under 271 s. 394.459(12). If the minors parent or guardian is not present 272 at the time of the minors arrival, the facility must attempt to 273 notify the parent or guardian as required by s. 394.4599(2)(c)2. 274 and seek his or her consent for further examination of the 275 minor, except to the extent such consent is not required under 276 subparagraph (2)(c)3. 277 3.Regardless of whether a facility receives written 278 certification that the minor meets the criteria for involuntary 279 examination under subparagraph 2., the law enforcement officer 280 who took the minor into custody must execute a written report 281 detailing the circumstances under which the minor was taken into 282 custody, and the report must be made a part of the minors 283 clinical record. The facility shall send a copy of the report to 284 the department within 5 working days, regardless of whether the 285 minor is admitted. The law enforcement officers law enforcement 286 agency shall retain a copy of the report pursuant to the 287 agencys policy and provide it to the minors parent or guardian 288 at his or her request. The report must state the reasons the 289 examination was initiated; specify whether the minor was taken 290 into custody at a school and, if so, provide the name and 291 address of the school; and specify which criteria were met under 292 paragraph (2)(c). If the criterion under subparagraph (2)(c)1. 293 was met, the report must include the parents or guardians name 294 and contact information. If the criterion under subparagraph 295 (2)(c)2. was met, the report must state the means by which the 296 law enforcement officer attempted to locate each parent or 297 guardian. If the criterion under subparagraph (2)(c)3. was met, 298 the report must include the recent and affirmative evidence that 299 led to a conclusion that contacting the parent or guardian would 300 pose an imminent risk of death, serious bodily harm, or physical 301 or sexual abuse of the minor. 302 (c)1.A physician, clinical psychologist, psychiatric 303 nurse, school psychologist, mental health counselor, marriage 304 and family therapist, or clinical social worker may provide 305 written certification stating that he or she has examined a 306 minor, either in person or through telehealth, within the 307 preceding 48 hours and finds that the minor appears to meet the 308 criteria for involuntary examination and stating the 309 observations upon which that conclusion is based. 310 2.If other less restrictive means, such as voluntary 311 appearance for outpatient evaluation, are not available, a 312 parent or guardian, the parents or guardians designee, a 313 family member, a friend, a medical provider, a school counselor, 314 a school administrator, or a law enforcement officer must take 315 the minor named in the certification into custody and deliver 316 him or her to the appropriate, or nearest, facility within the 317 designated receiving system pursuant to s. 394.462 for 318 involuntary examination. Upon the minors arrival, the facility 319 staff shall verbally explain to the minor, and, if present, the 320 minors parent or guardian, the rights of patients under s. 321 394.459 using language and terminology the minor understands and 322 shall provide a copy of the rights or physically show the minor 323 where the notice of rights of patients is posted in the facility 324 as required under s. 394.459(12). If the minors parent or 325 guardian is not present at the time of the minors arrival, the 326 facility must attempt to notify the parent or guardian pursuant 327 to s. 394.4599(2)(c)2. and seek his or her consent for further 328 examination of the minor, except to the extent such consent is 329 not required under subparagraph (2)(c)3. The minor must be 330 transported consistent with the requirements under subsection 331 (6). If the person transporting the minor is a law enforcement 332 officer, the officer must also execute a written report 333 detailing the circumstances under which the minor was taken into 334 custody. The report must state the reasons the examination was 335 initiated; specify whether the minor was taken into custody at a 336 school and, if so, provide the name and address of the school; 337 and specify which criteria were met under paragraph (2)(c). If 338 the criterion under subparagraph (2)(c)1. was met, the report 339 must include the parents or guardians name and contact 340 information. If the criterion under subparagraph (2)(c)2. was 341 met, the report must state the means by which the law 342 enforcement officer attempted to locate each parent or guardian. 343 If the criterion under subparagraph (2)(c)3. was met, the report 344 must include the recent and affirmative evidence that led to a 345 conclusion that contacting the parent or guardian would pose an 346 imminent risk of death, serious bodily harm, or physical or 347 sexual abuse of the minor. 348 3.The report and certificate must be made a part of the 349 minors clinical record. Any facility accepting the minor based 350 on the certificate must send a copy of the certificate to the 351 department within 5 working days, regardless of whether the 352 minor is not admitted or is admitted on a voluntary or 353 involuntary basis. The document may be submitted electronically 354 through existing data systems, if applicable. A full and 355 complete copy of the minors clinical record or any portion of 356 it, including the report and certificate, must be provided to 357 the minors parent or guardian upon his or her request. 358 (4)REQUIRED FACILITY REPORTS. 359 (a)1.At the time the minor arrives at the receiving 360 facility, the facility shall record whether the minor meets the 361 criteria for involuntary services at that time; whether the 362 minor meets the criteria because of risk of death or serious 363 bodily harm to himself or herself or others; the means by which 364 the minor arrived at the facility, including whether he or she 365 was transported there by law enforcement; whether the areas 366 mobile crisis response team was contacted before the admission; 367 the time and date the minor arrived at the facility; whether the 368 minor has Medicaid, Medicare, private health insurance, or no 369 health insurance; the minors age, name, race, gender, national 370 origin, disability status, including whether the minor has a 371 developmental disability, and social security number; what 372 actions were taken after the initial examination, including 373 whether the minor was released or examined further; and any 374 other information the department requires by rule. 375 2.At the conclusion of the period specified in subsection 376 (8), the facility shall record the time and date the minor left 377 the facility or a petition for involuntary services was 378 initiated pursuant to paragraph (8)(d); whether psychotropic 379 medication was administered while the minor was in the facility; 380 if the minor left the facility, a description of the follow-up 381 services provided; and any other information the department 382 requires by rule. 383 (b)A receiving facility shall submit the records created 384 in paragraph (a) to the department in a sworn written report 385 that also includes copies of any reports prepared by law 386 enforcement or school personnel required under this section. The 387 information in the report shall also be made a part of the 388 minors clinical record. The department may adopt rules 389 governing such reports. 390 (5)RIGHT TO COUNSEL.Upon a minors arrival at a receiving 391 facility, the facility shall notify the minor and his or her 392 parent or guardian of the minors right to counsel and shall 393 provide the minor the opportunity to immediately consult with 394 and be represented by a public defender or the minors attorney. 395 (6)TRANSPORTATION.All persons initiating the involuntary 396 examination of a minor shall make every effort to avoid 397 transporting minors in vehicles ordinarily used for law 398 enforcement purposes. When law enforcement officers initiate or 399 participate in the transportation of a minor for involuntary 400 examination, officers must use the least restrictive means for 401 transporting the minor and must use unmarked vehicles or 402 ambulances if available. Law enforcement officers must allow a 403 minors parent or guardian or the parents or guardians 404 designee, if available, to transport the minor to the receiving 405 facility unless there is compelling evidence that doing so would 406 endanger the minor. If the parent or guardian of a minor, or the 407 parents or guardians designee, is unavailable to transport the 408 minor, law enforcement officers must allow other appropriate and 409 willing persons to transport the minor, if available, including 410 a school counselor, school administrator, family member, friend, 411 or medical provider, unless there is compelling evidence that 412 doing so would endanger the minor. If a minor is transported by 413 a law enforcement officer, the officer must also allow the 414 minors parent or guardian to ride in the same vehicle with the 415 minor unless there is compelling evidence that doing so would 416 endanger the minor. Law enforcement officers may not use 417 restraints on a minor being transported for involuntary 418 examination, including handcuffs, hobbles, and zip ties, except 419 in a situation where there is no other available means to 420 prevent imminent serious bodily harm to the minor or others. A 421 department or agency policy requiring that all persons 422 transported in police cars be restrained may not be used to 423 justify the use of restraint on minors transported pursuant to 424 this section. 425 (7)MINIMAL DETENTION.When a minor is admitted to a 426 receiving facility after an involuntary examination is initiated 427 by someone other than a physician, a clinical psychologist, or a 428 psychiatric nurse performing within the framework of an 429 established protocol with a psychiatrist at a facility, a 430 physician, a clinical psychologist, or a psychiatric nurse must 431 examine the minor immediately upon admission to determine if the 432 criteria for involuntary services are met. A minor shall be 433 released from a receiving facility as soon as a physician, a 434 clinical psychologist, a psychiatric nurse, an advanced practice 435 registered nurse registered under s. 464.0123, a mental health 436 counselor, a marriage and family therapist, or a clinical social 437 worker at the facility determines the minor no longer meets the 438 criteria for involuntary examination of minors. Facilities may 439 establish procedures to designate one or more employees to make 440 such determination, but the facility must have at least one 441 staff member with the authority to make such determination at 442 the facility at all times. Emergency treatment may be provided 443 to a minor upon the order of a physician if the physician 444 determines that such treatment is necessary for the safety of 445 the minor or others. A minor must be immediately released if the 446 minors parent or guardian revokes consent for his or her 447 admission to a facility. 448 (8)DURATION AND CONCLUSION OF INVOLUNTARY EXAMINATION.The 449 examination period for a minor may not last longer than 72 450 hours. Within the examination period one of the following 451 actions must be taken, based on the individual needs of the 452 minor: 453 (a)The minor must be released pursuant to subsection (7). 454 (b)The minor must be released for voluntary outpatient 455 treatment. 456 (c)If the minor and the minors parent or guardian have 457 given express and informed written consent to placement as a 458 voluntary patient, the minor must be admitted as a voluntary 459 patient. 460 (d)A petition for involuntary services must be filed in 461 the circuit court if inpatient treatment is deemed necessary or 462 with the criminal county court, as defined in s. 394.4655(1), as 463 applicable. If inpatient treatment is deemed necessary, the 464 least restrictive treatment consistent with the optimum 465 improvement of the minors condition must be made available. A 466 petition for involuntary inpatient placement must state, under 467 penalty of perjury, that the receiving facility administrator 468 believes the minor meets the criteria for involuntary placement 469 and the facility intends to pursue such placement. The petition 470 must be filed by the facility administrator. 471 (9)REMOVAL FROM SCHOOLS. 472 (a)A student may not be removed from any school as defined 473 in s. 1003.01(2) and transported to a receiving facility for 474 involuntary examination unless the school principal, the school 475 counselor, the school psychologist, or any other school official 476 who has the most knowledge about the circumstances of the 477 students removal submits a written report to the department 478 containing all of the following information: 479 1.The school name and address. 480 2.The time and date of the removal. 481 3.The students name, age, grade, race, gender, and 482 national origin. 483 4.Whether the student has a disability, including whether 484 he or she has a Section 504 plan or an individual education plan 485 (IEP), and the basis for such classification or receipt of 486 services, including the nature of the disability or medical 487 diagnosis. 488 5.Whether the student is experiencing homelessness as 489 described in s. 1003.01(12). 490 6.Whether the student has limited English proficiency as 491 defined in s. 1003.56(2)(a). 492 7.The circumstances leading to the involuntary 493 examination, including whether the behavior leading to the 494 involuntary examination was observed by a law enforcement 495 officer directly or relayed to law enforcement indirectly and 496 whether the basis for the removal was for danger to self or 497 others. 498 8.If the involuntary examination was initiated because of 499 danger to self, whether the school used a suicide screening 500 instrument approved under s. 1012.583. 501 9.Whether a physician, clinical psychologist, psychiatric 502 nurse, school psychologist, mental health counselor, marriage 503 and family therapist, clinical social worker, or mobile crisis 504 team, and, if the student has a disability, an exceptional 505 student education director or a member of the students IEP 506 team, was present on the school campus at the time of the 507 decision to remove the student or to contact law enforcement to 508 do so. 509 10.Whether a physician, clinical psychologist, psychiatric 510 nurse, school psychologist, mental health counselor, marriage 511 and family therapist, clinical social worker, or mobile crisis 512 team, and, if the student has a disability, an exceptional 513 student education director or a member of the students IEP 514 team, was consulted before the decision to remove the student 515 from the school for involuntary examination. 516 11.If the student is a minor, whether a parent or guardian 517 was contacted before the students removal and, if so, whether 518 the parent or guardian consented to the removal and whether he 519 or she was given the opportunity to remove the student from 520 school. 521 12.Any other information the department determines is 522 appropriate. 523 (b)If a receiving facility receives a student for 524 involuntary examination and the report of the law enforcement 525 officer made pursuant to subsection (3) indicates that the 526 student was removed from a school but the student is not 527 accompanied by the schools report required under paragraph (a) 528 or the report is incomplete, the facility must contact the 529 school by the end of the next working day and obtain a completed 530 copy of the report. If the school fails to provide the report, 531 the facility must notify the department by certified mail or by 532 e-mail, if available, by the next working day. The department 533 shall keep records of all such notifications and take all 534 appropriate steps, in consultation with the Department of 535 Education, to ensure that any failures to notify do not reoccur. 536 (c)The department may adopt rules governing such reports. 537 (10)PRIVACY.A minor receiving treatment for mental 538 illness may not be deprived of his or her right to privacy under 539 state and federal law, the United States Constitution, or the 540 State Constitution, including the right to keep the fact of such 541 treatment confidential and not disclose the information except 542 to those individuals who provide medical services or collect 543 data on the use of involuntary and voluntary examination. This 544 subsection may not be construed to limit any other rights minors 545 may have under this chapter or other law, including, but not 546 limited to, s. 394.459. Each entity sharing, collecting, or 547 maintaining data or information under this section is required 548 to meet the standards set forth in the National Institute of 549 Standards and Technology Cybersecurity Framework Version 1.1. 550 (11)ACCESS TO PARENTS OR GUARDIANS.A minor shall be 551 provided as much contact with his or her parent or guardian as 552 he or she desires and is practicable unless the treating 553 psychiatrist executes a written certificate under penalty of 554 perjury indicating that doing so would pose a risk of serious 555 psychological harm. At a minimum, such contact must include 556 daily in-person visiting hours and unlimited use of a telephone 557 for the minor to contact his or her parent or guardian and, to 558 the extent practicable, allow a minors parent or guardian to 559 stay with the minor overnight in the receiving facility. This 560 subsection may not be construed to limit any other rights minors 561 may have under this chapter or other law, including, but not 562 limited to, s. 394.459. 563 (12)CONTINUITY OF CARE.Receiving facility staff shall 564 consult with the parent or guardian of a minor and any medical 565 professionals treating the minor to ensure continuity of care 566 and prevent disruption to the minors existing medication 567 regimen. Psychotropic medication that a minor is not prescribed 568 at the time of evaluation or treatment must be given or 569 prescribed to a minor only after every reasonable effort has 570 been made to consult with the minors existing medical and 571 psychiatric providers. 572 (13)VIOLATIONS.Any minor whose rights under this chapter 573 have been violated may file suit through his or her legal 574 representative against any person, agency, municipality, 575 district, or other entity in any court of this state having 576 jurisdiction. A minor who files suit may seek declaratory 577 relief, injunctive relief, and damages. Any person who acts in 578 good faith in compliance with this part is immune from civil or 579 criminal liability for his or her actions in connection with the 580 admission, diagnosis, treatment, or discharge of a minor from a 581 receiving facility, or the decision not to admit the minor or 582 initiate an examination. However, this section does not relieve 583 any person from liability if such person is negligent. 584 (14)REPORTING ON VOLUNTARY EXAMINATION. 585 (a)For each minor examined on a voluntary basis by a 586 receiving facility, the facility shall compile all of the 587 following information in a written report to the department: 588 1.The means by which the minor arrived at the facility, 589 including whether he or she was transported by law enforcement. 590 2.Whether the areas mobile crisis response team was 591 contacted. 592 3.Whether the minor is a student at a school as defined in 593 s. 1003.01(2) or at a private school as defined in s. 594 1002.01(2), whether the minor was transported to the facility 595 from that school, and, if so, the name of the school. 596 4.The time and date the minor arrived at the facility. 597 5.Whether the facility recommended that the minor 598 voluntarily consent to admission. 599 6.Whether the minor has Medicaid, Medicare, private health 600 insurance, or no health insurance. 601 7.Whether the minor has a developmental disability. 602 8.The minors age, name, race, gender, and national 603 origin. 604 9.The time and date the minor left the facility and a 605 description of the follow-up services provided, if applicable. 606 10.Any other information the department deems appropriate. 607 (b)For any minor examined or admitted on a voluntary 608 basis, the receiving facility must send a copy of the report to 609 the department within 5 working days after the examination, and 610 the facility must attach copies of any reports provided by law 611 enforcement and schools pursuant to this section to the report. 612 The department shall publish aggregated data, broken down by 613 demographics, for each category of information listed in 614 subparagraphs (a)1.-10. for every receiving facility on an 615 annual basis, no later than 6 months after the conclusion of the 616 fiscal year during which the data was collected. 617 (c)This subsection may not be construed to alter or expand 618 the authority of any person to examine a minor on a voluntary 619 basis under s. 394.4625. 620 (15)OUTSIDE REVIEW.The department shall contract with a 621 nationally recognized consultancy on crisis services for minors 622 which is based outside this state to review this states 623 provision of crisis services for minors. Such review must 624 include examining the clinical records of a random sample of 625 minors involuntarily examined and determining if they meet with 626 national best practices. The consultancy must make 627 recommendations for improvement of crisis services for minors. 628 The review must also provide an estimate of the per-minor cost 629 of involuntary examination compared with other methods of 630 addressing minors in crisis. 631 (16)CONSTRUCTION.The provisions of this section take 632 precedence over any provision of this chapter which is 633 inconsistent with this section. 634 Section 3.Subsection (1) of section 394.467, Florida 635 Statutes, is amended to read: 636 394.467Involuntary inpatient placement. 637 (1)CRITERIA. 638 (a)A person 18 years of age or older may be ordered for 639 involuntary inpatient placement for treatment upon a finding of 640 the court by clear and convincing evidence that: 641 1.(a)He or she has a mental illness and because of his or 642 her mental illness: 643 a.(I)1.a.He or she has refused voluntary inpatient 644 placement for treatment after sufficient and conscientious 645 explanation and disclosure of the purpose of inpatient placement 646 for treatment; or 647 (II)b.He or she is unable to determine for himself or 648 herself whether inpatient placement is necessary; and 649 b.(I)2.a.He or she is incapable of surviving alone or with 650 the help of willing and responsible family or friends, including 651 available alternative services, and, without treatment, is 652 likely to suffer from neglect or refuse to care for himself or 653 herself, and such neglect or refusal poses a real and present 654 threat of substantial harm to his or her well-being; 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 alternatives 660 that would offer an opportunity for improvement of his or her 661 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 inpatient 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 restrictive 672 means of preventing the minor from imminently causing serious 673 bodily harm to himself or herself or others. 674 4.a.The minors parent or guardian with the authority to 675 consent to medical treatment, after being informed of the 676 specific circumstances giving rise to the recommendation to do 677 so, provides his or her express and informed voluntary consent 678 for the minors examination at a receiving facility; 679 b.The parents or guardians consent cannot be obtained 680 under sub-subparagraph a. because the minors parents or 681 guardians cannot be located after exhausting all reasonable 682 efforts to contact each of them; or 683 c.There is recent and affirmative evidence, including, but 684 not limited to, evidence provided by the minor, that contacting 685 the minors parent or guardian would cause an imminent risk of 686 death, serious bodily harm, or physical or sexual abuse of the 687 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 organs function. 693 Section 4.Paragraphs (a) and (b) of subsection (21) of 694 section 409.996, Florida Statutes, are amended to read: 695 409.996Duties of the Department of Children and Families. 696 The department shall contract for the delivery, administration, 697 or management of care for children in the child protection and 698 child welfare system. In doing so, the department retains 699 responsibility for the quality of contracted services and 700 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 consultation 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 organizations, 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 annually. 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 dependency 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 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 1001.212Office 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 oversight 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 health 750 services pursuant to s. 1004.44. 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 students name, age, grade, race, gender, and 759 national origin; 760 b.The students disability status, including whether he or 761 she has or is eligible for a Section 504 plan or an individual 762 education plan (IEP), and whether the reason for such services 763 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 before the examination, and, if so, whether the team conducted 776 an examination of the child and the teams recommendations; 777 h.Whether the students 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 departments 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 departments 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 setting 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, for each school, the 799 number of incidents of mandatory mental health treatment and the 800 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 to this section; or 816 5.Mental health treatment or examination required as part 817 of determining a students 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, policies and 822 procedures that are consistent with this subsection and that 823 govern the following: 824 a.Compliance with paragraphs (a) and (b); 825 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 entitys plan for selecting personnel to be trained; 832 f.The entitys plan for eliminating the inappropriate use 833 of involuntary examinations and other inappropriate mandatory 834 mental health treatment. The plan must include a goal for 835 reducing the necessity for involuntary examination and mandatory 836 mental health treatment and must include activities, skills, and 837 resources required to achieve that goal. 838 2.The office shall monitor the effectiveness of the 839 policies and procedures submitted pursuant to subparagraph 1., 840 and the department shall adopt rules to implement the most 841 effective policies and procedures on a statewide basis. 842 Section 6.(1)Effective September 1, 2022, a Telehealth 843 Pilot Program is created within the Department of Children and 844 Families to provide services to Hillsborough, Leon, and Miami 845 Dade Counties for 1 year. The purpose of this pilot program is 846 to assess whether the use of involuntary examination of a minor 847 is appropriate before the minor is transported for an 848 involuntary examination. 849 (2)In each of the counties participating in the pilot 850 program, before transporting a minor to a receiving facility for 851 involuntary examination pursuant to s. 394.4635(3), Florida 852 Statutes, the person transporting the minor must use telehealth 853 services to obtain the advice of a medical professional 854 authorized to initiate involuntary examinations as to whether 855 the minor meets the criteria for involuntary examination. The 856 telehealth services may not be provided by an entity that 857 provides involuntary examination services. 858 (3)The Department of Children and Families shall analyze 859 and compare data on the use of involuntary examinations of 860 minors before and after implementation of the pilot program and 861 shall prepare a report summarizing the impact of the pilot 862 program and submit the report to the Governor, the President of 863 the Senate, and the Speaker of the House of Representatives 864 within 90 days after September 1, 2023. 865 (4)The Legislature shall appropriate funds necessary for 866 the creation and administration of the pilot program. 867 (5)The Department of Children and Families shall adopt 868 rules to administer the pilot program. 869 (6)This section expires January 1, 2024. 870 Section 7.Subsection (1) and paragraphs (a), (f), and (g) 871 of subsection (2) of section 394.463, Florida Statutes, are 872 amended to read: 873 394.463Involuntary examination. 874 (1)CRITERIA.A person 18 years of age or older may be 875 taken to a receiving facility for involuntary examination if 876 there is reason to believe that the person has a mental illness 877 and because of his or her mental illness: 878 (a)1.The person has refused voluntary examination after 879 conscientious explanation and disclosure of the purpose of the 880 examination; or 881 2.The person is unable to determine for himself or herself 882 whether examination is necessary; and 883 (b)1.Without care or treatment, the person is likely to 884 suffer from neglect or refuse to care for himself or herself; 885 such neglect or refusal poses a real and present threat of 886 substantial harm to his or her well-being; and it is not 887 apparent that such harm may be avoided through the help of 888 willing family members or friends or the provision of other 889 services; or 890 2.There is a substantial likelihood that without care or 891 treatment the person will cause serious bodily harm to himself 892 or herself or others in the near future, as evidenced by recent 893 behavior. 894 (2)INVOLUNTARY EXAMINATION. 895 (a)An involuntary examination may be initiated on a person 896 18 years of age or older by any one of the following means: 897 1.A circuit or county court may enter an ex parte order 898 stating that a person appears to meet the criteria for 899 involuntary examination and specifying the findings on which 900 that conclusion is based. The ex parte order for involuntary 901 examination must be based on written or oral sworn testimony 902 that includes specific facts that support the findings. If other 903 less restrictive means are not available, such as voluntary 904 appearance for outpatient evaluation, a law enforcement officer, 905 or other designated agent of the court, shall take the person 906 into custody and deliver him or her to an appropriate, or the 907 nearest, facility within the designated receiving system 908 pursuant to s. 394.462 for involuntary examination. The order of 909 the court shall be made a part of the patients clinical record. 910 A fee may not be charged for the filing of an order under this 911 subsection. A facility accepting the patient based on this order 912 must send a copy of the order to the department within 5 working 913 days. The order may be submitted electronically through existing 914 data systems, if available. The order shall be valid only until 915 the person is delivered to the facility or for the period 916 specified in the order itself, whichever comes first. If a time 917 limit is not specified in the order, the order is valid for 7 918 days after the date that the order was signed. 919 2.A law enforcement officer shall take a person who 920 appears to meet the criteria for involuntary examination into 921 custody and deliver the person or have him or her delivered to 922 an appropriate, or the nearest, facility within the designated 923 receiving system pursuant to s. 394.462 for examination. The 924 officer shall execute a written report detailing the 925 circumstances under which the person was taken into custody, 926 which must be made a part of the patients clinical record. Any 927 facility accepting the patient based on this report must send a 928 copy of the report to the department within 5 working days. 929 3.A physician, a physician assistant, a clinical 930 psychologist, a psychiatric nurse, an advanced practice 931 registered nurse registered under s. 464.0123, a mental health 932 counselor, a marriage and family therapist, or a clinical social 933 worker may execute a certificate stating that he or she has 934 examined a person within the preceding 48 hours and finds that 935 the person appears to meet the criteria for involuntary 936 examination and stating the observations upon which that 937 conclusion is based. If other less restrictive means, such as 938 voluntary appearance for outpatient evaluation, are not 939 available, a law enforcement officer shall take into custody the 940 person named in the certificate and deliver him or her to the 941 appropriate, or nearest, facility within the designated 942 receiving system pursuant to s. 394.462 for involuntary 943 examination. The law enforcement officer shall execute a written 944 report detailing the circumstances under which the person was 945 taken into custody. The report and certificate shall be made a 946 part of the patients clinical record. Any facility accepting 947 the patient based on this certificate must send a copy of the 948 certificate to the department within 5 working days. The 949 document may be submitted electronically through existing data 950 systems, if applicable. 951 952 When sending the order, report, or certificate to the 953 department, a facility shall, at a minimum, provide information 954 about which action was taken regarding the patient under 955 paragraph (g), which information shall also be made a part of 956 the patients clinical record. 957 (f)A patient 18 years of age or older shall be examined by 958 a physician or a clinical psychologist, or by a psychiatric 959 nurse performing within the framework of an established protocol 960 with a psychiatrist at a facility without unnecessary delay to 961 determine if the criteria for involuntary services are met. 962 Emergency treatment may be provided upon the order of a 963 physician if the physician determines that such treatment is 964 necessary for the safety of the patient or others. The patient 965 may not be released by the receiving facility or its contractor 966 without the documented approval of a psychiatrist or a clinical 967 psychologist or, if the receiving facility is owned or operated 968 by a hospital or health system, the release may also be approved 969 by a psychiatric nurse performing within the framework of an 970 established protocol with a psychiatrist, or an attending 971 emergency department physician with experience in the diagnosis 972 and treatment of mental illness after completion of an 973 involuntary examination pursuant to this subsection. A 974 psychiatric nurse may not approve the release of a patient if 975 the involuntary examination was initiated by a psychiatrist 976 unless the release is approved by the initiating psychiatrist. 977 (g)The examination period must be for up to 72 hours. For 978 a minor, the examination shall be initiated within 12 hours 979 after the patients arrival at the facility. Within the 980 examination period or, if the examination period ends on a 981 weekend or holiday, no later than the next working day 982 thereafter, one of the following actions must be taken, based on 983 the individual needs of the patient: 984 1.The patient shall be released, unless he or she is 985 charged with a crime, in which case the patient shall be 986 returned to the custody of a law enforcement officer; 987 2.The patient shall be released, subject to subparagraph 988 1., for voluntary outpatient treatment; 989 3.The patient, unless he or she is charged with a crime, 990 shall be asked to give express and informed consent to placement 991 as a voluntary patient and, if such consent is given, the 992 patient shall be admitted as a voluntary patient; or 993 4.A petition for involuntary services shall be filed in 994 the circuit court if inpatient treatment is deemed necessary or 995 with the criminal county court, as defined in s. 394.4655(1), as 996 applicable. When inpatient treatment is deemed necessary, the 997 least restrictive treatment consistent with the optimum 998 improvement of the patients condition shall be made available. 999 When a petition is to be filed for involuntary outpatient 1000 placement, it shall be filed by one of the petitioners specified 1001 in s. 394.4655(4)(a). A petition for involuntary inpatient 1002 placement shall be filed by the facility administrator. 1003 Section 8.Except as otherwise expressly provided in this 1004 act, this act shall take effect July 1, 2022.