Florida Senate - 2023 CS for SB 1412 By the Committee on Children, Families, and Elder Affairs; and Senator Bradley 586-02750-23 20231412c1 1 A bill to be entitled 2 An act relating to mental health; amending s. 394.461, 3 F.S.; authorizing the Department of Children and 4 Families to issue a conditional designation for up to 5 a certain number of days to allow the implementation 6 of certain corrective measures by receiving 7 facilities, treatment facilities, and receiving 8 systems; amending s. 916.107, F.S.; requiring the 9 sheriff to administer or to permit the department to 10 administer the appropriate psychotropic medication to 11 forensic clients before admission to a state mental 12 health treatment facility; amending s. 916.12, F.S.; 13 revising what an expert is required to specifically 14 report on for recommended treatment for a defendant to 15 attain competence to proceed, if the expert finds that 16 a defendant is incompetent to proceed; providing 17 report requirements; amending s. 916.13, F.S.; 18 revising the circumstances under which every defendant 19 who is charged with a felony and who is adjudicated 20 incompetent to proceed may be involuntarily committed 21 for treatment upon specified findings by the court; 22 requiring a court to review the examining experts 23 report before issuing a commitment order; decreasing 24 the timeframe in which an administrator or his or her 25 designee is required to file a certain report with the 26 court; requiring that a defendant be transported to 27 the committing courts jurisdiction within a certain 28 number of days after certain occurrences; requiring 29 that the referring mental health facility transfer the 30 defendant with medication and assist in discharge 31 planning with medical teams at the receiving county 32 jail to ensure continuity of care; reenacting ss. 33 394.658(1)(a), 916.106(9), and 916.17(1) and (2), 34 F.S., relating to the Criminal Justice, Mental Health, 35 and Substance Abuse Reinvestment Grant Program 36 requirements; the definition of the term forensic 37 client or client; and conditional release; 38 respectively, to incorporate the amendment made to s. 39 916.13, F.S., in references thereto; providing an 40 effective date. 41 42 Be It Enacted by the Legislature of the State of Florida: 43 44 Section 1.Section 394.461, Florida Statutes, is amended to 45 read: 46 394.461Designation of receiving and treatment facilities 47 and receiving systems.The department is authorized to designate 48 and monitor receiving facilities, treatment facilities, and 49 receiving systems and may suspend or withdraw such designation 50 for failure to comply with this part and rules adopted under 51 this part. The department may issue a conditional designation 52 for up to 60 days to allow the implementation of corrective 53 measures. Unless designated by the department, facilities are 54 not permitted to hold or treat involuntary patients under this 55 part. 56 (1)RECEIVING FACILITY.The department may designate any 57 community facility as a receiving facility. Any other facility 58 within the state, including a private facility or a federal 59 facility, may be so designated by the department, provided that 60 such designation is agreed to by the governing body or authority 61 of the facility. 62 (2)TREATMENT FACILITY.The department may designate any 63 state-owned, state-operated, or state-supported facility as a 64 state treatment facility. A civil patient may shall not be 65 admitted to a state treatment facility without previously 66 undergoing a transfer evaluation. Before a court hearing for 67 involuntary placement in a state treatment facility, the court 68 shall receive and consider the information documented in the 69 transfer evaluation. Any other facility, including a private 70 facility or a federal facility, may be designated as a treatment 71 facility by the department, provided that such designation is 72 agreed to by the appropriate governing body or authority of the 73 facility. 74 (3)PRIVATE FACILITIES.Private facilities designated as 75 receiving and treatment facilities by the department may provide 76 examination and treatment of involuntary patients, as well as 77 voluntary patients, and are subject to all the provisions of 78 this part. 79 (4)REPORTING REQUIREMENTS. 80 (a)A facility designated as a public receiving or 81 treatment facility under this section shall report to the 82 department on an annual basis the following data, unless these 83 data are currently being submitted to the Agency for Health Care 84 Administration: 85 1.Number of licensed beds. 86 2.Number of contract days. 87 3.Number of admissions by payor class and diagnoses. 88 4.Number of bed days by payor class. 89 5.Average length of stay by payor class. 90 6.Total revenues by payor class. 91 (b)For the purposes of this subsection, payor class 92 means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private 93 pay health insurance, private-pay health maintenance 94 organization, private preferred provider organization, the 95 Department of Children and Families, other government programs, 96 self-pay patients, and charity care. 97 (c)The data required under this subsection shall be 98 submitted to the department no later than 90 days following the 99 end of the facilitys fiscal year. 100 (d)The department shall issue an annual report based on 101 the data required pursuant to this subsection. The report shall 102 include individual facilities data, as well as statewide 103 totals. The report shall be submitted to the Governor, the 104 President of the Senate, and the Speaker of the House of 105 Representatives. 106 (5)RECEIVING SYSTEM.The department shall designate as a 107 receiving system one or more facilities serving a defined 108 geographic area developed pursuant to s. 394.4573 which is 109 responsible for assessment and evaluation, both voluntary and 110 involuntary, and treatment, stabilization, or triage for 111 patients who have a mental illness, a substance use disorder, or 112 co-occurring disorders. Any transportation plans developed 113 pursuant to s. 394.462 must support the operation of the 114 receiving system. 115 (6)RULES.The department may adopt rules relating to: 116 (a)Procedures and criteria for receiving and evaluating 117 facility applications for designation, which may include onsite 118 facility inspection and evaluation of an applicants licensing 119 status and performance history, as well as consideration of 120 local service needs. 121 (b)Minimum standards consistent with this part that a 122 facility must meet and maintain in order to be designated as a 123 receiving or treatment facility and procedures for monitoring 124 continued adherence to such standards. 125 (c)Procedures and criteria for designating receiving 126 systems which may include consideration of the adequacy of 127 services provided by facilities within the receiving system to 128 meet the needs of the geographic area using available resources. 129 (d)Procedures for receiving complaints against a 130 designated facility or designated receiving system and for 131 initiating inspections and investigations of facilities or 132 receiving systems alleged to have violated the provisions of 133 this part or rules adopted under this part. 134 (e)Procedures and criteria for the suspension or 135 withdrawal of designation as a receiving facility or receiving 136 system. 137 Section 2.Subsection (1) of section 916.107, Florida 138 Statutes, is amended to read: 139 916.107Rights of forensic clients. 140 (1)RIGHT TO INDIVIDUAL DIGNITY. 141 (a)The policy of the state is that the individual dignity 142 of the client shall be respected at all times and upon all 143 occasions, including any occasion when the forensic client is 144 detained, transported, or treated. Clients with mental illness, 145 intellectual disability, or autism and who are charged with 146 committing felonies shall receive appropriate treatment or 147 training. In a criminal case involving a client who has been 148 adjudicated incompetent to proceed or not guilty by reason of 149 insanity, a jail may be used as an emergency facility for up to 150 15 days following the date the department or agency receives a 151 completed copy of the court commitment order containing all 152 documentation required by the applicable Florida Rules of 153 Criminal Procedure. For a forensic client who is held in a jail 154 awaiting admission to a facility of the department or agency, 155 evaluation and treatment or training may be provided in the jail 156 by the local community mental health provider for mental health 157 services, by the developmental disabilities program for persons 158 with intellectual disability or autism, the clients physician 159 or psychologist, or any other appropriate program until the 160 client is transferred to a civil or forensic facility. The 161 sheriff shall administer or permit the department to administer 162 the appropriate psychotropic medication to a forensic client 163 before his or her admission to a state mental health treatment 164 facility. 165 (b)Forensic clients who are initially placed in, or 166 subsequently transferred to, a civil facility as described in 167 part I of chapter 394 or to a residential facility as described 168 in chapter 393 shall have the same rights as other persons 169 committed to these facilities for as long as they remain there. 170 Section 3.Subsection (4) of section 916.12, Florida 171 Statutes, is amended to read: 172 916.12Mental competence to proceed. 173 (4)If an expert finds that the defendant is incompetent to 174 proceed, the expert shall report on any recommended treatment 175 for the defendant to attain competence to proceed. In 176 considering the issues relating to treatment, the examining 177 expert shall specifically report on all of the following: 178 (a)The mental illness causing the incompetence.; 179 (b)The completion of a clinical assessment by approved 180 mental health experts trained by the department to ensure the 181 safety of the defendant and the community. 182 (c)The treatment or treatments appropriate for the mental 183 illness of the defendant and an explanation of each of the 184 possible treatment alternatives, including, at a minimum, mental 185 health services, treatment services, rehabilitative services, 186 support services, and case management services as those terms 187 are defined in s. 394.67(16), which may be provided by or within 188 multidisciplinary community treatment teams, such as Florida 189 Assertive Community Treatment, conditional release programs, 190 outpatient services or intensive outpatient treatment programs, 191 and supportive employment and supportive housing opportunities 192 in treating and supporting the recovery of the defendant. in 193 order of choices; 194 (d)(c)The availability of acceptable treatment, and, if 195 treatment is available in the community, the expert shall so 196 state in the report.; and 197 (e)(d)The likelihood of the defendants attaining 198 competence under the treatment recommended, an assessment of the 199 probable duration of the treatment required to restore 200 competence, and the probability that the defendant will attain 201 competence to proceed in the foreseeable future. 202 203 The examining experts report to the court must include a full 204 and detailed explanation regarding why the alternative treatment 205 options referenced in the evaluation are insufficient to meet 206 the needs of the defendant. 207 Section 4.Section 916.13, Florida Statutes, is amended to 208 read: 209 916.13Involuntary commitment of defendant adjudicated 210 incompetent. 211 (1)Every defendant who is charged with a felony and who is 212 adjudicated incompetent to proceed may be involuntarily 213 committed for treatment upon a finding by the court of clear and 214 convincing evidence that: 215 (a)The defendant has a mental illness and because of the 216 mental illness: 217 1.The defendant is manifestly incapable of surviving alone 218 or with the help of willing and responsible family or friends, 219 including available alternative services, and, without 220 treatment, the defendant is likely to suffer from neglect or 221 refuse to care for herself or himself and such neglect or 222 refusal poses a real and present threat of substantial harm to 223 the defendants well-being; or 224 2.There is a substantial likelihood that in the near 225 future the defendant will inflict serious bodily harm on herself 226 or himself or another person, as evidenced by recent behavior 227 causing, attempting, or threatening such harm; 228 (b)All available, less restrictive treatment alternatives, 229 including treatment in community residential facilities, or 230 community inpatient or outpatient settings, or any other mental 231 health services, treatment services, rehabilitative services, 232 support services, or case management services as those terms are 233 defined or described in s. 394.67(16) which would offer an 234 opportunity for improvement of the defendants condition have 235 been judged to be inappropriate; and 236 (c)There is a substantial probability that the mental 237 illness causing the defendants incompetence will respond to 238 treatment and the defendant will regain competency to proceed in 239 the reasonably foreseeable future. 240 241 Before issuing a commitment order, the court must review the 242 examining experts report to ensure alternative treatment 243 options have been fully considered and found insufficient to 244 meet the needs of the defendant. 245 (2)A defendant who has been charged with a felony and who 246 has been adjudicated incompetent to proceed due to mental 247 illness, and who meets the criteria for involuntary commitment 248 under this chapter, may be committed to the department, and the 249 department shall retain and treat the defendant. 250 (a)Immediately after receipt of a completed copy of the 251 court commitment order containing all documentation required by 252 the applicable Florida Rules of Criminal Procedure, the 253 department shall request all medical information relating to the 254 defendant from the jail. The jail shall provide the department 255 with all medical information relating to the defendant within 3 256 business days after receipt of the departments request or at 257 the time the defendant enters the physical custody of the 258 department, whichever is earlier. 259 (b)Within 60 days 6 months after the date of admission and 260 at the end of any period of extended commitment, or at any time 261 the administrator or his or her designee determines that the 262 defendant has regained competency to proceed or no longer meets 263 the criteria for continued commitment, the administrator or 264 designee shall file a report with the court pursuant to the 265 applicable Florida Rules of Criminal Procedure. 266 (c)A competency hearing must be held within 30 days after 267 the court receives notification that the defendant is competent 268 to proceed or no longer meets the criteria for continued 269 commitment. The defendant must be transported in accordance with 270 s. 916.107 to the committing courts jurisdiction within 7 days 271 after notification that the defendant is competent to proceed or 272 no longer meets the criteria for continued commitment. A 273 determination on the issue of competency must be made at a 274 hearing within 30 days after the notification for the hearing. 275 If the defendant is receiving psychotropic medication at a 276 mental health facility at the time he or she is discharged and 277 transferred to the jail, the administering of such medication 278 must continue unless the jail physician documents the need to 279 change or discontinue it. To ensure continuity of care, the 280 referring mental health facility shall transfer the defendant 281 with up to 30 days of medications and assist in discharge 282 planning with medical teams at the receiving county jail. The 283 jail and department physicians shall collaborate to ensure that 284 medication changes do not adversely affect the defendants 285 mental health status or his or her ability to continue with 286 court proceedings; however, the final authority regarding the 287 administering of medication to an inmate in jail rests with the 288 jail physician. 289 Section 5.For the purpose of incorporating the amendment 290 made by this act to section 916.13, Florida Statutes, in a 291 reference thereto, paragraph (a) of subsection (1) of section 292 394.658, Florida Statutes, is reenacted to read: 293 394.658Criminal Justice, Mental Health, and Substance 294 Abuse Reinvestment Grant Program requirements. 295 (1)The Criminal Justice, Mental Health, and Substance 296 Abuse Statewide Grant Review Committee, in collaboration with 297 the Department of Children and Families, the Department of 298 Corrections, the Department of Juvenile Justice, the Department 299 of Elderly Affairs, and the Office of the State Courts 300 Administrator, shall establish criteria to be used to review 301 submitted applications and to select the county that will be 302 awarded a 1-year planning grant or a 3-year implementation or 303 expansion grant. A planning, implementation, or expansion grant 304 may not be awarded unless the application of the county meets 305 the established criteria. 306 (a)The application criteria for a 1-year planning grant 307 must include a requirement that the applicant county or counties 308 have a strategic plan to initiate systemic change to identify 309 and treat individuals who have a mental illness, substance abuse 310 disorder, or co-occurring mental health and substance abuse 311 disorders who are in, or at risk of entering, the criminal or 312 juvenile justice systems. The 1-year planning grant must be used 313 to develop effective collaboration efforts among participants in 314 affected governmental agencies, including the criminal, 315 juvenile, and civil justice systems, mental health and substance 316 abuse treatment service providers, transportation programs, and 317 housing assistance programs. The collaboration efforts shall be 318 the basis for developing a problem-solving model and strategic 319 plan for treating adults and juveniles who are in, or at risk of 320 entering, the criminal or juvenile justice system and doing so 321 at the earliest point of contact, taking into consideration 322 public safety. The planning grant shall include strategies to 323 divert individuals from judicial commitment to community-based 324 service programs offered by the Department of Children and 325 Families in accordance with ss. 916.13 and 916.17. 326 Section 6.For the purpose of incorporating the amendment 327 made by this act to section 916.13, Florida Statutes, in a 328 reference thereto, subsection (9) of section 916.106, Florida 329 Statutes, is reenacted to read: 330 916.106Definitions.For the purposes of this chapter, the 331 term: 332 (9)Forensic client or client means any defendant who 333 has been committed to the department or agency pursuant to s. 334 916.13, s. 916.15, or s. 916.302. 335 Section 7.For the purpose of incorporating the amendment 336 made by this act to section 916.13, Florida Statutes, in 337 references thereto, subsections (1) and (2) of section 916.17, 338 Florida Statutes, are reenacted to read: 339 916.17Conditional release. 340 (1)Except for an inmate currently serving a prison 341 sentence, the committing court may order a conditional release 342 of any defendant in lieu of an involuntary commitment to a 343 facility pursuant to s. 916.13 or s. 916.15 based upon an 344 approved plan for providing appropriate outpatient care and 345 treatment. Upon a recommendation that outpatient treatment of 346 the defendant is appropriate, a written plan for outpatient 347 treatment, including recommendations from qualified 348 professionals, must be filed with the court, with copies to all 349 parties. Such a plan may also be submitted by the defendant and 350 filed with the court with copies to all parties. The plan shall 351 include: 352 (a)Special provisions for residential care or adequate 353 supervision of the defendant. 354 (b)Provisions for outpatient mental health services. 355 (c)If appropriate, recommendations for auxiliary services 356 such as vocational training, educational services, or special 357 medical care. 358 359 In its order of conditional release, the court shall specify the 360 conditions of release based upon the release plan and shall 361 direct the appropriate agencies or persons to submit periodic 362 reports to the court regarding the defendants compliance with 363 the conditions of the release and progress in treatment, with 364 copies to all parties. 365 (2)Upon the filing of an affidavit or statement under oath 366 by any person that the defendant has failed to comply with the 367 conditions of release, that the defendants condition has 368 deteriorated to the point that inpatient care is required, or 369 that the release conditions should be modified, the court shall 370 hold a hearing within 7 days after receipt of the affidavit or 371 statement under oath. After the hearing, the court may modify 372 the release conditions. The court may also order that the 373 defendant be returned to the department if it is found, after 374 the appointment and report of experts, that the person meets the 375 criteria for involuntary commitment under s. 916.13 or s. 376 916.15. 377 Section 8.This act shall take effect July 1, 2023.