FL
Florida House Bill H1349

Florida 2023 Regular Session

Florida House Bill H1349 Compare Versions

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1010 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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14+A bill to be entitled 1
1515 An act relating to mental health treatment; amending 2
1616 s. 394.461, F.S.; authorizing the Department of 3
1717 Children and Families to issue a conditional 4
1818 designation to certain facilities for a limited period 5
1919 to allow such facilities to implement corrective 6
2020 measures; amending s. 916.107, F.S.; providing that 7
2121 forensic clients must receive psychiatric medication 8
2222 therapy before admission to a state mental health 9
2323 treatment facility in certain circumstances; 10
2424 authorizing the sheriff to administer such medication 11
2525 within a county jail; amending s. 916.12, F.S.; 12
2626 specifying some possible treatment alternatives 13
2727 appropriate for the mental illness of a criminal 14
2828 defendant who is incompe tent to proceed; requiring an 15
2929 examining expert to report why alternative treatment 16
3030 options are inappropriate in certain circumstances; 17
3131 amending s. 916.13, F.S.; providing that a court order 18
3232 committing a defendant to the department may include 19
3333 certain information; requiring a court to determine 20
3434 that alternative treatment options have been fully 21
3535 considered and found insufficient; revising the 22
3636 deadline for a report on certain persons committed for 23
3737 treatment; revising provisions relating to competency 24
3838 hearings; providing an effective date. 25
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4747 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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5151 26
5252 Be It Enacted by the Legislature of the State of Florida: 27
5353 28
5454 Section 1. Section 394.461, Florida Statutes, is amended 29
5555 to read: 30
5656 394.461 Designation of receiving and treatment facilities 31
5757 and receiving systems. —The department is authorized to designate 32
5858 and monitor receiving facilities, treatment facilities, and 33
5959 receiving systems and may suspend or withdraw such designation 34
6060 for failure to comply with this part and rules adopted under 35
6161 this part. The department may issue a c onditional designation 36
6262 for up to 60 days to allow the implementation of corrective 37
6363 measures. Unless designated by the department, facilities are 38
6464 not permitted to hold or treat involuntary patients under this 39
6565 part. 40
6666 (1) RECEIVING FACILITY. —The department may designate any 41
6767 community facility as a receiving facility. Any other facility 42
6868 within the state, including a private facility or a federal 43
6969 facility, may be so designated by the department, provided that 44
7070 such designation is agreed to by the governing body or authority 45
7171 of the facility. 46
7272 (2) TREATMENT FACILITY. —The department may designate any 47
7373 state-owned, state-operated, or state-supported facility as a 48
7474 state treatment facility. A civil patient shall not be admitted 49
7575 to a state treatment facility without pre viously undergoing a 50
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8484 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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8888 transfer evaluation. Before a court hearing for involuntary 51
8989 placement in a state treatment facility, the court shall receive 52
9090 and consider the information documented in the transfer 53
9191 evaluation. Any other facility, including a private fa cility or 54
9292 a federal facility, may be designated as a treatment facility by 55
9393 the department, provided that such designation is agreed to by 56
9494 the appropriate governing body or authority of the facility. 57
9595 (3) PRIVATE FACILITIES. —Private facilities designated a s 58
9696 receiving and treatment facilities by the department may provide 59
9797 examination and treatment of involuntary patients, as well as 60
9898 voluntary patients, and are subject to all the provisions of 61
9999 this part. 62
100100 (4) REPORTING REQUIREMENTS. — 63
101101 (a) A facility designa ted as a public receiving or 64
102102 treatment facility under this section shall report to the 65
103103 department on an annual basis the following data, unless these 66
104104 data are currently being submitted to the Agency for Health Care 67
105105 Administration: 68
106106 1. Number of licensed b eds. 69
107107 2. Number of contract days. 70
108108 3. Number of admissions by payor class and diagnoses. 71
109109 4. Number of bed days by payor class. 72
110110 5. Average length of stay by payor class. 73
111111 6. Total revenues by payor class. 74
112112 (b) For the purposes of this subsection, "payor class" 75
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121121 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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125125 means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private -76
126126 pay health insurance, private -pay health maintenance 77
127127 organization, private preferred provider organization, the 78
128128 Department of Children and Families, other government programs, 79
129129 self-pay patients, and charity care. 80
130130 (c) The data required under this subsection shall be 81
131131 submitted to the department no later than 90 days following the 82
132132 end of the facility's fiscal year. 83
133133 (d) The department shall issue an annual report based on 84
134134 the data required pursuant to this subsection. The report shall 85
135135 include individual facilities' data, as well as statewide 86
136136 totals. The report shall be submitted to the Governor, the 87
137137 President of the Senate, and the Speaker of the House of 88
138138 Representatives. 89
139139 (5) RECEIVING SYSTEM. —The department shall designate as a 90
140140 receiving system one or more facilities serving a defined 91
141141 geographic area developed pursuant to s. 394.4573 which is 92
142142 responsible for assessment and evaluation, both voluntary and 93
143143 involuntary, and treatment, stabilization, or triage for 94
144144 patients who have a mental illness, a substance use disorder, or 95
145145 co-occurring disorders. Any transportation plans developed 96
146146 pursuant to s. 394.462 must support the operation of the 97
147147 receiving system. 98
148148 (6) RULES.—The department may adopt rules relating to: 99
149149 (a) Procedures and criteria for receiving and evaluating 100
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158158 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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162162 facility applications for designation, which may include onsite 101
163163 facility inspection and evaluation of an applicant's licensing 102
164164 status and performance history, as well as consideration of 103
165165 local service needs. 104
166166 (b) Minimum standards consistent with this part that a 105
167167 facility must meet and maintain in order to be designated as a 106
168168 receiving or treatment facility and procedures for mon itoring 107
169169 continued adherence to such standards. 108
170170 (c) Procedures and criteria for designating receiving 109
171171 systems which may include consideration of the adequacy of 110
172172 services provided by facilities within the receiving system to 111
173173 meet the needs of the geographi c area using available resources. 112
174174 (d) Procedures for receiving complaints against a 113
175175 designated facility or designated receiving system and for 114
176176 initiating inspections and investigations of facilities or 115
177177 receiving systems alleged to have violated the provi sions of 116
178178 this part or rules adopted under this part. 117
179179 (e) Procedures and criteria for the suspension or 118
180180 withdrawal of designation as a receiving facility or receiving 119
181181 system. 120
182182 Section 2. Subsection (1) of section 916.107, Florida 121
183183 Statutes, is amended t o read: 122
184184 916.107 Rights of forensic clients. — 123
185185 (1) RIGHT TO INDIVIDUAL DIGNITY. — 124
186186 (a) The policy of the state is that the individual dignity 125
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195195 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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199199 of the client shall be respected at all times and upon all 126
200200 occasions, including any occasion when the forensic c lient is 127
201201 detained, transported, or treated. Clients with mental illness, 128
202202 intellectual disability, or autism and who are charged with 129
203203 committing felonies shall receive appropriate treatment or 130
204204 training. In a criminal case involving a client who has been 131
205205 adjudicated incompetent to proceed or not guilty by reason of 132
206206 insanity, a jail may be used as an emergency facility for up to 133
207207 15 days following the date the department or agency receives a 134
208208 completed copy of the court commitment order containing all 135
209209 documentation required by the applicable Florida Rules of 136
210210 Criminal Procedure. For a forensic client who is held in a jail 137
211211 awaiting admission to a facility of the department or agency, 138
212212 evaluation and treatment or training may be provided in the jail 139
213213 by the local community mental health provider for mental health 140
214214 services, by the developmental disabilities program for persons 141
215215 with intellectual disability or autism, the client's physician 142
216216 or psychologist, or any other appropriate program until the 143
217217 client is transferred to a civil or forensic facility. The 144
218218 sheriff shall administer or permit the department to administer 145
219219 the appropriate psychotropic medication to forensic clients 146
220220 before admission to a state mental health treatment facility. 147
221221 (b) Forensic clients who are in itially placed in, or 148
222222 subsequently transferred to, a civil facility as described in 149
223223 part I of chapter 394 or to a residential facility as described 150
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232232 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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236236 in chapter 393 shall have the same rights as other persons 151
237237 committed to these facilities for as long as they remain there. 152
238238 Section 3. Subsection (4) of section 916.12, Florida 153
239239 Statutes, is amended to read: 154
240240 916.12 Mental competence to proceed. — 155
241241 (4) If an expert finds that the defendant is incompetent 156
242242 to proceed, the expert shall report on any recommended treatment 157
243243 for the defendant to attain competence to proceed. In 158
244244 considering the issues relating to treatment, the examining 159
245245 expert shall specifically report on: 160
246246 (a) The mental illness causing the incompetence .; 161
247247 (b) The completion of a clinical assessme nt by approved 162
248248 mental health experts trained by the department to ensure safety 163
249249 of the patient and the community. 164
250250 (c)(b) The treatment or treatments appropriate for the 165
251251 mental illness of the defendant and an explanation of each of 166
252252 the possible treatment alternatives, including, at a minimum, 167
253253 mental health services, treatment services, rehabilitative 168
254254 services, support services, and case management services as 169
255255 described in s. 394.67, which may be provided by or within 170
256256 multi-disciplinary community treatment teams, such as Florida 171
257257 Assertive Community Treatment, conditional release programs, 172
258258 outpatient services or intensive outpatient treatment programs, 173
259259 and supportive employment and supportive housing opportunities 174
260260 in treating and supporting the recovery of th e patient. in order 175
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269269 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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273273 of choices; 176
274274 (d)(c) The availability of acceptable treatment and, if 177
275275 treatment is available in the community, the expert shall so 178
276276 state in the report.; and 179
277277 (e)(d) The likelihood of the defendant's attaining 180
278278 competence under the treat ment recommended, an assessment of the 181
279279 probable duration of the treatment required to restore 182
280280 competence, and the probability that the defendant will attain 183
281281 competence to proceed in the foreseeable future. 184
282282 185
283283 The examining expert's report to the court shall include a full 186
284284 and detailed explanation regarding why the alternative treatment 187
285285 options referenced in the evaluation are insufficient to meet 188
286286 the needs of the defendant. 189
287287 Section 4. Section 916.13, Florida Statutes, is amended to 190
288288 read: 191
289289 916.13 Involuntary commitment of defendant adjudicated 192
290290 incompetent.— 193
291291 (1) Every defendant who is charged with a felony and who 194
292292 is adjudicated incompetent to proceed may be involuntarily 195
293293 committed for treatment upon a finding by the court of clear and 196
294294 convincing evidence that: 197
295295 (a) The defendant has a mental illness and because of the 198
296296 mental illness: 199
297297 1. The defendant is manifestly incapable of surviving 200
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306306 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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310310 alone or with the help of willing and responsible family or 201
311311 friends, including available alternative services, and, without 202
312312 treatment, the defendant is likely to suffer from neglect or 203
313313 refuse to care for herself or himself and such neglect or 204
314314 refusal poses a real and present threat of substantial harm to 205
315315 the defendant's well -being; or 206
316316 2. There is a substantial likelih ood that in the near 207
317317 future the defendant will inflict serious bodily harm on herself 208
318318 or himself or another person, as evidenced by recent behavior 209
319319 causing, attempting, or threatening such harm; 210
320320 (b) All available, less restrictive treatment 211
321321 alternatives, including treatment in community residential 212
322322 facilities, or community inpatient or outpatient settings, and 213
323323 any other mental health services, treatment services, 214
324324 rehabilitative services, support services, and case management 215
325325 services as described in s. 39 4.67, which would offer an 216
326326 opportunity for improvement of the defendant's condition have 217
327327 been judged to be inappropriate; and 218
328328 (c) There is a substantial probability that the mental 219
329329 illness causing the defendant's incompetence will respond to 220
330330 treatment and the defendant will regain competency to proceed in 221
331331 the reasonably foreseeable future. 222
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333333 Before issuing a commitment order, the court shall review the 224
334334 examining expert's report to ensure alternative treatment 225
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343343 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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347347 options have been fully considered and found in sufficient to 226
348348 meet the needs of the defendant. 227
349349 (2) A defendant who has been charged with a felony and who 228
350350 has been adjudicated incompetent to proceed due to mental 229
351351 illness, and who meets the criteria for involuntary commitment 230
352352 under this chapter, may be committed to the department, and the 231
353353 department shall retain and treat the defendant. 232
354354 (a) Immediately after receipt of a completed copy of the 233
355355 court commitment order containing all documentation required by 234
356356 the applicable Florida Rules of Criminal Proced ure, the 235
357357 department shall request all medical information relating to the 236
358358 defendant from the jail. The jail shall provide the department 237
359359 with all medical information relating to the defendant within 3 238
360360 business days after receipt of the department's request or at 239
361361 the time the defendant enters the physical custody of the 240
362362 department, whichever is earlier. 241
363363 (b) Within 60 days 6 months after the date of admission 242
364364 and at the end of any period of extended commitment, or at any 243
365365 time the administrator or his or her designee determines that 244
366366 the defendant has regained competency to proceed or no longer 245
367367 meets the criteria for continued commitment, the administrator 246
368368 or designee shall file a report with the court pursuant to the 247
369369 applicable Florida Rules of Criminal Proce dure. 248
370370 (c) A competency hearing must be held within 30 days after 249
371371 the court receives notification that the defendant is competent 250
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380380 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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384384 to proceed or no longer meets the criteria for continued 251
385385 commitment. The defendant must be transported , in accordance 252
386386 with s. 916.107, to the committing court's jurisdiction within 7 253
387387 days of notification that the defendant is competent to proceed 254
388388 or no longer meets the criteria for continued commitment. A 255
389389 determination on the issue of competency must be made at a 256
390390 hearing within 30 days of the notification for the hearing. If 257
391391 the defendant is receiving psychotropic medication at a mental 258
392392 health facility at the time he or she is discharged and 259
393393 transferred to the jail, the administering of such medication 260
394394 must continue unless the ja il physician documents the need to 261
395395 change or discontinue it. To ensure continuity of care, the 262
396396 referring mental health facility must transfer the patient with 263
397397 up to 30 days of medications and assist in discharge planning 264
398398 with medical teams at the receiving county jail. The jail and 265
399399 department physicians shall collaborate to ensure that 266
400400 medication changes do not adversely affect the defendant's 267
401401 mental health status or his or her ability to continue with 268
402402 court proceedings; however, the final authority regardi ng the 269
403403 administering of medication to an inmate in jail rests with the 270
404404 jail physician. 271
405405 Section 5. This act shall take effect July 1, 2023. 272