HB 1349 2023
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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 mental health treatment; amending 2
s. 394.461, F.S.; authorizing the Department of 3
Children and Families to issue a conditional 4
designation to certain facilities for a limited period 5
to allow such facilities to implement corrective 6
measures; amending s. 916.107, F.S.; providing that 7
forensic clients must receive psychiatric medication 8
therapy before admission to a state mental health 9
treatment facility in certain circumstances; 10
authorizing the sheriff to administer such medication 11
within a county jail; amending s. 916.12, F.S.; 12
specifying some possible treatment alternatives 13
appropriate for the mental illness of a criminal 14
defendant who is incompe tent to proceed; requiring an 15
examining expert to report why alternative treatment 16
options are inappropriate in certain circumstances; 17
amending s. 916.13, F.S.; providing that a court order 18
committing a defendant to the department may include 19
certain information; requiring a court to determine 20
that alternative treatment options have been fully 21
considered and found insufficient; revising the 22
deadline for a report on certain persons committed for 23
treatment; revising provisions relating to competency 24
hearings; providing an effective date. 25
HB 1349 2023
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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
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Be It Enacted by the Legislature of the State of Florida: 27
28
Section 1. Section 394.461, Florida Statutes, is amended 29
to read: 30
394.461 Designation of receiving and treatment facilities 31
and receiving systems. —The department is authorized to designate 32
and monitor receiving facilities, treatment facilities, and 33
receiving systems and may suspend or withdraw such designation 34
for failure to comply with this part and rules adopted under 35
this part. The department may issue a c onditional designation 36
for up to 60 days to allow the implementation of corrective 37
measures. Unless designated by the department, facilities are 38
not permitted to hold or treat involuntary patients under this 39
part. 40
(1) RECEIVING FACILITY. —The department may designate any 41
community facility as a receiving facility. Any other facility 42
within the state, including a private facility or a federal 43
facility, may be so designated by the department, provided that 44
such designation is agreed to by the governing body or authority 45
of the facility. 46
(2) TREATMENT FACILITY. —The department may designate any 47
state-owned, state-operated, or state-supported facility as a 48
state treatment facility. A civil patient shall not be admitted 49
to a state treatment facility without pre viously undergoing a 50
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transfer evaluation. Before a court hearing for involuntary 51
placement in a state treatment facility, the court shall receive 52
and consider the information documented in the transfer 53
evaluation. Any other facility, including a private fa cility or 54
a federal facility, may be designated as a treatment facility by 55
the department, provided that such designation is agreed to by 56
the appropriate governing body or authority of the facility. 57
(3) PRIVATE FACILITIES. —Private facilities designated a s 58
receiving and treatment facilities by the department may provide 59
examination and treatment of involuntary patients, as well as 60
voluntary patients, and are subject to all the provisions of 61
this part. 62
(4) REPORTING REQUIREMENTS. — 63
(a) A facility designa ted as a public receiving or 64
treatment facility under this section shall report to the 65
department on an annual basis the following data, unless these 66
data are currently being submitted to the Agency for Health Care 67
Administration: 68
1. Number of licensed b eds. 69
2. Number of contract days. 70
3. Number of admissions by payor class and diagnoses. 71
4. Number of bed days by payor class. 72
5. Average length of stay by payor class. 73
6. Total revenues by payor class. 74
(b) For the purposes of this subsection, "payor class" 75
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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
means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private -76
pay health insurance, private -pay health maintenance 77
organization, private preferred provider organization, the 78
Department of Children and Families, other government programs, 79
self-pay patients, and charity care. 80
(c) The data required under this subsection shall be 81
submitted to the department no later than 90 days following the 82
end of the facility's fiscal year. 83
(d) The department shall issue an annual report based on 84
the data required pursuant to this subsection. The report shall 85
include individual facilities' data, as well as statewide 86
totals. The report shall be submitted to the Governor, the 87
President of the Senate, and the Speaker of the House of 88
Representatives. 89
(5) RECEIVING SYSTEM. —The department shall designate as a 90
receiving system one or more facilities serving a defined 91
geographic area developed pursuant to s. 394.4573 which is 92
responsible for assessment and evaluation, both voluntary and 93
involuntary, and treatment, stabilization, or triage for 94
patients who have a mental illness, a substance use disorder, or 95
co-occurring disorders. Any transportation plans developed 96
pursuant to s. 394.462 must support the operation of the 97
receiving system. 98
(6) RULES.—The department may adopt rules relating to: 99
(a) Procedures and criteria for receiving and evaluating 100
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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
facility applications for designation, which may include onsite 101
facility inspection and evaluation of an applicant's licensing 102
status and performance history, as well as consideration of 103
local service needs. 104
(b) Minimum standards consistent with this part that a 105
facility must meet and maintain in order to be designated as a 106
receiving or treatment facility and procedures for mon itoring 107
continued adherence to such standards. 108
(c) Procedures and criteria for designating receiving 109
systems which may include consideration of the adequacy of 110
services provided by facilities within the receiving system to 111
meet the needs of the geographi c area using available resources. 112
(d) Procedures for receiving complaints against a 113
designated facility or designated receiving system and for 114
initiating inspections and investigations of facilities or 115
receiving systems alleged to have violated the provi sions of 116
this part or rules adopted under this part. 117
(e) Procedures and criteria for the suspension or 118
withdrawal of designation as a receiving facility or receiving 119
system. 120
Section 2. Subsection (1) of section 916.107, Florida 121
Statutes, is amended t o read: 122
916.107 Rights of forensic clients. — 123
(1) RIGHT TO INDIVIDUAL DIGNITY. — 124
(a) The policy of the state is that the individual dignity 125
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of the client shall be respected at all times and upon all 126
occasions, including any occasion when the forensic c lient is 127
detained, transported, or treated. Clients with mental illness, 128
intellectual disability, or autism and who are charged with 129
committing felonies shall receive appropriate treatment or 130
training. In a criminal case involving a client who has been 131
adjudicated incompetent to proceed or not guilty by reason of 132
insanity, a jail may be used as an emergency facility for up to 133
15 days following the date the department or agency receives a 134
completed copy of the court commitment order containing all 135
documentation required by the applicable Florida Rules of 136
Criminal Procedure. For a forensic client who is held in a jail 137
awaiting admission to a facility of the department or agency, 138
evaluation and treatment or training may be provided in the jail 139
by the local community mental health provider for mental health 140
services, by the developmental disabilities program for persons 141
with intellectual disability or autism, the client's physician 142
or psychologist, or any other appropriate program until the 143
client is transferred to a civil or forensic facility. The 144
sheriff shall administer or permit the department to administer 145
the appropriate psychotropic medication to forensic clients 146
before admission to a state mental health treatment facility. 147
(b) Forensic clients who are in itially placed in, or 148
subsequently transferred to, a civil facility as described in 149
part I of chapter 394 or to a residential facility as described 150
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in chapter 393 shall have the same rights as other persons 151
committed to these facilities for as long as they remain there. 152
Section 3. Subsection (4) of section 916.12, Florida 153
Statutes, is amended to read: 154
916.12 Mental competence to proceed. — 155
(4) If an expert finds that the defendant is incompetent 156
to proceed, the expert shall report on any recommended treatment 157
for the defendant to attain competence to proceed. In 158
considering the issues relating to treatment, the examining 159
expert shall specifically report on: 160
(a) The mental illness causing the incompetence .; 161
(b) The completion of a clinical assessme nt by approved 162
mental health experts trained by the department to ensure safety 163
of the patient and the community. 164
(c)(b) The treatment or treatments appropriate for the 165
mental illness of the defendant and an explanation of each of 166
the possible treatment alternatives, including, at a minimum, 167
mental health services, treatment services, rehabilitative 168
services, support services, and case management services as 169
described in s. 394.67, which may be provided by or within 170
multi-disciplinary community treatment teams, such as Florida 171
Assertive Community Treatment, conditional release programs, 172
outpatient services or intensive outpatient treatment programs, 173
and supportive employment and supportive housing opportunities 174
in treating and supporting the recovery of th e patient. in order 175
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of choices; 176
(d)(c) The availability of acceptable treatment and, if 177
treatment is available in the community, the expert shall so 178
state in the report.; and 179
(e)(d) The likelihood of the defendant's attaining 180
competence under the treat ment recommended, an assessment of the 181
probable duration of the treatment required to restore 182
competence, and the probability that the defendant will attain 183
competence to proceed in the foreseeable future. 184
185
The examining expert's report to the court shall include a full 186
and detailed explanation regarding why the alternative treatment 187
options referenced in the evaluation are insufficient to meet 188
the needs of the defendant. 189
Section 4. Section 916.13, Florida Statutes, is amended to 190
read: 191
916.13 Involuntary commitment of defendant adjudicated 192
incompetent.— 193
(1) Every defendant who is charged with a felony and who 194
is adjudicated incompetent to proceed may be involuntarily 195
committed for treatment upon a finding by the court of clear and 196
convincing evidence that: 197
(a) The defendant has a mental illness and because of the 198
mental illness: 199
1. The defendant is manifestly incapable of surviving 200
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alone or with the help of willing and responsible family or 201
friends, including available alternative services, and, without 202
treatment, the defendant is likely to suffer from neglect or 203
refuse to care for herself or himself and such neglect or 204
refusal poses a real and present threat of substantial harm to 205
the defendant's well -being; or 206
2. There is a substantial likelih ood that in the near 207
future the defendant will inflict serious bodily harm on herself 208
or himself or another person, as evidenced by recent behavior 209
causing, attempting, or threatening such harm; 210
(b) All available, less restrictive treatment 211
alternatives, including treatment in community residential 212
facilities, or community inpatient or outpatient settings, and 213
any other mental health services, treatment services, 214
rehabilitative services, support services, and case management 215
services as described in s. 39 4.67, which would offer an 216
opportunity for improvement of the defendant's condition have 217
been judged to be inappropriate; and 218
(c) There is a substantial probability that the mental 219
illness causing the defendant's incompetence will respond to 220
treatment and the defendant will regain competency to proceed in 221
the reasonably foreseeable future. 222
223
Before issuing a commitment order, the court shall review the 224
examining expert's report to ensure alternative treatment 225
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options have been fully considered and found in sufficient to 226
meet the needs of the defendant. 227
(2) A defendant who has been charged with a felony and who 228
has been adjudicated incompetent to proceed due to mental 229
illness, and who meets the criteria for involuntary commitment 230
under this chapter, may be committed to the department, and the 231
department shall retain and treat the defendant. 232
(a) Immediately after receipt of a completed copy of the 233
court commitment order containing all documentation required by 234
the applicable Florida Rules of Criminal Proced ure, the 235
department shall request all medical information relating to the 236
defendant from the jail. The jail shall provide the department 237
with all medical information relating to the defendant within 3 238
business days after receipt of the department's request or at 239
the time the defendant enters the physical custody of the 240
department, whichever is earlier. 241
(b) Within 60 days 6 months after the date of admission 242
and at the end of any period of extended commitment, or at any 243
time the administrator or his or her designee determines that 244
the defendant has regained competency to proceed or no longer 245
meets the criteria for continued commitment, the administrator 246
or designee shall file a report with the court pursuant to the 247
applicable Florida Rules of Criminal Proce dure. 248
(c) A competency hearing must be held within 30 days after 249
the court receives notification that the defendant is competent 250
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to proceed or no longer meets the criteria for continued 251
commitment. The defendant must be transported , in accordance 252
with s. 916.107, to the committing court's jurisdiction within 7 253
days of notification that the defendant is competent to proceed 254
or no longer meets the criteria for continued commitment. A 255
determination on the issue of competency must be made at a 256
hearing within 30 days of the notification for the hearing. If 257
the defendant is receiving psychotropic medication at a mental 258
health facility at the time he or she is discharged and 259
transferred to the jail, the administering of such medication 260
must continue unless the ja il physician documents the need to 261
change or discontinue it. To ensure continuity of care, the 262
referring mental health facility must transfer the patient with 263
up to 30 days of medications and assist in discharge planning 264
with medical teams at the receiving county jail. The jail and 265
department physicians shall collaborate to ensure that 266
medication changes do not adversely affect the defendant's 267
mental health status or his or her ability to continue with 268
court proceedings; however, the final authority regardi ng the 269
administering of medication to an inmate in jail rests with the 270
jail physician. 271
Section 5. This act shall take effect July 1, 2023. 272