Florida 2023 2023 Regular Session

Florida House Bill H1349 Analysis / Analysis

Filed 04/12/2023

                    This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives. 
STORAGE NAME: h1349c.APC 
DATE: 4/12/2023 
 
HOUSE OF REPRESENTATIVES STAFF ANALYSIS  
 
BILL #: HB 1349    Mental Health Treatment 
SPONSOR(S): Melo and other 
TIED BILLS:   IDEN./SIM. BILLS: CS/SB 1412 
 
REFERENCE 	ACTION ANALYST STAFF DIRECTOR or 
BUDGET/POLICY CHIEF 
1) Children, Families & Seniors Subcommittee 16 Y, 0 N Curry Brazzell 
2) Appropriations Committee 	27 Y, 0 N Fontaine Pridgeon 
3) Health & Human Services Committee   
SUMMARY ANALYSIS 
Chapter 916, F.S., governs the state forensic system, which is a network of state facilities and community services 
for persons who have mental health issues, an intellectual disability, or autism and who are involved with the 
criminal justice system. Offenders who are charged with a felony and adjudicated incompetent to proceed due to 
mental illness and offenders who are adjudicated not guilty by reason of insanity may be involuntarily committed to 
state civil and forensic treatment facilities by the circuit court, or in lieu of such commitment, may be released on 
conditional release by the circuit court if the person is not serving a prison sentence. The committing court retains 
jurisdiction over the defendant while the defendant is under involuntary commitment or conditional release. 
 
DCF is authorized to designate and monitor receiving and treatment facilities. The agency is also authorized to 
adopt rules establishing the procedures, criteria, and standards for obtaining and maintaining status as a designated 
facility and may suspend or withdraw such designation for noncompliance. A facility may not hold or treat involuntary 
patients unless it is designated by the agency.  
 
The bill authorizes DCF to issue a conditional designation, for up to 60 days, to allow the agency time to work with 
facilities to address inspection and minor compliance issues without DCF having to suspend or withdraw the 
facilities’ designation. This enables facilities time to address inspection issues without having to suspend services or 
reapply for a designation.   
 
The bill also: 
 Requires expert evaluators and the courts to consider alternative treatment options before ordering a 
defendant who has been found incompetent to proceed into a treatment facility; 
 Requires the administrator of the treatment facility to notify the court within 60 days, instead of 6 months, 
after the defendant’s admission date and at the end of any period of extended commitment, or at any time 
the administrator has determined that the defendant has regained competency or no longer meets the 
criteria for involuntary commitment; 
 Reduces the maximum time defendants may wait to be transported out of a treatment facility from 30 days 
to 7 days, once they are competent to proceed or no longer meet the criteria for continued commitment, and 
requires the courts to conduct a hearing to make a determination of competency within 30 days of 
notification; 
 Requires the sheriffs to either administer or permit DCF to administer psychotropic medication therapy to 
forensic clients who are held in jail awaiting admission to a state mental health treatment facility before the 
client is admitted into the facility; 
 Requires the referring treatment facility to transfer the defendant with up to 30 days of medication and to 
assist in discharge planning with medical teams at the receiving jail. 
 
This bill does not have a fiscal impact on state or local government. 
 
The bill provides an effective date of July 1, 2023. 
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DATE: 4/12/2023 
  
FULL ANALYSIS 
I.  SUBSTANTIVE ANALYSIS 
 
A. EFFECT OF PROPOSED CHANGES: 
Background 
 
Baker Act 
 
The Baker Act was enacted in 1971 to revise the state’s mental health commitment laws.
 1
 The Act 
provides legal procedures for mental health examination and treatment, including voluntary and 
involuntary examinations and treatment. It additionally protects the rights of all individuals examined or 
treated for mental illness in Florida.
2
  
 
An involuntary examination is required if there is reason to believe that the person has a mental illness 
and has, because of his or her mental illness, refused involuntary examination, and is likely to refuse to 
care for him or herself or cause harm to him or herself or others in the near future.
3
  
 
Involuntary patients must be taken to either a public or a private facility that has been designated by the 
Department of Children and Families (DCF) as a Baker Act receiving facility. The purpose of receiving 
facilities is to receive and hold or refer, as appropriate, involuntary patients for mental health or 
substance abuse evaluation and to provide treatment or transportation to the appropriate service 
provider.
4
  
 
Designation of Receiving and Treatment Facilities and Receiving Systems 
 
DCF is authorized to designate and monitor receiving facilities,
5
 treatment facilities,
6
 and receiving 
systems.
7
 The agency is also authorized to adopt rules establishing the procedures, criteria, and 
standards for obtaining and maintaining status as a designated facility
8
 and may suspend or withdraw 
such designation for noncompliance.
9
 A facility may not hold or treat involuntary patients unless it is 
designated by the agency.  
 
Designated receiving facilities include public or private hospitals, crisis stabilization units (CSU),
10
 or 
addictions receiving facilities that provide, at a minimum, emergency screening, evaluation, and short-
term stabilization for mental health or substance abuse disorders, and which may have an agreement 
with a corresponding facility for transportation and services.
11
  
 
Treatment facilities are state-owned, state-operated, or state-supported hospitals, centers, or clinics 
designated by DCF for extended treatment and hospitalization, beyond that provided for by a receiving 
facility, of persons who have a mental illness. This includes federal and private facilities designated by 
the department to provide such services.
12
  
 
A public facility is a facility that has contracted with DCF and receives state funds to provide mental 
health service to all persons, regardless of the ability to pay.
13
 A private facility is a hospital or facility 
                                                
1
 Sections 394.451-394.47892, F.S. 
2
 Section 394.459, F.S. 
3
 S. 394.463(1), F.S. 
4
 S. 394.455(39), F.S. This term does not include a county jail. 
5
 S. 394.455(13), F.S. 
6
 S. 394.455(49), F.S. 
7
 Ss. 394.461 and 394.4573, F.S. 
8
 S. 394.461(6), F.S. 
9
 S. 394.461, F.S. 
10
 A crisis stabilization unit is a program that provides an alternative to inpatient hospitalization and that provides brief, intensive 
services 24 hours a day, 7 days a week, for mentally ill individuals who are in an acutely disturbed state. See s. 394.67, F.S. 
11
 S. 394.455(13), F.S. 
12
 S. 394.455(49), F.S. Patients treated in facilities of the United States Government shall be solely those whose care is the 
responsibility of the United States Department of Veterans Affairs. 
13
 S. 394.455(38), F.S.  STORAGE NAME: h1349c.APC 	PAGE: 3 
DATE: 4/12/2023 
  
operated by a for-profit or not-for-profit corporation or association which provides mental health or 
substance abuse services.
14
 Private facilities do not receive state funds. There are currently 126 public 
and private designated receiving facilities in Florida.
15
 
 
 Application Process 
 
To be eligible to apply for designation as a receiving facility, the facility must be a hospital licensed 
under chapter 395 or a substance abuse or mental health facility licensed under chapter 394, Part IV.
16
 
All designated facilities are required to provide emergency services, consistent with their facility’s 
licensure to persons regardless of age, unless statutory or regulatory exceptions apply for specific 
circumstances for designation.
17
  
 
To apply for designation, each applicant must complete and submit an application and provide the 
required supporting documentation, which includes:
18
 
 A copy of the facility’s license issued pursuant to Chapter 394 or 395, F.S., evidencing its 
eligibility to apply for designation; 
 A current certificate of good standing for the applicant organization issued by the Florida 
Secretary of State; 
 Documentation of the applicant’s governing authority action authorizing the application for 
designation; 
 Description of proposed psychiatric services including any distinct programs to be provided to 
each of the following consumer age groups, and the projected numbers of persons to be served 
in each following group: 
o Minors below 10 years of age, 
o Minors between the ages of 10 to 17 years, 
o Adults, 
o Persons 60 or more years of age; and, 
o Other specific populations. 
 The corresponding street address for each reception and treatment location providing services. 
Designation is limited to only the locations specified in the application and approved by the 
department; 
 Documentation of community need for maintaining or expanding the present level of designated 
facilities’ services to meet the existing need, and why the applicant is best suited to meet this 
need; 
 Documentation of key facility protocols to assure all involved practitioners and staff are 
knowledgeable of, and implement, persons’ legal rights, psychiatric care, records standards, 
complaint reporting, investigation and reviews to maintain a consistently high level of 
compliance with applicable Baker Act laws, ethical principles, and rights protections; 
 Description of how the facility’s physical structure, staffing and policies offer frequent, if not 
daily, opportunity for persons to have exercise, fresh air and sunshine, except as individually 
restricted and documented in the person’s clinical record and within the physical limitations of 
the facility; 
 Description of how the facility’s discharge planning policies provide for continuity of psychotropic 
medication availability until post-discharge follow-up services are scheduled; and 
 For general hospitals, a description of the means utilized to create or approximate a distinct 
psychiatric emergency reception and triage area that minimizes individuals’ exposure to undue 
and exacerbating environmental stresses while awaiting or receiving services. 
 
Designation as a receiving facility is valid for three years and may be renewed by submitting a renewal 
application along with the required documentation at least 90 days prior to the expiration of the existing 
designation.
19
 
                                                
14
 S. 394.455(35), F.S. 
15
 DCF, Agency Bill Analysis HB 1349 (2023), p. 2 (on file with the House Children, Families, & Seniors Subcommittee). 
16
 Rule 65E-5.350, F.A.C. 
17
 Id. 
18
 Id. 
19
 Id.  STORAGE NAME: h1349c.APC 	PAGE: 4 
DATE: 4/12/2023 
  
 
 Standards for Designated Receiving Facilities 
 
Designated receiving facilities must comply with the following minimum standards:
20
 
 Have policies and procedures that prescribe, monitor and enforce all applicable regulatory 
requirements; 
 Assure that the facility’s reception, screening, and inpatient services are fully operational 24-
hours-per-day, 7-days-per-week; 
 Have a compliance program that monitors facility and professional compliance with Chapter 
394, Part I, F.S. Every such program shall specifically monitor the adequacy of and the 
timeframes involved in the facility procedures utilized to expedite obtaining informed consent for 
treatment. This program may be integrated with other activities; and 
 Ensure the centralized provision and coordination of acute care services for eligible individuals 
with an acute mental illness, if a public receiving facility that is affiliated with a publicly funded 
community mental health center. 
  
Any facility designated as a receiving facility that fails to comply with the statutory and regulatory 
requirements may have its designation suspended or withdrawn for noncompliance. 
21
  
 
Under current law, DCF is only authorized to suspend or withdraw a facility’s designation for 
compliance violations. As a result, a facility’s designation may be suspended or withdrawn while the 
facility works to correct inspection violations or other issues that generally are not serious threats to 
health and safety such as lack of and deficiencies in staff training, outdated policies and procedures, 
and documentation deficiencies. In circumstances where a provider is the only available public 
receiving facility in a county or geographic area, “suspending” or “withdrawing” the designation based 
on an inspection violation or a minor infraction is not a viable option because either of these actions 
would result in reducing access to crisis care services. 
 
State Forensic System – Mental Health Treatment for Criminal Defendants 
 
The Due Process Clause of the 14th Amendment prohibits the states from trying and convicting 
defendants who are incompetent to stand trial.
22
 The states must have procedures in place that 
adequately protect the defendant’s right to a fair trial, which includes his or her participation in all 
material stages of the process.
23
 Defendants must be able to appreciate the range and nature of the 
charges and penalties that may be imposed, understand the adversarial nature of the legal process, 
and disclose to counsel facts pertinent to the proceedings. Defendants also must manifest appropriate 
courtroom behavior and be able to testify relevantly.
24
 
 
 
 
 
State Forensic System 
 
Chapter 916, F.S., governs the state forensic system, which is a network of state facilities and 
community services for persons who have mental health issues, an intellectual disability, or autism and 
who are involved with the criminal justice system. Offenders who are charged with a felony and 
adjudicated incompetent to proceed due to mental illness
25
 and offenders who are adjudicated not 
                                                
20
 Rule 65E-5.352, F.A.C 
21
 Id. 
22
 Pate v. Robinson, 383 U.S. 375, 86 S.Ct. 836, 15 L.Ed. 815 (1966); Bishop v. U.S., 350 U.S.961, 76 S.Ct. 440, 100 L.Ed. 835 (1956); 
Jones v. State, 740 So.2d 520 (Fla. 1999). 
23
 Id. See also Rule 3.210(a)(1), Fla.R.Crim.P. 
24
 Id. See also s. 916.12, 916.3012, and 985.19, F.S. 
25
 “Incompetent to proceed” means “the defendant does not have sufficient present ability to consult with her or his lawyer with a 
reasonable degree of rational understanding” or “the defendant has no rational, as well as factual, understanding of the proceedings 
against her or him.” s. 916.12(1), F.S.  STORAGE NAME: h1349c.APC 	PAGE: 5 
DATE: 4/12/2023 
  
guilty by reason of insanity may be involuntarily committed to state civil
26
 and forensic
27
 treatment 
facilities by the circuit court,
28
 or in lieu of such commitment, may be released on conditional release
29
 
by the circuit court if the person is not serving a prison sentence.
30
 The committing court retains 
jurisdiction over the defendant while the defendant is under involuntary commitment or conditional 
release.
31
 In Fiscal Year (FY) 2021-2022 there were a total 3,349 adults served by DCF in forensic 
commitment and 1,654 in civil commitment.
32
 
 
A civil facility is, in part, a mental health facility established within DCF or by contract with DCF to serve 
individuals committed pursuant to ch. 394, F.S., and defendants pursuant to ch. 916, F.S., who do not 
require the security provided in a forensic facility.
33
 
 
A forensic facility is a separate and secure facility established within DCF or the Agency for Persons 
with Disabilities (APD) to service forensic clients committed pursuant to ch. 916, F.S.
34
 A separate and 
secure facility means a security-grade building for the purposes of separately housing individuals with 
mental illness from persons who have intellectual disabilities or autism and separately housing persons 
who have been involuntarily committed from non-forensic residents.
35
 
 
If a defendant is suspected of being mentally incompetent, the court, counsel for the defendant, or the 
state may file a motion for examination to have the defendant’s cognitive state assessed.
36
 If the motion 
is well-founded the court will appoint experts to evaluate the defendant’s cognitive state. The 
defendant’s competency is then determined by the judge in a subsequent hearing.
37
 If the defendant is 
found to be mentally competent, the criminal proceeding resumes.
38
 If the defendant is found to be 
mentally incompetent to proceed, the proceeding may not resume unless competency is restored.
39
 
 
 
 
 
Mental Competence Evaluation 
 
A defendant is considered incompetent to proceed if the defendant does not have sufficient present 
ability to consult with her or his lawyer with a reasonable degree of rational understanding or the 
defendant has no rational, as well as factual, understanding of the proceedings against her or him.
40
 
 
Under current law, the court may appoint no more than three experts to determine the mental condition 
of a defendant in a criminal case, including competency to proceed, insanity, involuntary placement, 
and treatment.
41
 The experts may evaluate the defendant in jail or in another appropriate local facility or 
                                                
26
 A “civil facility” is a mental health facility established within the Department of Children and Families (DCF) or by contract with DCF to 
serve individuals committed pursuant to chapter 394, F.S., and defendants pursuant to chapter 916, F.S., who do not require the 
security provided in a forensic facility; or an intermediate care facility for the developmentally disabled, a foster care facility, a group 
home facility, or a supported living setting designated by the Agency for Persons with Disabilities (APD) to serve defendants who do not 
require the security provided in a forensic facility. Section 916.106(4), F.S. DCF oversees two state-operated forensic facilities, Florida 
State Hospital and North Florida Evaluation and Treatment Center, and two privately-operated, maximum security forensic treatment 
facilities, South Florida Evaluation and Treatment Center and Treasure Coast Treatment Center. 
27
 Section 916.106(10), F.S.  
28
 Sections 916.13, 916.15, and 916.302, F.S. 
29
 Conditional release is release into the community accompanied by outpatient care and treatment. Section 916.17, F.S. 
30
 Section 916.17(1), F.S. 
31
 Section 916.16(1), F.S. 
32
 DCF, Long Range Program Plan, September 20, 2022, p. 57 at http://floridafiscalportal.state.fl.us/Document.aspx?I     
D=24397&DocType=PDF (last visited March 24, 2023). 
33
 Section 916.106(4), F.S. 
34
 Section 916.106(10), F.S. A separate and secure facility means a security-grade building for the purpose of separately housing 
persons who have mental illness from persons who have intellectual disabilities or autism and separately housing persons who have 
been involuntarily committed pursuant to chapter 916, F.S., from non-forensic residents. 
35
 Id. 
36
 Rule 3.210, Fla.R.Crim.P. 
37
 Id. 
38
 Rule 3.212, Fla.R.Crim.P. 
39
 Id. 
40
 S. 916.12(1), F.S. 
41
 S. 916.115, F.S.  STORAGE NAME: h1349c.APC 	PAGE: 6 
DATE: 4/12/2023 
  
in a facility of the Department of Corrections. A defendant must be evaluated by no fewer than two 
experts before the court commits the defendant or takes other action, except if one expert finds that the 
defendant is incompetent to proceed and the parties stipulate to that finding.
42
 The court may commit 
the defendant or take other action without further evaluation or hearing, or the court may appoint no 
more than two additional experts to evaluate the defendant. Notwithstanding any stipulation by the 
state and the defendant, the court may require a hearing with testimony from the expert or experts 
before ordering the commitment of a defendant.
43
 
 
In considering the issue of competence to proceed, an examining expert must first consider and 
specifically include in his or her report the defendant’s capacity to:
44
 
 Appreciate the charges or allegations against the defendant;  
 Appreciate the range and nature of possible penalties, if applicable, that may be imposed in the 
proceedings against the defendant;  
 Understand the adversarial nature of the legal process;  
 Disclose to counsel facts pertinent to the proceedings at issue;  
 Manifest appropriate courtroom behavior; and  
 Testify relevantly. 
 
In addition, an examining expert shall consider and include in his or her report any other factor deemed 
relevant by the expert.  
 
If an expert finds that the defendant is incompetent to proceed, the expert must report on any 
recommended treatment for the defendant to attain competence to proceed. The statute does not 
specify the treatment options that should be considered. However, in considering the issues relating to 
treatment, the examining expert must report on the following:
45
 
 The mental illness causing the incompetence; 
 The treatment or treatments appropriate for the mental illness of the defendant and an 
explanation of each of the possible treatment alternatives in order of choices; 
 The availability of acceptable treatment and, if treatment is available in the community, the 
expert shall so state in the report; and 
 The likelihood of the defendant’s attaining competence under the treatment recommended, an 
assessment of the probable duration of the treatment required to restore competence, and the 
probability that the defendant will attain competence to proceed in the foreseeable future. 
 
A defendant who, because of psychotropic medication, is able to understand the nature of proceedings 
and assist in the defendant’s own defense shall not automatically be deemed incompetent to proceed 
simply because the defendant’s satisfactory mental functioning is dependent upon such medication. 
Psychotropic medication means any drug or compound used to treat mental or emotional disorders 
affecting the mind, behavior, intellectual functions, perception, moods, or emotions and includes 
antipsychotic, antidepressant, antimanic, and antianxiety drugs. 
 
Involuntary Commitment of Defendant Adjudicated Incompetent 
 
A court may only involuntarily commit a defendant adjudicated incompetent to proceed for treatment 
upon finding clear and convincing evidence that:
46
 
 The defendant has a mental illness and because of the mental illness: 
o The defendant is manifestly incapable of surviving alone or with the help of willing and 
responsible family or friends, including available alternative services, and, without 
treatment, the defendant is likely to suffer from neglect or refuse to care for herself or 
himself and such neglect or refusal poses a real and present threat of substantial harm 
to the defendant’s well-being; or 
                                                
42
 S. 916.12(2), F.S. 
43
 Id. 
44
 S. 916.12(3). F.S. 
45
 S. 916.12(4), F.S. 
46
 S. 916.13(1), F.S.  STORAGE NAME: h1349c.APC 	PAGE: 7 
DATE: 4/12/2023 
  
o There is a substantial likelihood that in the near future the defendant will inflict serious 
bodily harm on herself or himself or another person, as evidenced by recent behavior 
causing, attempting, or threatening such harm; 
 All available, less restrictive treatment alternatives, including treatment in community residential 
facilities or community inpatient or outpatient settings, which would offer an opportunity for 
improvement of the defendant’s condition have been judged to be inappropriate; and 
 There is a substantial probability that the mental illness causing the defendant’s incompetence 
will respond to treatment and the defendant will regain competency to proceed in the 
reasonably foreseeable future. 
 
If a person is committed pursuant to chapter 916, the administrator at the commitment facility must 
submit a report to the court:
 47
 
 No later than 6 months after a defendant’s admission date and at the end of any period of 
extended commitment; or 
 At any time the administrator has determined that the defendant has regained competency or 
no longer meets the criteria for involuntary commitment.   
 
In Florida, 66 percent of adults in forensic commitment who were found not guilty by reason of insanity, 
showed an improvement in functional level during FY 2021-2022. The average number of days to 
restore competency for adults in forensic commitment was 103 days.
48
 
 
Transportation to Committing Jurisdiction 
 
Under current law, a competency hearing must be held within 30 days after the court receives 
notification that the defendant is competent to proceed or no longer meets the criteria for continued 
commitment.
49
 The defendant must be transported back to the committing jurisdiction for the hearing. 
However, in some instances, defendants are not transported back timely.  In order for a transport to 
occur, the judge must sign a transport order authorizing the defendant to be picked up by jail 
transportation providers, usually the sheriffs or their designee, and transported back to the committing 
jurisdiction. While the defendant awaits transportation back to the county with jurisdiction, he or she 
remains at a treatment facility. If the defendant is receiving psychotropic medication at the treatment 
facility when discharged or transferred to the jail, the administration of the medication must continue 
unless a jail physician documents the need to change or discontinue use.
50
 
 
Although a competency hearing is required to be held within 30 days after the court receives 
notification of competency, sometimes the courts do not make a determination during the initial hearing. 
As a result, the defendant remains in the treatment facility beyond the 30-day timeframe. In other 
instances, a determination of competency is not made during the statutory timeframe because the 
hearing is continued or not scheduled within 30-days as required under current law. As a result, some 
defendants who are transported back to the committing jurisdiction decompensate before a 
determination of competency is made.
51
 
 
On average, there are between 80 and 100 competent individuals in treatment facilities awaiting 
transportation back to the committing jurisdiction each day.
52
 This directly impacts the waitlist for state 
mental health services, increasing the list as defendants left in state facilities continue occupying beds 
that could be utilized for those awaiting treatment.  As of March 2023, there were 319 defendants 
awaiting placement into a treatment facility; of those waiting, 202 have been waiting more than 15 days. 
For Fiscal Year (FY) 2022-2023, the average wait time to be admitted was 52 days. Twenty (20) 
percent of the discharged defendants recommended as competent to proceed have taken 31 days or 
                                                
47
 S. 916.13(2), F.S. 
48
 Id. at note 32. 
49
 S. 916.13(2)(c), F.S. 
50
 Id. 
51
 DCF, Agency Bill Analysis HB 1349 (2023), p. 4 (on file with the House Children, Families, & Seniors Subcommittee). 
52
 Id.  STORAGE NAME: h1349c.APC 	PAGE: 8 
DATE: 4/12/2023 
  
more to be transported with the average pickup time ranging from as low as 21 days to as high as 132 
days.
53
  
 
Rights of Forensic Clients 
 
Section 916.107, F.S., establishes the rights of clients in the state’s forensic system. The policy of the 
state is that the individual dignity of the client shall be respected at all times and upon all occasions, 
including any occasion when the forensic client is detained, transported, or treated. Clients with mental 
illness, intellectual disability, or autism and who are charged with committing felonies shall receive 
appropriate treatment or training. In a criminal case involving a client who has been adjudicated 
incompetent to proceed or not guilty by reason of insanity, a jail may be used as an emergency facility 
for up to 15 days following the date the department or agency receives a completed copy of the court 
commitment order containing all documentation required by the applicable Florida Rules of Criminal 
Procedure.
54
  
 
For a forensic client who is held in a jail awaiting admission to a facility for DCF or APD evaluation, 
treatment or training may be provided in the jail by the local community mental health provider for 
mental health services, by the developmental disabilities program for persons with intellectual disability 
or autism, the client’s physician or psychologist, or any other appropriate program until the client is 
transferred to a civil or forensic facility.
55
 
 
Clients also have the right to treatment. A client shall not be denied treatment or training and services 
shall not be delayed because the client is indigent and unable to pay. At the time of admission and at 
regular intervals thereafter, the client must be given a physical examination, which shall include 
screening for communicable disease by a health practitioner authorized by law to give such screenings 
and examinations. Every forensic client shall be afforded the opportunity to participate in activities 
designed to enhance self-image and the beneficial effects of other treatments or training, as 
determined by the facility. Within 30 days after admission, each client shall have and receive, in writing, 
an individualized treatment or training plan which the client has had the opportunity to assist in 
preparing.
56
   
 
 
 
 
 
 
Effect of Bill 
 
Conditional Designation  
 
The bill authorizes DCF to issue a conditional designation for up to 60 days to allow for the 
implementation of corrective measures. The bill expands DCF’s ability to work with facilities to correct 
program deficiencies while they remain in business, examining and treating individuals in their care. For 
facilities with minor deficiencies, the amendment will allow DCF time to enforce corrective action plans 
without suspending or withdrawing their designation and would allow facilities time to address 
inspection issues without having to suspend services or reapply for a designation.  
 
Rights of Forensic Clients 
 
The bill requires the sheriffs to either administer or permit DCF to administer psychotropic medication 
therapy to forensic clients who are held in jail awaiting admission to a state mental health treatment 
facility before the client is admitted into the facility. This will help the defendant regain competency and 
                                                
53
 Id. According to DCF, the average pick is as low as 21 days and as high as 132 days. 
54
 S. 916.107(1), F.S. 
55
 Id. 
56
 S. 916.107(2), F.S.  STORAGE NAME: h1349c.APC 	PAGE: 9 
DATE: 4/12/2023 
  
reduce the length of time the defendant will need to receive treatment once admitted into the treatment 
facility. 
 
Mental Competence Evaluation 
 
The bill requires the expert evaluators and the courts to consider a list of DCF funded minimum 
alternative treatment options before ordering a defendant who has been found incompetent to proceed 
into a treatment facility. In considering issues relating to treatment, the bill requires the evaluator to 
report on the completion of a clinical assessment made by approved DCF trained mental health experts 
to ensure the safety of the patient and the community. Experts must also consider the following 
treatment options: 
 Mental health services; 
 Treatment services; 
 Rehabilitative services; 
 Support services; and 
 Case management services as those terms are defined in s. 394.67(16), F.S., which may be 
provided by or within: 
o Multidisciplinary community treatment teams; 
o Community treatment teams, such as Florida Assertive Community Treatment (FACT) 
teams; 
o Conditional release programs; 
o Outpatient services or intensive outpatient treatment programs; and 
o Supportive employment and supportive housing opportunities. 
 
The bill also requires the examining expert’s report to the court to include a full and detailed explanation 
of why the alternative treatment options referenced in the evaluation are insufficient to meet the 
defendant’s needs.  
 
Involuntary Commitment of Defendant Adjudicated Incompetent  
 
Before issuing a commitment order, the bill requires the court to review the examining expert’s report to 
ensure that alternative treatment options have been fully considered and found insufficient to meet the 
needs of the defendant.  
 
The bill requires the administrator of the treatment facility to evaluate the defendant and file a report 
with the court within 60 days, instead of 6 months, after the defendant’s admission date and at the end 
of any period of extended commitment, or at any time the administrator has determined that the 
defendant has regained competency or no longer meets the criteria for involuntary commitment.   
 
The bill reduces the maximum time defendants may wait to be transported out of a treatment facility, 
from 30 days to 7 days, once they are competent to proceed or no longer meet the criteria for continued 
commitment. The bill also requires the courts to conduct a hearing to make a determination of 
competency within 30 days of notification. 
 
The bill requires the referring treatment facility to transfer the defendant with up to 30 days of 
medication and to assist in discharge planning with medical teams at the receiving jail.   
 
B. SECTION DIRECTORY: 
Section 1: Amends s. 394.461, F.S., relating to designation of receiving and treatment facilities and 
receiving systems. 
Section 2: Amends s. 916.107, F.S., relating to right to individual dignity. 
Section 3: Amends s. 916.12, F.S., relating to mental competence to proceed. 
Section 4: Amends s. 916.13, F.S., relating to involuntary commitment of defendant adjudicated 
incompetent. 
Section 5: Provides an effective date of July 1, 2023. 
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DATE: 4/12/2023 
  
II.  FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT 
 
A. FISCAL IMPACT ON STATE GOVERNMENT: 
 
1. Revenues: 
None. 
 
2. Expenditures: 
None. 
 
B. FISCAL IMPACT ON LOCAL GOVERNMENTS: 
 
1. Revenues: 
None. 
 
2. Expenditures: 
The bill may have an indeterminate, insignificant fiscal impact on local jails and detention centers.  
Section 951(4)(a), F.S., establishes the Florida Model Jail Standards Working Group (FMJS), which 
provides standards of care to county and municipal detention facilities.  The FMJS standards 
include guidance to ensure that each jail has the medical staff and resources for incarcerated 
individuals with medical or psychiatric needs.  This support would include the initiation of psychiatric 
medication while the individual remains in custody.   
 
Additionally, the bill amends section 916.107, F.S., to provide that sheriffs shall administer (or allow 
DCF to administer) psychotropic medication to forensic clients while awaiting admission to a state 
mental health treatment facility. 
 
The bill is not expected to have a significant fiscal impact as local jails and detention centers are 
currently required to properly manage the medical needs of incarcerated individuals, which would 
include psychiatric care and medications.  
  
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR: 
None. 
 
D. FISCAL COMMENTS: 
None. 
III.  COMMENTS 
 
A. CONSTITUTIONAL ISSUES: 
 
 1. Applicability of Municipality/County Mandates Provision: 
Not applicable. This bill does not appear to affect county or municipal governments. 
 
 2. Other: 
None. 
 
B. RULE-MAKING AUTHORITY: 
Current law provides DCF with sufficient rulemaking authority to execute the provisions of the bill. 
 
C. DRAFTING ISSUES OR OTHER COMMENTS: 
None. 
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DATE: 4/12/2023 
  
IV.  AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES