FL
Florida House Bill H0915

Florida 2024 Regular Session

Florida House Bill H0915 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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1414 A bill to be entitled 1
15-An act relating to outpatient health services; 2
16-amending s. 394.4599, F.S.; revising written notice 3
17-requirements relating to filing petitions for 4
18-involuntary services; amending s. 394.4615, F.S.; 5
19-conforming provisions to changes made by the act; 6
20-amending s. 394.463, F.S.; authorizing, rather than 7
21-requiring, law enforcement officers to take certain 8
22-persons into custody for involuntary examinations; 9
23-requiring written reports by law enforcement officers 10
24-to contain certain information; removing a provision 11
25-prohibiting a psychiatric nurse from approving the 12
26-release of a patient under certain circumstances; 13
27-revising the types of documents that the department is 14
28-required to receive and maintain and that are 15
29-considered part of the clinical record; requiring the 16
30-department to post a specified report on its website; 17
31-revising requirements for releasing a patient from a 18
32-receiving facility; revising requirements for 19
33-petitions for involuntary services; amending s. 20
34-394.4655, F.S.; defining the term "involuntary 21
35-outpatient placement"; authorizing a court to order a 22
36-respondent into outpatient treatment under certain 23
37-circumstances; removing provisions relating to 24
38-criteria, retention of a patient, and petition for 25
15+An act relating to outpatient mental health services; 2
16+amending s. 394.455, F.S.; revising and providing 3
17+definitions; amending s. 394.4655, F.S.; authorizing a 4
18+court to order a respondent into outpatient treatment 5
19+for a specified amount of time under certain 6
20+circumstances; providing criteria for involuntary 7
21+outpatient treatment; requiring monitoring of the 8
22+respondent for the duration of his or her treatment; 9
23+requiring the court to retain jurisdiction over the 10
24+case and parties under certain circumstances; 11
25+authorizing certain courts exercising original 12
26+jurisdiction to order certain respondents into 13
27+involuntary outpatient services; prohibiting such 14
28+court from using incarceration as a sanction for 15
29+noncompliance with the outpatient treatment plan; 16
30+amending s. 394.467, F.S.; revising criteria for 17
31+involuntary inpatient placement; amending ss. 18
32+394.4599, 394.4615, 394.463, 394.467, 394.495, 19
33+394.496, 394.9085, 409.972, 464.0 12, 744.2007, and 20
34+790.065, F.S.; conforming provisions and cross -21
35+references to changes made by the act; providing an 22
36+effective date. 23
37+ 24
38+Be It Enacted by the Legislature of the State of Florida: 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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51-involuntary outpatient services and court proceedings 26
52-relating to involuntary outpatient services; amending 27
53-s. 394.467, F.S.; providing definitions; revising 28
54-requirements for ordering a person for involuntary 29
55-services and treatment, petitions for involuntary 30
56-services, appointment of counsel, and continuances of 31
57-hearings, respectively; revising the conditions under 32
58-which a court may waive the requirement for a patient 33
59-to be present at an involuntary inpatient placement 34
60-hearing; authorizing the court to permit witnesses to 35
61-attend and testify remotely at the hearing through 36
62-specified means; providing requirements for a witness 37
63-to attend and testify remotely; requiring facilities 38
64-to make certain clinical records available to a state 39
65-attorney within a specified timeframe; specifying that 40
66-such records remain confidential and may not be used 41
67-for certain purposes; revising the circumstances under 42
68-which a court may appoint a magistrate to preside over 43
69-certain proceedings; requiring the court to allow 44
70-certain testimony from specified persons; revising the 45
71-length of time a court may r equire a patient to 46
72-receive services; requiring facilities to discharge 47
73-patients when they no longer meet the criteria for 48
74-involuntary inpatient treatment; prohibiting courts 49
75-from ordering individuals with developmental 50
51+ 26
52+ Section 1. Subsections (32) through (39) and (40) throu gh 27
53+(50) of section 394.455, Florida Statutes, are renumbered as 28
54+subsections (33) through (40) and (42) through (52), 29
55+respectively, subsection (23) is amended, and new subsections 30
56+(32) and (41) are added to that section, to read: 31
57+ 394.455 Definitions. —As used in this part, the term: 32
58+ (23) "Involuntary examination" means an examination 33
59+performed under s. 394.463, s. 397.6772, s. 397.679, s. 34
60+397.6798, or s. 397.6957 s. 397.6811 to determine whether a 35
61+person qualifies for involuntary services. 36
62+ (32) "Neglect or refuse to care for himself or herself" 37
63+means a refusal to accept treatment and includes, but is not 38
64+limited to, evidence that a person: 39
65+ (a) Is, for a reason other than indigence, unable to 40
66+satisfy basic needs for nourishment, clothing, medical care, 41
67+shelter, or safety, thereby creating a substantial probability 42
68+of imminent death, serious physical debilitation, or disease; or 43
69+ (b) Is substantially unable to make an informed treatment 44
70+choice, after an explanation of the advantages and disadvantages 45
71+of, and alternatives to, treatment, and needs care or treatment 46
72+to prevent deterioration. However, the following do not 47
73+constitute a refusal to accept treatment: 48
74+ 1. A willingness to take medication appropriate for the 49
75+person's condition, but a reasonable di sagreement about type or 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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88-disabilities to be involuntarily pla ced in a state 51
89-treatment facility; requiring courts to refer such 52
90-individuals, and authorizing courts to refer certain 53
91-other individuals, to specified agencies for 54
92-evaluation and services; providing requirements for 55
93-treatment plan modifications, noncomplia nce with 56
94-involuntary outpatient services, and discharge, 57
95-respectively; revising requirements for the procedure 58
96-for continued involuntary services and return to 59
97-treatment facilities, respectively; amending ss. 60
98-394.492, 394.495, 394.496, 394.9085, 409.972, 4 64.012, 61
99-and 744.2007, F.S.; conforming provisions and cross -62
100-references to changes made by the act; providing an 63
101-effective date. 64
102- 65
103-Be It Enacted by the Legislature of the State of Florida: 66
104- 67
105- Section 1. Paragraph (d) of subsection (2) of section 68
106-394.4599, Florida Statutes, is amended to read: 69
107- 394.4599 Notice.— 70
108- (2) INVOLUNTARY ADMISSION. — 71
109- (d) The written notice of the filing of the petition for 72
110-involuntary services for an individual being held must contain 73
111-the following: 74
112- 1. Notice that the petiti on for: 75
88+dosage; 51
89+ 2. A good faith effort to follow a reasonable treatment 52
90+plan; 53
91+ 3. An inability to obtain access to appropriate treatment 54
92+because of inadequate health care coverage or an insurer's 55
93+refusal or delay in providing coverage f or treatment; or 56
94+ 4. An inability to obtain access to needed services 57
95+because the provider has no available treatment beds or 58
96+qualified professionals, the provider only accepts patients 59
97+under court order, or the provider gives persons under court 60
98+order priority over voluntary patients in obtaining treatment 61
99+and services. 62
100+ (41) "Real and present threat of substantial harm" 63
101+includes, but is not limited to, evidence of a substantial 64
102+probability that the untreated person will: 65
103+ (a) Lack, refuse, or not recei ve services for health and 66
104+safety which are actually available in the community; or 67
105+ (b) Suffer severe mental, emotional, or physical harm that 68
106+will result in the loss of his or her ability to function in the 69
107+community or in the loss of cognitive or volitional control over 70
108+his or her thoughts or actions. 71
109+ Section 2. Section 394.4655, Florida Statutes, is amended 72
110+to read: 73
111+ (Substantial rewording of section. See 74
112+ s. 394.4655, F.S., for present text.) 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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125- a. Involuntary services inpatient treatment pursuant to s. 76
126-394.467 has been filed with the circuit court and the address of 77
127-such court in the county in which the individual is hospitalized 78
128-and the address of such court ; or 79
129- b. Involuntary outpat ient services pursuant to s. 394.467 80
130-s. 394.4655 has been filed with the criminal county court, as 81
131-defined in s. 394.4655(1), or the circuit court, as applicable, 82
132-in the county in which the individual is hospitalized and the 83
133-address of such court. 84
134- 2. Notice that the office of the public defender has been 85
135-appointed to represent the individual in the proceeding, if the 86
136-individual is not otherwise represented by counsel. 87
137- 3. The date, time, and place of the hearing and the name 88
138-of each examining expert and every other person expected to 89
139-testify in support of continued detention. 90
140- 4. Notice that the individual, the individual's guardian, 91
141-guardian advocate, health care surrogate or proxy, or 92
142-representative, or the administrator may apply for a change of 93
143-venue for the convenience of the parties or witnesses or because 94
144-of the condition of the individual. 95
145- 5. Notice that the individual is entitled to an 96
146-independent expert examination and, if the individual cannot 97
147-afford such an examination, that the court will p rovide for one. 98
148- Section 2. Subsection (3) of section 394.4615, Florida 99
149-Statutes, is amended to read: 100
125+ 394.4655 Involuntary outpatient services. — 76
126+ (1)(a) A court may order a respondent into outpatient 77
127+treatment for up to 6 months if, during the initial hearing 78
128+under s. 394.467 or a subsequent hearing before a respondent's 79
129+anticipated discharge from inpatient placement, at the request 80
130+of the facility, and providing at least 1 week notice to the 81
131+court and the parties of its belief that the respondent would 82
132+benefit from involuntary outpatient services, it is established 83
133+that the respondent meets the involuntary placement criteria and 84
134+all of the following: 85
135+ 1. The respondent has been incarcerated, has been 86
136+involuntarily admitted to a receiving facility or treatment 87
137+facility as defined in s. 394.455, or has received mental health 88
138+services in a forensic or correctional facility at least twice 89
139+during the previous 36 months. 90
140+ 2. The outpatient treatment is provided and available in 91
141+the county in which the respondent resides or will reside if he 92
142+or she is being placed from a state treatment facility. 93
143+ 3. The respondent's treating physician certifies, within a 94
144+reasonable degree of medical probability, that the respondent: 95
145+ a. May be appropriately treated on an outpatient basis. 96
146+ b. Is able to follow and benefit from the prescribed 97
147+treatment plan. 98
148+ (b) For the duration of his or her treatment, the 99
149+respondent must be monitored by a social worker or case manager 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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162- 394.4615 Clinical records; confidentiality. — 101
163- (3) Information from the clinical record may be released 102
164-in the following circumstances: 103
165- (a) When a patient has communicated to a service provider 104
166-a specific threat to cause serious bodily injury or death to an 105
167-identified or a readily available person, if the service 106
168-provider reasonably believes, or should reasonably believe 107
169-according to the standards of his or her profession, that the 108
170-patient has the apparent intent and ability to imminently or 109
171-immediately carry out such threat. When such communication has 110
172-been made, the administrator may authorize the release of 111
173-sufficient information to provide adequat e warning to the person 112
174-threatened with harm by the patient. 113
175- (b) When the administrator of the facility or secretary of 114
176-the department deems release to a qualified researcher as 115
177-defined in administrative rule, an aftercare treatment provider, 116
178-or an employee or agent of the department is necessary for 117
179-treatment of the patient, maintenance of adequate records, 118
180-compilation of treatment data, aftercare planning, or evaluation 119
181-of programs. 120
182- 121
183-For the purpose of determining whether a person meets the 122
184-criteria for involuntary services outpatient placement or for 123
185-preparing the proposed treatment plan pursuant to s. 394.4655 or 124
186-s. 394.467, the clinical record may be released to the state 125
162+of the outpatient treatment provider, or a willing, able, and 101
163+responsible individual appointed by the court who must inform 102
164+the court, state attorney, and respondent's counsel of any 103
165+failure by the responde nt to comply with his or her outpatient 104
166+program. 105
167+ (2) The court shall, if required, retain jurisdiction over 106
168+the case and parties for the entry of further orders after a 107
169+hearing. Such jurisdiction includes, but is not limited to, 108
170+ordering inpatient treatm ent to stabilize a respondent who 109
171+decompensates while under court -ordered treatment and meets the 110
172+commitment criteria of s. 394.467(1), and extending, modifying, 111
173+or ending outpatient services. For a court to extend, modify, or 112
174+end outpatient services, the appropriate motion must be filed 113
175+with the court before the operating order expires, and the court 114
176+shall schedule a hearing as soon as practicable to determine 115
177+whether the respondent still meets the commitment criteria and 116
178+assess the appropriateness of any treatment modification. 117
179+ (3) A criminal county court exercising its original 118
180+jurisdiction in a misdemeanor case under s. 34.01 may order into 119
181+involuntary outpatient services a respondent who meets the 120
182+commitment criteria. The court may not use incarcerati on as a 121
183+sanction for noncompliance with the outpatient treatment plan, 122
184+but it may order an evaluation for possible inpatient placement 123
185+if there is significant, or multiple instances of, 124
186+noncompliance. 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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199-attorney, the public defender or the patient's private legal 126
200-counsel, the court, and to the appropriate mental health 127
201-professionals, including the service provider under s. 394.4655 128
202-or s. 394.467 identified in s. 394.4655(7)(b)2. , in accordance 129
203-with state and federal law. 130
204- Section 3. Subsection (1) and paragraphs (a), (e), (f), 131
205-(g), and (h) of subsection (2) of section 394.463, Florida 132
206-Statutes, are amended to read: 133
207- 394.463 Involuntary examination. — 134
208- (1) CRITERIA.—A person may be taken to a receiving 135
209-facility for involuntary examination if there is reason to 136
210-believe that the pers on has a mental illness and because of his 137
211-or her mental illness: 138
212- (a)1. The person has refused voluntary examination after 139
213-conscientious explanation and disclosure of the purpose of the 140
214-examination; or 141
215- 2. The person is unable to determine for himself o r 142
216-herself whether examination is necessary; and 143
217- (b)1. Without care or treatment, the person is likely to 144
218-suffer from neglect or refuse to care for himself or herself; 145
219-such neglect or refusal poses a real and present threat of 146
220-substantial harm to his or h er well-being; and it is not 147
221-apparent that such harm may be avoided through the help of 148
222-willing, able, and responsible family members or friends or the 149
223-provision of other services; or 150
199+ Section 3. Paragraph (a) of subsection (1) of secti on 126
200+394.467, Florida Statutes, is amended to read: 127
201+ 394.467 Involuntary inpatient placement. — 128
202+ (1) CRITERIA.—A person may be ordered for involuntary 129
203+inpatient placement for treatment upon a finding of the court by 130
204+clear and convincing evidence that: 131
205+ (a) He or she has a mental illness and because of his or 132
206+her mental illness: 133
207+ 1.a. He or she has refused voluntary inpatient placement 134
208+for treatment after sufficient and conscientious explanation and 135
209+disclosure of the purpose of inpatient placement for treat ment; 136
210+or 137
211+ b. He or she is unable to determine for himself or herself 138
212+whether inpatient placement is necessary; and 139
213+ 2.a. He or she is incapable of surviving alone or with the 140
214+help of willing and responsible family or friends, including 141
215+available alternative services, and, without treatment, is 142
216+likely to suffer from neglect or refuse to care for himself or 143
217+herself, and such neglect or refusal poses a real and present 144
218+threat of substantial harm to his or her well -being; or 145
219+ b. There is substantial likeliho od that in the near 146
220+future, and without services, he or she will inflict serious 147
221+bodily harm to on self or others, as evidenced by recent acts, 148
222+omissions, or behavior causing, attempting, or threatening such 149
223+harm, including, but not limited to, significant property 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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236- 2. There is a substantial likelihood that without care or 151
237-treatment the person will cause serious bodily harm to himself 152
238-or herself or others in the near future, as evidenced by recent 153
239-behavior. 154
240- (2) INVOLUNTARY EXAMINATION. — 155
241- (a) An involuntary examination may be initiated by any one 156
242-of the following means: 157
243- 1. A circuit or county court may enter an ex parte order 158
244-stating that a person appears to meet the criteria for 159
245-involuntary examination and specifying the findings on which 160
246-that conclusion is based. The ex parte order for involuntary 161
247-examination must be based on writt en or oral sworn testimony 162
248-that includes specific facts that support the findings. If other 163
249-less restrictive means are not available, such as voluntary 164
250-appearance for outpatient evaluation, a law enforcement officer, 165
251-or other designated agent of the court, shall take the person 166
252-into custody and deliver him or her to an appropriate, or the 167
253-nearest, facility within the designated receiving system 168
254-pursuant to s. 394.462 for involuntary examination. The order of 169
255-the court shall be made a part of the patient's c linical record. 170
256-A fee may not be charged for the filing of an order under this 171
257-subsection. A facility accepting the patient based on this order 172
258-must send a copy of the order to the department within 5 working 173
259-days. The order may be submitted electronically through existing 174
260-data systems, if available. The order shall be valid only until 175
236+damage; and 151
237+ Section 4. Paragraph (d) of subsection (2) of section 152
238+394.4599, Florida Statutes, is amended to read: 153
239+ 394.4599 Notice.— 154
240+ (2) INVOLUNTARY ADMISSION. — 155
241+ (d) The written notice of the filing of the petition for 156
242+involuntary services for an individual being held must contain 157
243+the following: 158
244+ 1. Notice that the petition for: 159
245+ a. Involuntary inpatient treatment pursuant to s. 394.467 160
246+has been filed with the circuit court in the county in which the 161
247+individual is hospitalized and the ad dress of such court; or 162
248+ b. Involuntary outpatient services pursuant to s. 394.4655 163
249+has been filed with the criminal county court, as provided under 164
250+s. 394.4655 defined in s. 394.4655(1) , or the circuit court, as 165
251+applicable, in the county in which the ind ividual is 166
252+hospitalized and the address of such court. 167
253+ 2. Notice that the office of the public defender has been 168
254+appointed to represent the individual in the proceeding, if the 169
255+individual is not otherwise represented by counsel. 170
256+ 3. The date, time, and place of the hearing and the name 171
257+of each examining expert and every other person expected to 172
258+testify in support of continued detention. 173
259+ 4. Notice that the individual, the individual's guardian, 174
260+guardian advocate, health care surrogate or proxy, or 175
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273-the person is delivered to the facility or for the period 176
274-specified in the order itself, whichever comes first. If a time 177
275-limit is not specified in the order, the order is va lid for 7 178
276-days after the date that the order was signed. 179
277- 2. A law enforcement officer may shall take a person who 180
278-appears to meet the criteria for involuntary examination into 181
279-custody and deliver the person or have him or her delivered to 182
280-an appropriate, or the nearest, facility within the designated 183
281-receiving system pursuant to s. 394.462 for examination. A law 184
282-enforcement officer transporting a person pursuant to this 185
283-section subparagraph shall restrain the person in the least 186
284-restrictive manner availab le and appropriate under the 187
285-circumstances. The officer shall execute a written report 188
286-detailing the circumstances under which the person was taken 189
287-into custody, which must be made a part of the patient's 190
288-clinical record. The report must include all emerge ncy contact 191
289-information for the person that is readily accessible to the law 192
290-enforcement officer, including information available through 193
291-electronic databases maintained by the Department of Law 194
292-Enforcement or by the Department of Highway Safety and Motor 195
293-Vehicles. Such emergency contact information may be used by a 196
294-receiving facility only for the purpose of informing listed 197
295-emergency contacts of a patient's whereabouts pursuant to s. 198
296-119.0712(2)(d). Any facility accepting the patient based on this 199
297-report must send a copy of the report to the department within 5 200
273+representative, or the administrator may apply for a change of 176
274+venue for the convenience of the parties or witnesses or because 177
275+of the condition of the individual. 178
276+ 5. Notice that the individual is entitled to an 179
277+independent expert examination and, if the indi vidual cannot 180
278+afford such an examination, that the court will provide for one. 181
279+ Section 5. Subsection (3) of section 394.4615, Florida 182
280+Statutes, is amended to read: 183
281+ 394.4615 Clinical records; confidentiality. — 184
282+ (3) Information from the clinical recor d may be released 185
283+in the following circumstances: 186
284+ (a) When a patient has communicated to a service provider 187
285+a specific threat to cause serious bodily injury or death to an 188
286+identified or a readily available person, if the service 189
287+provider reasonably belie ves, or should reasonably believe 190
288+according to the standards of his or her profession, that the 191
289+patient has the apparent intent and ability to imminently or 192
290+immediately carry out such threat. When such communication has 193
291+been made, the administrator may aut horize the release of 194
292+sufficient information to provide adequate warning to the person 195
293+threatened with harm by the patient. 196
294+ (b) When the administrator of the facility or secretary of 197
295+the department deems release to a qualified researcher as 198
296+defined in administrative rule, an aftercare treatment provider, 199
297+or an employee or agent of the department is necessary for 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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310-working days. 201
311- 3. A physician, a physician assistant, a clinical 202
312-psychologist, a psychiatric nurse, an advanced practice 203
313-registered nurse registered under s. 464.0123, a mental health 204
314-counselor, a marriage and family therapist, or a clinical social 205
315-worker may execute a certificate stating that he or she has 206
316-examined a person within the preceding 48 hours and finds that 207
317-the person appears to meet the criteria for involuntary 208
318-examination and stating th e observations upon which that 209
319-conclusion is based. If other less restrictive means, such as 210
320-voluntary appearance for outpatient evaluation, are not 211
321-available, a law enforcement officer shall take into custody the 212
322-person named in the certificate and delive r him or her to the 213
323-appropriate, or nearest, facility within the designated 214
324-receiving system pursuant to s. 394.462 for involuntary 215
325-examination. The law enforcement officer shall execute a written 216
326-report detailing the circumstances under which the person w as 217
327-taken into custody and include all emergency contact information 218
328-required under subparagraph 2 . The report must include all 219
329-emergency contact information for the person that is readily 220
330-accessible to the law enforcement officer, including information 221
331-available through electronic databases maintained by the 222
332-Department of Law Enforcement or by the Department of Highway 223
333-Safety and Motor Vehicles. Such emergency contact information 224
334-may be used by a receiving facility only for the purpose of 225
310+treatment of the patient, maintenance of adequate records, 201
311+compilation of treatment data, aftercare planning, or evaluation 202
312+of programs. 203
313+ 204
314+For the purpose of determining whether a person meets the 205
315+criteria for involuntary outpatient placement or for preparing 206
316+the proposed treatment plan pursuant to s. 394.4655, the 207
317+clinical record may be released to the state attorney, the 208
318+public defender or the pat ient's private legal counsel, the 209
319+court, and to the appropriate mental health professionals, 210
320+including the service provider identified in s. 211
321+394.4655(7)(b)2., in accordance with state and federal law. 212
322+ Section 6. Paragraph (g) of subsection (2) of section 213
323+394.463, Florida Statutes, is amended to read: 214
324+ 394.463 Involuntary examination. — 215
325+ (2) INVOLUNTARY EXAMINATION. — 216
326+ (g) The examination period must be for up to 72 hours. For 217
327+a minor, the examination shall be initiated within 12 hours 218
328+after the patient's arrival at the facility. Within the 219
329+examination period, one of the following actions must be taken, 220
330+based on the individual needs of the patient: 221
331+ 1. The patient shall be released, unless he or she is 222
332+charged with a crime, in which case the patien t shall be 223
333+returned to the custody of a law enforcement officer; 224
334+ 2. The patient shall be released, subject to subparagraph 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
344344
345345
346346
347-informing listed emergency contacts of a patient's whereabouts 226
348-pursuant to s. 119.0712(2)(d). The report and certificate shall 227
349-be made a part of the patient's clinical record. Any facility 228
350-accepting the patient based on this certificate must send a copy 229
351-of the certificate t o the department within 5 working days. The 230
352-document may be submitted electronically through existing data 231
353-systems, if applicable. 232
354- 233
355-When sending the order, report, or certificate to the 234
356-department, a facility shall, at a minimum, provide information 235
357-about which action was taken regarding the patient under 236
358-paragraph (g), which information shall also be made a part of 237
359-the patient's clinical record. 238
360- (e) The department shall receive and maintain the copies 239
361-of ex parte orders, involuntary outpatient services orders 240
362-issued pursuant to ss. 394.4655 and 394.467 s. 394.4655, 241
363-involuntary inpatient placement orders issued pursuant to s. 242
364-394.467, professional certificates, law enforcement officers' 243
365-reports, and reports relating to the transportation of patients. 244
366-These documents shall be considered part of the clinical record, 245
367-governed by the provisions of s. 394.4615. These documents shall 246
368-be used to prepare annual reports analyzing the data obtained 247
369-from these documents, without including the personal identifying 248
370-information of the patient. The department identifying patients, 249
371-and shall post the reports on its website and provide copies of 250
347+1., for voluntary outpatient treatment; 226
348+ 3. The patient, unless he or she is charged with a crime, 227
349+shall be asked to give express and informed consent to placement 228
350+as a voluntary patient and, if such consent is given, the 229
351+patient shall be admitted as a voluntary patient; or 230
352+ 4. A petition for involuntary services shall be filed in 231
353+the circuit court if inpatient treatment is deemed n ecessary or 232
354+with the criminal county court, as defined in s. 394.4655(1), as 233
355+applicable. When inpatient treatment is deemed necessary, the 234
356+least restrictive treatment consistent with the optimum 235
357+improvement of the patient's condition shall be made availabl e. 236
358+When a petition is to be filed for involuntary outpatient 237
359+placement, it shall be filed by one of the petitioners specified 238
360+in s. 394.4655(4)(a). A petition for involuntary inpatient 239
361+placement shall be filed by the facility administrator. If a 240
362+patient's 72-hour examination period ends on a weekend or 241
363+holiday, and the receiving facility: 242
364+ a. Intends to file a petition for involuntary services, 243
365+such patient may be held at a receiving facility through the 244
366+next working day thereafter and such petition for in voluntary 245
367+services must be filed no later than such date. If the receiving 246
368+facility fails to file a petition for involuntary services at 247
369+the close of the next working day, the patient shall be released 248
370+from the receiving facility following approval pursuan t to 249
371+paragraph (f). 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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384-such reports to the department, the President of the Senate, the 251
385-Speaker of the House of Representatives, and the minority 252
386-leaders of the Senate and the House of Representatives by 253
387-November 30 of each year . 254
388- (f) A patient shall be examined by a physician or a 255
389-clinical psychologist, or by a psychiatric nurse performing 256
390-within the framework of an established protocol with a 257
391-psychiatrist at a facility without unnecessary delay to 258
392-determine if the criteria for involuntary services are met. 259
393-Emergency treatment may be provided upon the order of a 260
394-physician if the physician determines that such treatment is 261
395-necessary for the safety of the pa tient or others. The patient 262
396-may not be released by the receiving facility or its contractor 263
397-without the documented approval of a psychiatrist or a clinical 264
398-psychologist or, if the receiving facility is owned or operated 265
399-by a hospital, health system, or na tionally accredited community 266
400-mental health center, the release may also be approved by a 267
401-psychiatric nurse performing within the framework of an 268
402-established protocol with a psychiatrist, or an attending 269
403-emergency department physician with experience in th e diagnosis 270
404-and treatment of mental illness after completion of an 271
405-involuntary examination pursuant to this subsection. A 272
406-psychiatric nurse may not approve the release of a patient if 273
407-the involuntary examination was initiated by a psychiatrist 274
408-unless the release is approved by the initiating psychiatrist. 275
384+ b. Does not intend to file a petition for involuntary 251
385+services, a receiving facility may postpone release of a patient 252
386+until the next working day thereafter only if a qualified 253
387+professional documents that adequate discharge planning a nd 254
388+procedures in accordance with s. 394.468, and approval pursuant 255
389+to paragraph (f), are not possible until the next working day. 256
390+ Section 7. Paragraph (c) of subsection (6) of section 257
391+394.467, Florida Statutes, is amended to read: 258
392+ 394.467 Involuntary inpatient placement. — 259
393+ (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT. — 260
394+ (c) If at any time before the conclusion of the hearing on 261
395+involuntary inpatient placement it appears to the court that the 262
396+person does not meet the criteria for involuntary inpati ent 263
397+placement under this section, but instead meets the criteria for 264
398+involuntary outpatient services, the court may order the person 265
399+evaluated for involuntary outpatient services pursuant to s. 266
400+394.4655. The petition and hearing procedures set forth in s. 267
401+394.4655 shall apply. If the person instead meets the criteria 268
402+for involuntary assessment, protective custody, or involuntary 269
403+admission pursuant to s. 397.675, then the court may order the 270
404+person to be admitted for involuntary assessment for a period of 271
405+5 days pursuant to s. 397.6811. Thereafter, all proceedings are 272
406+governed by chapter 397. 273
407+ Section 8. Paragraphs (a) and (c) of subsection (3) of 274
408+section 394.495, Florida Statutes, are amended to read: 275
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417417 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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421-The release may be approved through telehealth. 276
422- (g) The examination period must be for up to 72 hours and 277
423-begins when a patient arrives at the receiving facility . For a 278
424-minor, the examination shall be in itiated within 12 hours after 279
425-the patient's arrival at the facility. Within the examination 280
426-period, one of the following actions must be taken, based on the 281
427-individual needs of the patient: 282
428- 1. The patient shall be released, unless he or she is 283
429-charged with a crime, in which case the patient shall be 284
430-returned to the custody of a law enforcement officer; 285
431- 2. The patient shall be released, subject to subparagraph 286
432-1., for voluntary outpatient treatment; 287
433- 3. The patient, unless he or she is charged with a cr ime, 288
434-shall be asked to give express and informed consent to placement 289
435-as a voluntary patient and, if such consent is given, the 290
436-patient shall be admitted as a voluntary patient; or 291
437- 4. A petition for involuntary services shall be filed in 292
438-the circuit court if inpatient treatment is deemed necessary or 293
439-with the criminal county court, as defined in s. 394.4655(1), as 294
440-applicable. When inpatient treatment is deemed necessary, the 295
441-least restrictive treatment consistent with the optimum 296
442-improvement of the patien t's condition shall be made available. 297
443-The When a petition is to be filed for involuntary outpatient 298
444-placement, it shall be filed by one of the petitioners specified 299
445-in s. 394.467, and the court shall dismiss an untimely filed 300
421+ 394.495 Child and adolescent mental health system of care; 276
422+programs and services. — 277
423+ (3) Assessments must be performed by: 278
424+ (a) A professional as defined in s. 394.455(5), (7), (34) 279
425+(33), (37) (36), or (38) (37); 280
426+ (c) A person who is under the direct supervision of a 281
427+qualified professional as defined in s. 394.455(5), (7), (34) 282
428+(33), (37) (36), or (38) (37) or a professional licensed under 283
429+chapter 491. 284
430+ Section 9. Subsection (5) of section 394.496, Florida 285
431+Statutes, is amended to read: 286
432+ 394.496 Service planning. — 287
433+ (5) A professional as defined in s. 394.455(5), (7), (34) 288
434+(33), (37) (36), or (38) (37) or a professional licensed under 289
435+chapter 491 must be included among those persons developing the 290
436+services plan. 291
437+ Section 10. Subsection (6) of section 394.9085, Florida 292
438+Statutes, is amended to read: 293
439+ 394.9085 Behavioral provider liability. — 294
440+ (6) For purposes of this section, the terms 295
441+"detoxification services," "addictions receiving facility," and 296
442+"receiving facility" have the same meanings as those provided in 297
443+ss. 397.311(26)(a)3., 397.311(26)(a)1., and 394.455 394.455(40), 298
444+respectively. 299
445+ Section 11. Paragraph (b) of subsection (1) of section 300
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454454 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
455455
456456
457457
458-petition s. 394.4655(4)(a). A petition for involuntary inpatient 301
459-placement shall be filed by the facility administrator. If a 302
460-patient's 72-hour examination period ends on a weekend or 303
461-holiday, including the hours before the ordinary business hours 304
462-on the morning of the next working day, and the receiving 305
463-facility: 306
464- a. Intends to file a petition for involuntary services, 307
465-such patient may be held at the a receiving facility through the 308
466-next working day thereafter and the such petition for 309
467-involuntary services must be filed no later th an such date. If 310
468-the receiving facility fails to file the a petition by for 311
469-involuntary services at the ordinary close of business on the 312
470-next working day, the patient shall be released from the 313
471-receiving facility following approval pursuant to paragraph ( f). 314
472- b. Does not intend to file a petition for involuntary 315
473-services, the a receiving facility may postpone release of a 316
474-patient until the next working day thereafter only if a 317
475-qualified professional documents that adequate discharge 318
476-planning and procedure s in accordance with s. 394.468, and 319
477-approval pursuant to paragraph (f), are not possible until the 320
478-next working day. 321
479- (h) A person for whom an involuntary examination has been 322
480-initiated who is being evaluated or treated at a hospital for an 323
481-emergency medical condition specified in s. 395.002 must be 324
482-examined by a facility within the examination period specified 325
458+409.972, Florida Statutes, is amended to read: 301
459+ 409.972 Mandatory and voluntary enrollment. — 302
460+ (1) The following Medicaid -eligible persons are exempt 303
461+from mandatory managed care enrollment required by s. 409.965, 304
462+and may voluntarily choose to participate in the managed medical 305
463+assistance program: 306
464+ (b) Medicaid recipien ts residing in residential commitment 307
465+facilities operated through the Department of Juvenile Justice 308
466+or a treatment facility as defined in s. 394.455 s. 394.455(49). 309
467+ Section 12. Paragraph (e) of subsection (4) of section 310
468+464.012, Florida Statutes, is a mended to read: 311
469+ 464.012 Licensure of advanced practice registered nurses; 312
470+fees; controlled substance prescribing. — 313
471+ (4) In addition to the general functions specified in 314
472+subsection (3), an advanced practice registered nurse may 315
473+perform the following act s within his or her specialty: 316
474+ (e) A psychiatric nurse, who meets the requirements in s. 317
475+394.455 s. 394.455(36), within the framework of an established 318
476+protocol with a psychiatrist, may prescribe psychotropic 319
477+controlled substances for the treatment of me ntal disorders. 320
478+ Section 13. Subsection (7) of section 744.2007, Florida 321
479+Statutes, is amended to read: 322
480+ 744.2007 Powers and duties. — 323
481+ (7) A public guardian may not commit a ward to a treatment 324
482+facility, as defined in s. 394.455 s. 394.455(49), without an 325
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491491 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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495-in paragraph (g). The examination period begins when the patient 326
496-arrives at the hospital and ceases when the attending physician 327
497-documents that the patient has an emergency medical condition. 328
498-If the patient is examined at a hospital providing emergency 329
499-medical services by a professional qualified to perform an 330
500-involuntary examination and is found as a result of that 331
501-examination not to meet the criteria for involuntary outpatient 332
502-services pursuant to s. 394.467 s. 394.4655(2) or involuntary 333
503-inpatient placement pursua nt to s. 394.467(1), the patient may 334
504-be offered voluntary outpatient or inpatient services or 335
505-placement, if appropriate, or released directly from the 336
506-hospital providing emergency medical services. The finding by 337
507-the professional that the patient has been examined and does not 338
508-meet the criteria for involuntary inpatient services or 339
509-involuntary outpatient placement must be entered into the 340
510-patient's clinical record. This paragraph is not intended to 341
511-prevent a hospital providing emergency medical services fro m 342
512-appropriately transferring a patient to another hospital before 343
513-stabilization if the requirements of s. 395.1041(3)(c) have been 344
514-met. 345
515- Section 4. Section 394.4655, Florida Statutes, is amended 346
516-to read: 347
517- 394.4655 Involuntary outpatient services. — 348
518- (1) DEFINITIONS.—As used in this section, the term: 349
519- (a) "Court" means a circuit court or a criminal county 350
495+involuntary placement proceeding as provided by law. 326
496+ Section 14. Paragraph (a) of subsection (2) of section 327
497+790.065, Florida Statutes, is amended to read: 328
498+ 790.065 Sale and delivery of firearms. — 329
499+ (2) Upon receipt of a request for a criminal hist ory 330
500+record check, the Department of Law Enforcement shall, during 331
501+the licensee's call or by return call, forthwith: 332
502+ (a) Review any records available to determine if the 333
503+potential buyer or transferee: 334
504+ 1. Has been convicted of a felony and is prohibited from 335
505+receipt or possession of a firearm pursuant to s. 790.23; 336
506+ 2. Has been convicted of a misdemeanor crime of domestic 337
507+violence, and therefore is prohibited from purchasing a firearm; 338
508+ 3. Has had adjudication of guilt withheld or imposition of 339
509+sentence suspended on any felony or misdemeanor crime of 340
510+domestic violence unless 3 years have elapsed since probation or 341
511+any other conditions set by the court have been fulfilled or 342
512+expunction has occurred; or 343
513+ 4. Has been adjudicated mentally defective or has b een 344
514+committed to a mental institution by a court or as provided in 345
515+sub-sub-subparagraph b.(II), and as a result is prohibited by 346
516+state or federal law from purchasing a firearm. 347
517+ a. As used in this subparagraph, "adjudicated mentally 348
518+defective" means a det ermination by a court that a person, as a 349
519+result of marked subnormal intelligence, or mental illness, 350
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528528 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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532-court. 351
533- (b) "Criminal county court" means a county court 352
534-exercising its original jurisdiction in a misdemeanor case under 353
535-s. 34.01. 354
536- (c) "Involuntary outpatient placement" means involuntary 355
537-outpatient services as defined in s. 394.467. 356
538- (2) A criminal county court may order an individual to 357
539-involuntary outpatient placement under s. 394.467. CRITERIA FOR 358
540-INVOLUNTARY OUTPATIENT SERVICES. —A person may be ordered to 359
541-involuntary outpatient services upon a finding of the court, by 360
542-clear and convincing evidence, that the person meets all of the 361
543-following criteria: 362
544- (a) The person is 18 years of age or older. 363
545- (b) The person has a mental illness. 364
546- (c) The person is unlikely to survive safely in the 365
547-community without supervision, based on a clinical 366
548-determination. 367
549- (d) The person has a history of lack of compliance with 368
550-treatment for mental illness. 369
551- (e) The person has: 370
552- 1. At least twice within the imme diately preceding 36 371
553-months been involuntarily admitted to a receiving or treatment 372
554-facility as defined in s. 394.455, or has received mental health 373
555-services in a forensic or correctional facility. The 36 -month 374
556-period does not include any period during whi ch the person was 375
532+incompetency, condition, or disease, is a danger to himself or 351
533+herself or to others or lacks the mental capacity to contract or 352
534+manage his or her own affa irs. The phrase includes a judicial 353
535+finding of incapacity under s. 744.331(6)(a), an acquittal by 354
536+reason of insanity of a person charged with a criminal offense, 355
537+and a judicial finding that a criminal defendant is not 356
538+competent to stand trial. 357
539+ b. As used in this subparagraph, "committed to a mental 358
540+institution" means: 359
541+ (I) Involuntary commitment, commitment for mental 360
542+defectiveness or mental illness, and commitment for substance 361
543+abuse. The phrase includes involuntary inpatient placement as 362
544+defined in s. 394.467, involuntary outpatient placement as 363
545+described defined in s. 394.4655, involuntary assessment and 364
546+stabilization under s. 397.6818, and involuntary substance abuse 365
547+treatment under s. 397.6957, but does not include a person in a 366
548+mental institution fo r observation or discharged from a mental 367
549+institution based upon the initial review by the physician or a 368
550+voluntary admission to a mental institution; or 369
551+ (II) Notwithstanding sub -sub-subparagraph (I), voluntary 370
552+admission to a mental institution for outpatient or inpatient 371
553+treatment of a person who had an involuntary examination under 372
554+s. 394.463, where each of the following conditions have been 373
555+met: 374
556+ (A) An examining physician found that the person is an 375
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565565 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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569-admitted or incarcerated; or 376
570- 2. Engaged in one or more acts of serious violent behavior 377
571-toward self or others, or attempts at serious bodily harm to 378
572-himself or herself or others, within the preceding 36 months. 379
573- (f) The person is, as a result of his or her mental 380
574-illness, unlikely to voluntarily participate in the recommended 381
575-treatment plan and has refused voluntary services for treatment 382
576-after sufficient and conscientious explanation and disclosure of 383
577-why the services are necessary or is unable to determine for 384
578-himself or herself whether services are necessary. 385
579- (g) In view of the person's treatment history and current 386
580-behavior, the person is in need of involuntary outpatient 387
581-services in order to prevent a relapse or deterioration that 388
582-would be likely to result in serious bodily harm to himself or 389
583-herself or others, or a substantial harm to his or her well -390
584-being as set forth in s. 394.463(1). 391
585- (h) It is likely that the person will benefit from 392
586-involuntary outpatient services. 393
587- (i) All available, less restrictive alternatives that 394
588-would offer an opportunity for improvement of his or her 395
589-condition have been judged to be inappropriate or unavailable. 396
590- (3) INVOLUNTARY OUTPATIENT SERVICES. — 397
591- (a)1. A patient who is being recommended for in voluntary 398
592-outpatient services by the administrator of the facility where 399
593-the patient has been examined may be retained by the facility 400
569+imminent danger to himself or herself or other s. 376
570+ (B) The examining physician certified that if the person 377
571+did not agree to voluntary treatment, a petition for involuntary 378
572+outpatient or inpatient treatment would have been filed under s. 379
573+394.463(2)(g)4., or the examining physician certified that a 380
574+petition was filed and the person subsequently agreed to 381
575+voluntary treatment prior to a court hearing on the petition. 382
576+ (C) Before agreeing to voluntary treatment, the person 383
577+received written notice of that finding and certification, and 384
578+written notice that as a result of such finding, he or she may 385
579+be prohibited from purchasing a firearm, and may not be eligible 386
580+to apply for or retain a concealed weapon or firearms license 387
581+under s. 790.06 and the person acknowledged such notice in 388
582+writing, in substantially t he following form: 389
583+"I understand that the doctor who examined me believes I am a 390
584+danger to myself or to others. I understand that if I do not 391
585+agree to voluntary treatment, a petition will be filed in court 392
586+to require me to receive involuntary treatment. I understand 393
587+that if that petition is filed, I have the right to contest it. 394
588+In the event a petition has been filed, I understand that I can 395
589+subsequently agree to voluntary treatment prior to a court 396
590+hearing. I understand that by agreeing to voluntary treatm ent in 397
591+either of these situations, I may be prohibited from buying 398
592+firearms and from applying for or retaining a concealed weapons 399
593+or firearms license until I apply for and receive relief from 400
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605605
606-after adherence to the notice procedures provided in s. 401
607-394.4599. The recommendation must be supported by the opinion of 402
608-a psychiatrist and the second opinion of a clinical psychologist 403
609-or another psychiatrist, both of whom have personally examined 404
610-the patient within the preceding 72 hours, that the criteria for 405
611-involuntary outpatient services are met. However, if the 406
612-administrator certifies that a psychiatrist or clinical 407
613-psychologist is not available to provide the second opinion, the 408
614-second opinion may be provided by a licensed physician who has 409
615-postgraduate training and experience in diagnosis and treatment 410
616-of mental illness, a physician assistant who has at least 3 411
617-years' experience and is supervised by such licensed physician 412
618-or a psychiatrist, a clinical social worker, or by a psychiatric 413
619-nurse. Any second opinion authorized in this subparagraph may be 414
620-conducted through a face-to-face examination, in person or by 415
621-electronic means. Such recommendation must be entered on an 416
622-involuntary outpatient services certificate that authorizes the 417
623-facility to retain the patient pending completion of a hearing. 418
624-The certificate must be made a part of the patient's clinical 419
625-record. 420
626- 2. If the patient has been stabilized and no longer meets 421
627-the criteria for involuntary examination pursuant to s. 422
628-394.463(1), the patient must be released from the facility while 423
629-awaiting the hearing for inv oluntary outpatient services. Before 424
630-filing a petition for involuntary outpatient services, the 425
606+that restriction under Florida law." 401
607+ (D) A judge or a magistr ate has, pursuant to sub -sub-402
608+subparagraph c.(II), reviewed the record of the finding, 403
609+certification, notice, and written acknowledgment classifying 404
610+the person as an imminent danger to himself or herself or 405
611+others, and ordered that such record be submitted to the 406
612+department. 407
613+ c. In order to check for these conditions, the department 408
614+shall compile and maintain an automated database of persons who 409
615+are prohibited from purchasing a firearm based on court records 410
616+of adjudications of mental defectiveness or commi tments to 411
617+mental institutions. 412
618+ (I) Except as provided in sub -sub-subparagraph (II), 413
619+clerks of court shall submit these records to the department 414
620+within 1 month after the rendition of the adjudication or 415
621+commitment. Reports shall be submitted in an automa ted format. 416
622+The reports must, at a minimum, include the name, along with any 417
623+known alias or former name, the sex, and the date of birth of 418
624+the subject. 419
625+ (II) For persons committed to a mental institution 420
626+pursuant to sub-sub-subparagraph b.(II), within 24 hours after 421
627+the person's agreement to voluntary admission, a record of the 422
628+finding, certification, notice, and written acknowledgment must 423
629+be filed by the administrator of the receiving or treatment 424
630+facility, as defined in s. 394.455, with the clerk of the court 425
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643-administrator of the facility or a designated department 426
644-representative must identify the service provider that will have 427
645-primary responsibility for service pro vision under an order for 428
646-involuntary outpatient services, unless the person is otherwise 429
647-participating in outpatient psychiatric treatment and is not in 430
648-need of public financing for that treatment, in which case the 431
649-individual, if eligible, may be ordered to involuntary treatment 432
650-pursuant to the existing psychiatric treatment relationship. 433
651- 3. The service provider shall prepare a written proposed 434
652-treatment plan in consultation with the patient or the patient's 435
653-guardian advocate, if appointed, for the cour t's consideration 436
654-for inclusion in the involuntary outpatient services order that 437
655-addresses the nature and extent of the mental illness and any 438
656-co-occurring substance use disorder that necessitate involuntary 439
657-outpatient services. The treatment plan must sp ecify the likely 440
658-level of care, including the use of medication, and anticipated 441
659-discharge criteria for terminating involuntary outpatient 442
660-services. Service providers may select and supervise other 443
661-individuals to implement specific aspects of the treatment plan. 444
662-The services in the plan must be deemed clinically appropriate 445
663-by a physician, clinical psychologist, psychiatric nurse, mental 446
664-health counselor, marriage and family therapist, or clinical 447
665-social worker who consults with, or is employed or contracte d 448
666-by, the service provider. The service provider must certify to 449
667-the court in the proposed plan whether sufficient services for 450
643+for the county in which the involuntary examination under s. 426
644+394.463 occurred. No fee shall be charged for the filing under 427
645+this sub-sub-subparagraph. The clerk must present the records to 428
646+a judge or magistrate within 24 hours after receipt of the 429
647+records. A judge or magistrate is required and has the lawful 430
648+authority to review the records ex parte and, if the judge or 431
649+magistrate determines that the record supports the classifying 432
650+of the person as an imminent danger to himself or herself or 433
651+others, to order that the record be submitted to the department. 434
652+If a judge or magistrate orders the submittal of the record to 435
653+the department, the record must be submitted to the department 436
654+within 24 hours. 437
655+ d. A person who has been adjudicated mentally defective or 438
656+committed to a mental institution, as those terms are defined in 439
657+this paragraph, may petition the court that made the 440
658+adjudication or commitment, or the court that ordered that the 441
659+record be submitted to the department pursuant to sub -sub-442
660+subparagraph c.(II), for relief from the firearm disabilities 443
661+imposed by such adjudication or commitment. A copy of the 444
662+petition shall be served on the state attorney for the county in 445
663+which the person was adjudicated or committed. The state 446
664+attorney may object to and present evidence relevant to the 447
665+relief sought by the petition. The hearing on the petition may 448
666+be open or closed as the petitioner may choose. The petitioner 449
667+may present evidence and subpoena witnesses to appear at the 450
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676676 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
677677
678678
679679
680-improvement and stabilization are currently available and 451
681-whether the service provider agrees to provide those services. 452
682-If the service provider certifies that the services in the 453
683-proposed treatment plan are not available, the petitioner may 454
684-not file the petition. The service provider must notify the 455
685-managing entity if the requested services are not available. The 456
686-managing entity must document such efforts to obtain the 457
687-requested services. 458
688- (b) If a patient in involuntary inpatient placement meets 459
689-the criteria for involuntary outpatient services, the 460
690-administrator of the facility may, before the expiration of the 461
691-period during which the facility is authorized to retain the 462
692-patient, recommend involuntary outpatient services. The 463
693-recommendation must be supported by the opinion of a 464
694-psychiatrist and the second opinion of a clinical psychologist 465
695-or another psychiatrist, both of whom hav e personally examined 466
696-the patient within the preceding 72 hours, that the criteria for 467
697-involuntary outpatient services are met. However, if the 468
698-administrator certifies that a psychiatrist or clinical 469
699-psychologist is not available to provide the second opin ion, the 470
700-second opinion may be provided by a licensed physician who has 471
701-postgraduate training and experience in diagnosis and treatment 472
702-of mental illness, a physician assistant who has at least 3 473
703-years' experience and is supervised by such licensed physici an 474
704-or a psychiatrist, a clinical social worker, or by a psychiatric 475
680+hearing on the petition. The petitio ner may confront and cross -451
681+examine witnesses called by the state attorney. A record of the 452
682+hearing shall be made by a certified court reporter or by court -453
683+approved electronic means. The court shall make written findings 454
684+of fact and conclusions of law on th e issues before it and issue 455
685+a final order. The court shall grant the relief requested in the 456
686+petition if the court finds, based on the evidence presented 457
687+with respect to the petitioner's reputation, the petitioner's 458
688+mental health record and, if applicable , criminal history 459
689+record, the circumstances surrounding the firearm disability, 460
690+and any other evidence in the record, that the petitioner will 461
691+not be likely to act in a manner that is dangerous to public 462
692+safety and that granting the relief would not be co ntrary to the 463
693+public interest. If the final order denies relief, the 464
694+petitioner may not petition again for relief from firearm 465
695+disabilities until 1 year after the date of the final order. The 466
696+petitioner may seek judicial review of a final order denying 467
697+relief in the district court of appeal having jurisdiction over 468
698+the court that issued the order. The review shall be conducted 469
699+de novo. Relief from a firearm disability granted under this 470
700+sub-subparagraph has no effect on the loss of civil rights, 471
701+including firearm rights, for any reason other than the 472
702+particular adjudication of mental defectiveness or commitment to 473
703+a mental institution from which relief is granted. 474
704+ e. Upon receipt of proper notice of relief from firearm 475
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713713 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
714714
715715
716716
717-nurse. Any second opinion authorized in this subparagraph may be 476
718-conducted through a face -to-face examination, in person or by 477
719-electronic means. Such recommendation must be entered on an 478
720-involuntary outpatient services certificate, and the certificate 479
721-must be made a part of the patient's clinical record. 480
722- (c)1. The administrator of the treatment facility shall 481
723-provide a copy of the involuntary outpatient services 482
724-certificate and a copy of the state mental health discharge form 483
725-to the managing entity in the county where the patient will be 484
726-residing. For persons who are leaving a state mental health 485
727-treatment facility, the petition for involuntary outpatient 486
728-services must be filed in the coun ty where the patient will be 487
729-residing. 488
730- 2. The service provider that will have primary 489
731-responsibility for service provision shall be identified by the 490
732-designated department representative before the order for 491
733-involuntary outpatient services and must, befo re filing a 492
734-petition for involuntary outpatient services, certify to the 493
735-court whether the services recommended in the patient's 494
736-discharge plan are available and whether the service provider 495
737-agrees to provide those services. The service provider must 496
738-develop with the patient, or the patient's guardian advocate, if 497
739-appointed, a treatment or service plan that addresses the needs 498
740-identified in the discharge plan. The plan must be deemed to be 499
741-clinically appropriate by a physician, clinical psychologist, 500
717+disabilities granted under sub -subparagraph d., the department 476
718+shall delete any mental health record of the person granted 477
719+relief from the automated database of persons who are prohibited 478
720+from purchasing a firearm based on court records of 479
721+adjudications of mental defectiveness or commitments to mental 480
722+institutions. 481
723+ f. The department is authorized to disclose data collected 482
724+pursuant to this subparagraph to agencies of the Federal 483
725+Government and other states for use exclusively in determining 484
726+the lawfulness of a firearm sale or transfer. The d epartment is 485
727+also authorized to disclose this data to the Department of 486
728+Agriculture and Consumer Services for purposes of determining 487
729+eligibility for issuance of a concealed weapons or concealed 488
730+firearms license and for determining whether a basis exists f or 489
731+revoking or suspending a previously issued license pursuant to 490
732+s. 790.06(10). When a potential buyer or transferee appeals a 491
733+nonapproval based on these records, the clerks of court and 492
734+mental institutions shall, upon request by the department, 493
735+provide information to help determine whether the potential 494
736+buyer or transferee is the same person as the subject of the 495
737+record. Photographs and any other data that could confirm or 496
738+negate identity must be made available to the department for 497
739+such purposes, notwith standing any other provision of state law 498
740+to the contrary. Any such information that is made confidential 499
741+or exempt from disclosure by law shall retain such confidential 500
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750750 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
751751
752752
753753
754-psychiatric nurse, mental health counselor, marriage and family 501
755-therapist, or clinical social worker, as defined in this 502
756-chapter, who consults with, or is employed or contracted by, the 503
757-service provider. 504
758- 3. If the service provider certifies that the services in 505
759-the proposed treatment or service plan are not available, the 506
760-petitioner may not file the petition. The service provider must 507
761-notify the managing entity if the requested services are not 508
762-available. The managing entity must document such efforts to 509
763-obtain the requested services. 510
764- (4) PETITION FOR INVOLUNTARY OUTPATIENT SERVICES. — 511
765- (a) A petition for involuntary outpatient services may be 512
766-filed by: 513
767- 1. The administrator of a receiving facility; or 514
768- 2. The administrator of a treatment facility. 515
769- (b) Each required criterion for involuntary outpatient 516
770-services must be alleged and substantiated in the petition for 517
771-involuntary outpatient services. A copy of the certificate 518
772-recommending involuntary outpatient services completed by a 519
773-qualified professional specified in subsection (3) must be 520
774-attached to the petition. A copy of the proposed treatment plan 521
775-must be attached to the petition. Before the petition is filed, 522
776-the service provider shall certify that the services in the 523
777-proposed plan are available . If the necessary services are not 524
778-available, the petition may not be filed. The service provider 525
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787-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
788-
789-
790-
791-must notify the managing entity if the requested services are 526
792-not available. The managing entity must document such efforts to 527
793-obtain the requested services. 528
794- (c) The petition for involuntary outpatient services must 529
795-be filed in the county where the patient is located, unless the 530
796-patient is being placed from a state treatment facility, in 531
797-which case the petition must be filed in the county where the 532
798-patient will reside. When the petition has been filed, the clerk 533
799-of the court shall provide copies of the petition and the 534
800-proposed treatment plan to the department, the managing entity, 535
801-the patient, the patient's guardian or representative, the state 536
802-attorney, and the public defender or the patient's private 537
803-counsel. A fee may not be charged for filing a petition under 538
804-this subsection. 539
805- (5) APPOINTMENT OF COUNSEL. —Within 1 court working day 540
806-after the filing of a petition for involuntary outpatient 541
807-services, the court shall appoint the public defender to 542
808-represent the person who is the subject of the petition, unless 543
809-the person is otherwise represented by counsel. The clerk of the 544
810-court shall immediately notify the public defender of the 545
811-appointment. The public defe nder shall represent the person 546
812-until the petition is dismissed, the court order expires, or the 547
813-patient is discharged from involuntary outpatient services. An 548
814-attorney who represents the patient must be provided access to 549
815-the patient, witnesses, and recor ds relevant to the presentation 550
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824-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
825-
826-
827-
828-of the patient's case and shall represent the interests of the 551
829-patient, regardless of the source of payment to the attorney. 552
830- (6) CONTINUANCE OF HEARING. —The patient is entitled, with 553
831-the concurrence of the patient's counse l, to at least one 554
832-continuance of the hearing. The continuance shall be for a 555
833-period of up to 4 weeks. 556
834- (7) HEARING ON INVOLUNTARY OUTPATIENT SERVICES. — 557
835- (a)1. The court shall hold the hearing on involuntary 558
836-outpatient services within 5 working days afte r the filing of 559
837-the petition, unless a continuance is granted. The hearing must 560
838-be held in the county where the petition is filed, must be as 561
839-convenient to the patient as is consistent with orderly 562
840-procedure, and must be conducted in physical settings not likely 563
841-to be injurious to the patient's condition. If the court finds 564
842-that the patient's attendance at the hearing is not consistent 565
843-with the best interests of the patient and if the patient's 566
844-counsel does not object, the court may waive the presence of th e 567
845-patient from all or any portion of the hearing. The state 568
846-attorney for the circuit in which the patient is located shall 569
847-represent the state, rather than the petitioner, as the real 570
848-party in interest in the proceeding. 571
849- 2. The court may appoint a magist rate to preside at the 572
850-hearing. One of the professionals who executed the involuntary 573
851-outpatient services certificate shall be a witness. The patient 574
852-and the patient's guardian or representative shall be informed 575
853-
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861-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
862-
863-
864-
865-by the court of the right to an independent expert examination. 576
866-If the patient cannot afford such an examination, the court 577
867-shall ensure that one is provided, as otherwise provided by law. 578
868-The independent expert's report is confidential and not 579
869-discoverable, unless the expert is to be called as a w itness for 580
870-the patient at the hearing. The court shall allow testimony from 581
871-individuals, including family members, deemed by the court to be 582
872-relevant under state law, regarding the person's prior history 583
873-and how that prior history relates to the person's c urrent 584
874-condition. The testimony in the hearing must be given under 585
875-oath, and the proceedings must be recorded. The patient may 586
876-refuse to testify at the hearing. 587
877- (b)1. If the court concludes that the patient meets the 588
878-criteria for involuntary outpatient s ervices pursuant to 589
879-subsection (2), the court shall issue an order for involuntary 590
880-outpatient services. The court order shall be for a period of up 591
881-to 90 days. The order must specify the nature and extent of the 592
882-patient's mental illness. The order of the c ourt and the 593
883-treatment plan must be made part of the patient's clinical 594
884-record. The service provider shall discharge a patient from 595
885-involuntary outpatient services when the order expires or any 596
886-time the patient no longer meets the criteria for involuntary 597
887-placement. Upon discharge, the service provider shall send a 598
888-certificate of discharge to the court. 599
889- 2. The court may not order the department or the service 600
890-
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898-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
899-
900-
901-
902-provider to provide services if the program or service is not 601
903-available in the patient's local co mmunity, if there is no space 602
904-available in the program or service for the patient, or if 603
905-funding is not available for the program or service. The service 604
906-provider must notify the managing entity if the requested 605
907-services are not available. The managing ent ity must document 606
908-such efforts to obtain the requested services. A copy of the 607
909-order must be sent to the managing entity by the service 608
910-provider within 1 working day after it is received from the 609
911-court. The order may be submitted electronically through 610
912-existing data systems. After the order for involuntary services 611
913-is issued, the service provider and the patient may modify the 612
914-treatment plan. For any material modification of the treatment 613
915-plan to which the patient or, if one is appointed, the patient's 614
916-guardian advocate agrees, the service provider shall send notice 615
917-of the modification to the court. Any material modifications of 616
918-the treatment plan which are contested by the patient or the 617
919-patient's guardian advocate, if applicable, must be approved or 618
920-disapproved by the court consistent with subsection (3). 619
921- 3. If, in the clinical judgment of a physician, the 620
922-patient has failed or has refused to comply with the treatment 621
923-ordered by the court, and, in the clinical judgment of the 622
924-physician, efforts were made to solicit compliance and the 623
925-patient may meet the criteria for involuntary examination, a 624
926-person may be brought to a receiving facility pursuant to s. 625
927-
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935-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
936-
937-
938-
939-394.463. If, after examination, the patient does not meet the 626
940-criteria for involuntary inpatient placeme nt pursuant to s. 627
941-394.467, the patient must be discharged from the facility. The 628
942-involuntary outpatient services order shall remain in effect 629
943-unless the service provider determines that the patient no 630
944-longer meets the criteria for involuntary outpatient se rvices or 631
945-until the order expires. The service provider must determine 632
946-whether modifications should be made to the existing treatment 633
947-plan and must attempt to continue to engage the patient in 634
948-treatment. For any material modification of the treatment plan 635
949-to which the patient or the patient's guardian advocate, if 636
950-applicable, agrees, the service provider shall send notice of 637
951-the modification to the court. Any material modifications of the 638
952-treatment plan which are contested by the patient or the 639
953-patient's guardian advocate, if applicable, must be approved or 640
954-disapproved by the court consistent with subsection (3). 641
955- (c) If, at any time before the conclusion of the initial 642
956-hearing on involuntary outpatient services, it appears to the 643
957-court that the person does not meet the criteria for involuntary 644
958-outpatient services under this section but, instead, meets the 645
959-criteria for involuntary inpatient placement, the court may 646
960-order the person admitted for involuntary inpatient examination 647
961-under s. 394.463. If the perso n instead meets the criteria for 648
962-involuntary assessment, protective custody, or involuntary 649
963-admission pursuant to s. 397.675, the court may order the person 650
964-
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973-
974-
975-
976-to be admitted for involuntary assessment for a period of 5 days 651
977-pursuant to s. 397.6811. Thereafte r, all proceedings are 652
978-governed by chapter 397. 653
979- (d) At the hearing on involuntary outpatient services, the 654
980-court shall consider testimony and evidence regarding the 655
981-patient's competence to consent to services. If the court finds 656
982-that the patient is incom petent to consent to treatment, it 657
983-shall appoint a guardian advocate as provided in s. 394.4598. 658
984-The guardian advocate shall be appointed or discharged in 659
985-accordance with s. 394.4598. 660
986- (e) The administrator of the receiving facility or the 661
987-designated department representative shall provide a copy of the 662
988-court order and adequate documentation of a patient's mental 663
989-illness to the service provider for involuntary outpatient 664
990-services. Such documentation must include any advance directives 665
991-made by the patient, a psychiatric evaluation of the patient, 666
992-and any evaluations of the patient performed by a psychologist 667
993-or a clinical social worker. 668
994- (8) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT 669
995-SERVICES.— 670
996- (a)1. If the person continues to meet the criteria for 671
997-involuntary outpatient services, the service provider shall, at 672
998-least 10 days before the expiration of the period during which 673
999-the treatment is ordered for the person, file in the court that 674
1000-issued the order for involuntary outpatient services a petition 675
1001-
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1009-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
1010-
1011-
1012-
1013-for continued involuntary outpatient services. The court shall 676
1014-immediately schedule a hearing on the petition to be held within 677
1015-15 days after the petition is filed. 678
1016- 2. The existing involuntary outpatient services order 679
1017-remains in effect until disposition on the petition for 680
1018-continued involuntary outpatient services. 681
1019- 3. A certificate shall be attached to the petition which 682
1020-includes a statement from the person's physician or clinical 683
1021-psychologist justifying the request, a brief description of the 684
1022-patient's treatment during the time he or she was receiving 685
1023-involuntary services, and an individualized plan of continued 686
1024-treatment. 687
1025- 4. The service provider shall develop the individualized 688
1026-plan of continued treatment in consultation with the patient or 689
1027-the patient's guardian advocate, if applicable. When the 690
1028-petition has been filed, the clerk of the court shall provide 691
1029-copies of the certificate and the individualized plan of 692
1030-continued services to the department, the patient, the patient's 693
1031-guardian advocate, the sta te attorney, and the patient's private 694
1032-counsel or the public defender. 695
1033- (b) Within 1 court working day after the filing of a 696
1034-petition for continued involuntary outpatient services, the 697
1035-court shall appoint the public defender to represent the person 698
1036-who is the subject of the petition, unless the person is 699
1037-otherwise represented by counsel. The clerk of the court shall 700
1038-
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1047-
1048-
1049-
1050-immediately notify the public defender of such appointment. The 701
1051-public defender shall represent the person until the petition is 702
1052-dismissed or the court order expires or the patient is 703
1053-discharged from involuntary outpatient services. Any attorney 704
1054-representing the patient shall have access to the patient, 705
1055-witnesses, and records relevant to the presentation of the 706
1056-patient's case and shall represent the interests of the patient, 707
1057-regardless of the source of payment to the attorney. 708
1058- (c) Hearings on petitions for continued involuntary 709
1059-outpatient services must be before the court that issued the 710
1060-order for involuntary outpatient services. The court may appoint 711
1061-a magistrate to preside at the hearing. The procedures for 712
1062-obtaining an order pursuant to this paragraph must meet the 713
1063-requirements of subsection (7), except that the time period 714
1064-included in paragraph (2)(e) is not applicable in determining 715
1065-the appropriateness of additional periods of involuntary 716
1066-outpatient placement. 717
1067- (d) Notice of the hearing must be provided as set forth in 718
1068-s. 394.4599. The patient and the patient's attorney may agree to 719
1069-a period of continued outpatient services without a court 720
1070-hearing. 721
1071- (e) The same procedure must be repeated before the 722
1072-expiration of each additional period the patient is placed in 723
1073-treatment. 724
1074- (f) If the patient has previously been found incompetent 725
1075-
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1084-
1085-
1086-
1087-to consent to treatment, the court shall consider testimony an d 726
1088-evidence regarding the patient's competence. Section 394.4598 727
1089-governs the discharge of the guardian advocate if the patient's 728
1090-competency to consent to treatment has been restored. 729
1091- Section 5. Section 394.467, Florida Statutes, is amended 730
1092-to read: 731
1093- 394.467 Involuntary services inpatient placement.— 732
1094- (1) DEFINITIONS.—As used in this section, the term: 733
1095- (a) "Court" means a circuit court. 734
1096- (b) "Involuntary inpatient placement" means services 735
1097-provided on an inpatient basis to a person 18 years of age or 736
1098-older who does not voluntarily consent to services under this 737
1099-chapter or a minor who does not voluntarily assent to services 738
1100-under this chapter. 739
1101- (c) "Involuntary outpatient services" means services 740
1102-provided on an outpatient basis to a person who does no t 741
1103-voluntarily consent to services under this chapter. 742
1104- (2)(1) CRITERIA FOR INVOLUNTARY SERVICES .—A person may be 743
1105-ordered by a court to be provided for involuntary services 744
1106-inpatient placement for treatment upon a finding of the court , 745
1107-by clear and convinc ing evidence, that the person meets the 746
1108-following criteria: 747
1109- (a) The person He or she has a mental illness and because 748
1110-of his or her mental illness: 749
1111- 1.a. Is unlikely to voluntarily participate in the 750
1112-
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1120-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
1121-
1122-
1123-
1124-recommended treatment plan and has refused voluntary services or 751
1125-He or she has refused voluntary inpatient placement for 752
1126-treatment after sufficient and conscientious explanation and 753
1127-disclosure of the purpose of inpatient placement for treatment; 754
1128-or 755
1129- b. He or she Is unable to determine for himself or herself 756
1130-whether services or inpatient placement is necessary; and 757
1131- 2.a. Is unlikely to survive safely in the community 758
1132-without supervision, based on clinical determination; 759
1133- b.2.a. He or she Is incapable of surviving alone or with 760
1134-the help of willing, able, and responsible family or friends, 761
1135-including available alternative services, and, without 762
1136-treatment, is likely to suffer from neglect or refuse to care 763
1137-for himself or herself, and such neglect or refusal poses a real 764
1138-and present threat of substantial harm to his or her well-being; 765
1139-or 766
1140- c.b. Without treatment, there is a substantial likelihood 767
1141-that in the near future the person he or she will inflict 768
1142-serious bodily harm on self or others, as evidenced by recent 769
1143-behavior causing, attempting to cause, or threatening to cause 770
1144-such harm.; and 771
1145- (b) In view of the person's treatment history and current 772
1146-behavior, the person is in need of involuntary outpatient 773
1147-services to prevent a relapse or deterioration of his or her 774
1148-mental health that would be likely to result in serious bodily 775
1149-
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1157-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
1158-
1159-
1160-
1161-harm to self or others, or a substantial harm to his or her 776
1162-well-being as set forth in s. 394.463(1). 777
1163- (c) The person has a history of lack of compliance with 778
1164-treatment for mental illness. 779
1165- (d) It is likely that the person will benefit fro m 780
1166-involuntary services. 781
1167- (e)(b) All available less restrictive treatment 782
1168-alternatives that would offer an opportunity for improvement of 783
1169-the person's his or her condition have been deemed judged to be 784
1170-inappropriate or unavailable. 785
1171- (3)(2) RECOMMENDATION FOR INVOLUNTARY SERVICES AND 786
1172-ADMISSION TO A TREATMENT FACILITY.—A patient may be recommended 787
1173-for involuntary inpatient placement, involuntary outpatient 788
1174-services, or a combination of both. 789
1175- (a) A patient may be retained by a facility for 790
1176-involuntary services or involuntarily placed in a treatment 791
1177-facility upon the recommendation of the administrator of the 792
1178-facility where the patient has been examined and after adherence 793
1179-to the notice and hearing procedures provided in s. 394.4599. 794
1180-However, if a patient who is being recommended for only 795
1181-involuntary outpatient services has been stabilized and no 796
1182-longer meets the criteria for involuntary examination pursuant 797
1183-to s. 394.463(1), the patient must be released from the facility 798
1184-while awaiting the hearing for involun tary outpatient services. 799
1185- (b) The recommendation must be supported by the opinion of 800
1186-
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1194-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
1195-
1196-
1197-
1198-a psychiatrist and the second opinion of a clinical psychologist 801
1199-or another psychiatrist, both of whom have personally examined 802
1200-the patient within the preceding 72 hours , that the criteria for 803
1201-involuntary services inpatient placement are met. 804
1202- (c) If However, if the administrator certifies that a 805
1203-psychiatrist or clinical psychologist is not available to 806
1204-provide a the second opinion, the administrator must certify 807
1205-that a clinical psychologist is not available and the second 808
1206-opinion may be provided by a licensed physician who has 809
1207-postgraduate training and experience in diagnosis and treatment 810
1208-of mental illness or by a psychiatric nurse. If the patient is 811
1209-being recommended for involuntary outpatient services only, the 812
1210-second opinion may be provided by a physician assistant who has 813
1211-at least 3 years' experience and is supervised by a licensed 814
1212-physician or psychiatrist or a clinical social worker. 815
1213- (d) Any opinion authorized i n this subsection may be 816
1214-conducted through a face -to-face or in-person examination, in 817
1215-person, or by electronic means. Recommendations for involuntary 818
1216-services must Such recommendation shall be entered on an a 819
1217-petition for involuntary services inpatient placement 820
1218-certificate, which shall be made a part of the patient's 821
1219-clinical record. The certificate must either authorize the 822
1220-facility to retain the patient pending completion of a hearing 823
1221-or authorize that authorizes the facility to retain the patient 824
1222-pending transfer to a treatment facility or completion of a 825
1223-
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1231-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
1232-
1233-
1234-
1235-hearing. 826
1236- (4)(3) PETITION FOR INVOLUNTARY SERVICES INPATIENT 827
1237-PLACEMENT.— 828
1238- (a) A petition for involuntary services may be filed by: 829
1239- 1. The administrator of a receiving the facility; or 830
1240- 2. The administrator of a treatment facility. 831
1241- (b) shall file A petition for involuntary inpatient 832
1242-placement, or inpatient placement followed by outpatient 833
1243-services, must be filed in the court in the county where the 834
1244-patient is located. 835
1245- (c) A petition for involunt ary outpatient services must be 836
1246-filed in the county where the patient is located, unless the 837
1247-patient is being placed from a state treatment facility, in 838
1248-which case the petition must be filed in the county where the 839
1249-patient will reside. 840
1250- (d)1. The petitioner must state in the petition: 841
1251- a. Whether the petitioner is recommending inpatient 842
1252-placement, outpatient services, or both. 843
1253- b. The length of time recommended for each type of 844
1254-involuntary services. 845
1255- c. The reasons for the recommendation. 846
1256- 2. If recommending involuntary outpatient services, or a 847
1257-combination of involuntary inpatient placement and involuntary 848
1258-outpatient services, the petitioner must identify the service 849
1259-provider that will have primary responsibility for providing 850
1260-
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1268-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
1269-
1270-
1271-
1272-such services under an or der for involuntary outpatient 851
1273-services, unless the person is otherwise participating in 852
1274-outpatient psychiatric treatment and is not in need of public 853
1275-financing for that treatment, in which case the individual, if 854
1276-eligible, may be ordered to involuntary tr eatment pursuant to 855
1277-the existing psychiatric treatment relationship. 856
1278- 3. If recommending an immediate order to involuntary 857
1279-outpatient placement, the service provider shall prepare a 858
1280-written proposed treatment plan in consultation with the patient 859
1281-or the patient's guardian advocate, if appointed, for the 860
1282-court's consideratio n for inclusion in the involuntary 861
1283-outpatient services order that addresses the nature and extent 862
1284-of the mental illness and any co -occurring substance use 863
1285-disorder that necessitate involuntary outpatient services. The 864
1286-treatment plan must specify the likely level of care, including 865
1287-the use of medication, and anticipated discharge criteria for 866
1288-terminating involuntary outpatient services. Service providers 867
1289-may select and supervise other individuals to implement specific 868
1290-aspects of the treatment plan. The servi ces in the plan must be 869
1291-deemed clinically appropriate by a physician, clinical 870
1292-psychologist, psychiatric nurse, mental health counselor, 871
1293-marriage and family therapist, or clinical social worker who 872
1294-consults with, or is employed or contracted by, the servic e 873
1295-provider. The service provider must certify to the court in the 874
1296-proposed plan whether sufficient services for improvement and 875
1297-
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1305-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
1306-
1307-
1308-
1309-stabilization are currently available and whether the service 876
1310-provider agrees to provide those services. If the service 877
1311-provider certifies that the services in the proposed treatment 878
1312-plan are not available, the petitioner may not file the 879
1313-petition. The service provider must notify the managing entity 880
1314-if the requested services are not available. The managing entity 881
1315-must document such efforts to obtain the requested services. 882
1316- (e) Each required criterion for the recommended 883
1317-involuntary services must be alleged and substantiated in the 884
1318-petition. A copy of the certificate recommending involuntary 885
1319-services completed by a qualified profe ssional specified in 886
1320-subsection (3) and, if applicable, a copy of the proposed 887
1321-treatment plan must be attached to the petition. 888
1322- (f) When the petition has been filed Upon filing, the 889
1323-clerk of the court shall provide copies of the petition and, if 890
1324-applicable, the proposed treatment plan to the department, the 891
1325-managing entity, the patient, the patient's guardian or 892
1326-representative, and the state attorney, and the public defender 893
1327-or the patient's private counsel of the judicial circuit in 894
1328-which the patient is located. A fee may not be charged for the 895
1329-filing of a petition under this subsection. 896
1330- (5)(4) APPOINTMENT OF COUNSEL. —Within 1 court working day 897
1331-after the filing of a petition for involuntary services 898
1332-inpatient placement, the court shall appoint the publi c defender 899
1333-to represent the person who is the subject of the petition, 900
1334-
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1342-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
1343-
1344-
1345-
1346-unless the person is otherwise represented by counsel or 901
1347-ineligible. The clerk of the court shall immediately notify the 902
1348-public defender of such appointment. The public defender shall 903
1349-represent the person until the petition is dismissed, the court 904
1350-order expires, or the patient is discharged from involuntary 905
1351-services. Any attorney who represents representing the patient 906
1352-shall be provided have access to the patient, witnesses, and 907
1353-records relevant to the presentation of the patient's case and 908
1354-shall represent the interests of the patient, regardless of the 909
1355-source of payment to the attorney. 910
1356- (6)(5) CONTINUANCE OF HEARING. —The patient and the state 911
1357-are independently is entitled, with the concurrence of the 912
1358-patient's counsel, to at least one continuance of the hearing . 913
1359-The patient's continuance may be for a period of up to 4 weeks 914
1360-and requires the concurrence of the patient's counsel. The 915
1361-state's continuance may be for a period of up to 5 cou rt working 916
1362-days and requires a showing of good cause and due diligence by 917
1363-the state before requesting the continuance. The state's failure 918
1364-to timely review any readily available document or failure to 919
1365-attempt to contact a known witness does not warrant a 920
1366-continuance. 921
1367- (7)(6) HEARING ON INVOLUNTARY SERVICES INPATIENT 922
1368-PLACEMENT.— 923
1369- (a)1. The court shall hold a the hearing on the 924
1370-involuntary services petition inpatient placement within 5 court 925
1371-
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1379-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
1380-
1381-
1382-
1383-working days after the filing of the petition , unless a 926
1384-continuance is granted. 927
1385- 2. The court must hold any hearing on involuntary 928
1386-outpatient services in the county where the petition is filed. A 929
1387-hearing on involuntary inpatient placement, or a combination of 930
1388-involuntary inpatient placement and involuntary outpatient 931
1389-services Except for good cause documented in the court file , the 932
1390-hearing must be held in the county or the facility, as 933
1391-appropriate, where the patient is located, except for good cause 934
1392-documented in the court file. 935
1393- 3. A hearing on involuntary services must be as convenient 936
1394-to the patient as is consistent with orderly procedure, and 937
1395-shall be conducted in physical settings not likely to be 938
1396-injurious to the patient's condition. If the court finds that 939
1397-the patient's attendance at the hearing is not consistent w ith 940
1398-the best interests of the patient, or the patient knowingly, 941
1399-intelligently, and voluntarily waives his or her right to be 942
1400-present, and if the patient's counsel does not object, the court 943
1401-may waive the attendance presence of the patient from all or any 944
1402-portion of the hearing. The state attorney for the circuit in 945
1403-which the patient is located shall represent the state, rather 946
1404-than the petitioner, as the real party in interest in the 947
1405-proceeding. The facility shall make the respondent's clinical 948
1406-records available to the state attorney and the respondent's 949
1407-attorney so that the state can evaluate and prepare its case. 950
1408-
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1416-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
1417-
1418-
1419-
1420-However, these records shall remain confidential, and the state 951
1421-attorney may not use any record obtained under this part for 952
1422-criminal investigation or prosecution purposes, or for any 953
1423-purpose other than the patient's civil commitment under this 954
1424-chapter petitioning facility administrator, as the real party in 955
1425-interest in the proceeding . 956
1426- (b)3. The court may appoint a magistrate to preside at the 957
1427-hearing on the petition and any ancillary proceedings, 958
1428-including, but not limited to, writs of habeas corpus issued 959
1429-pursuant to s. 394.459. Upon a finding of good cause, the court 960
1430-may permit all witnesses, including, but not limited to, medical 961
1431-professionals who are or have been involved with the patient's 962
1432-treatment, to remotely attend and testify at the hearing under 963
1433-oath via audio-video teleconference. A witness intending to 964
1434-remotely attend and testify must provide the parties with all 965
1435-relevant documents b y the close of business on the day before 966
1436-the hearing. One of the professionals who executed the petition 967
1437-for involuntary services inpatient placement certificate shall 968
1438-be a witness. The patient and the patient's guardian or 969
1439-representative shall be informe d by the court of the right to an 970
1440-independent expert examination. If the patient cannot afford 971
1441-such an examination, the court shall ensure that one is 972
1442-provided, as otherwise provided for by law. The independent 973
1443-expert's report is confidential and not disco verable, unless the 974
1444-expert is to be called as a witness for the patient at the 975
1445-
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1453-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
1454-
1455-
1456-
1457-hearing. The court shall allow testimony from persons, including 976
1458-family members, deemed by the court to be relevant under state 977
1459-law, regarding the person's prior history and how that prior 978
1460-history relates to the person's current condition. The testimony 979
1461-in the hearing must be given under oath, and the proceedings 980
1462-must be recorded. The patient may refuse to testify at the 981
1463-hearing. 982
1464- (c)(b) At the hearing, the court shall consider testimony 983
1465-and evidence regarding the patient's competence to consent to 984
1466-services and treatment. If the court finds that the patient is 985
1467-incompetent to consent to treatment, it shall appoint a guardian 986
1468-advocate as provided in s. 394.4598. 987
1469- (8) ORDERS OF THE COURT.— 988
1470- (a)1. If the court concludes that the patient meets the 989
1471-criteria for involuntary services, the court may order a patient 990
1472-to involuntary inpatient placement, involuntary outpatient 991
1473-services, or a combination of involuntary services depending on 992
1474-the criteria met and which type of involuntary services best 993
1475-meet the needs of the patient. However, if the court orders the 994
1476-patient to involuntary outpatient services, the court may not 995
1477-order the department or the service provider to provide services 996
1478-if the program or service is not available in the patient's 997
1479-local community, if there is no space available in the program 998
1480-or service for the patient, or if funding is not available for 999
1481-the program or service. The service provider must notify the 1000
1482-
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1490-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
1491-
1492-
1493-
1494-managing entity if the requested services are not available. The 1001
1495-managing entity must document such efforts to obtain the 1002
1496-requested services. A copy of the order must be sent to the 1003
1497-managing entity by the service provider within 1 working day 1004
1498-after it is received from t he court. 1005
1499- 2. The order must specify the nature and extent of the 1006
1500-patient's mental illness. 1007
1501- 3.a. An order for only involuntary outpatient services 1008
1502-shall be for a period of up to 90 days. 1009
1503- b. An order for involuntary inpatient placement, 1010
1504-involuntary outpatient services, or a combination of involuntary 1011
1505-services may be for up to 6 months. 1012
1506- 4. An order for a combination of involuntary services 1013
1507-shall specify the length of time the patient shall be ordered 1014
1508-for involuntary inpatient placement and involunta ry outpatient 1015
1509-services. 1016
1510- 5. The order of the court and the patient's treatment 1017
1511-plan, if applicable, must be made part of the patient's clinical 1018
1512-record. 1019
1513- (b) If the court orders a patient into involuntary 1020
1514-inpatient placement, the court it may order that the patient be 1021
1515-transferred to a treatment facility , or, if the patient is at a 1022
1516-treatment facility, that the patient be retained there or be 1023
1517-treated at any other appropriate facility, or that the patient 1024
1518-receive services, on an involuntary basis , for up to 90 days. 1025
1519-
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1527-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
1528-
1529-
1530-
1531-However, any order for involuntary mental health services in a 1026
1532-treatment facility may be for up to 6 months. The order shall 1027
1533-specify the nature and extent of the patient's mental illness. 1028
1534-The court may not order an individual with a developmental 1029
1535-disability as defined in s. 393.063 or a traumatic brain injury 1030
1536-or dementia who lacks a co -occurring mental illness to be 1031
1537-involuntarily placed in a state treatment facility. The facility 1032
1538-shall discharge a patient any time the patient no longer meets 1033
1539-the criteria for involuntary inpatient placement, unless the 1034
1540-patient has transferred to voluntary status. 1035
1541- (c) If at any time before the conclusion of a the hearing 1036
1542-on involuntary services inpatient placement it appears to the 1037
1543-court that the patient person does not meet the criteria for 1038
1544-involuntary inpatient placement under this section, but instead 1039
1545-meets the criteria for involuntary outpatient services, the 1040
1546-court may order the person evaluated for involuntary outpatient 1041
1547-services pursuant to s. 394.4655. The peti tion and hearing 1042
1548-procedures set forth in s. 394.4655 shall apply. If the person 1043
1549-instead meets the criteria for involuntary assessment, 1044
1550-protective custody, or involuntary admission or treatment 1045
1551-pursuant to s. 397.675, then the court may order the person to 1046
1552-be admitted for involuntary assessment for a period of 5 days 1047
1553-pursuant to s. 397.677 s. 397.6811. Thereafter, all proceedings 1048
1554-are governed by chapter 397. 1049
1555- (d) At the hearing on involuntary inpatient placement, the 1050
1556-
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1564-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
1565-
1566-
1567-
1568-court shall consider testimony and evide nce regarding the 1051
1569-patient's competence to consent to treatment. If the court finds 1052
1570-that the patient is incompetent to consent to treatment, it 1053
1571-shall appoint a guardian advocate as provided in s. 394.4598. 1054
1572- (d)(e) The administrator of the petitioning facil ity or 1055
1573-the designated department representative shall provide a copy of 1056
1574-the court order and adequate documentation of a patient's mental 1057
1575-illness to the service provider for involuntary outpatient 1058
1576-services or the administrator of a treatment facility if the 1059
1577-patient is ordered for involuntary inpatient placement , whether 1060
1578-by civil or criminal court . The documentation must include any 1061
1579-advance directives made by the patient, a psychiatric evaluation 1062
1580-of the patient, and any evaluations of the patient performed by 1063
1581-a psychiatric nurse, a clinical psychologist, a marriage and 1064
1582-family therapist, a mental health counselor, or a clinical 1065
1583-social worker. The administrator of a treatment facility may 1066
1584-refuse admission to any patient directed to its facilities on an 1067
1585-involuntary basis, whether by civil or criminal court order, who 1068
1586-is not accompanied by adequate orders and documentation. 1069
1587- (9) TREATMENT PLAN MODIFICATION. —After the order for 1070
1588-involuntary outpatient services is issued, the service provider 1071
1589-and the patient may modi fy the treatment plan. For any material 1072
1590-modification of the treatment plan to which the patient or, if 1073
1591-one is appointed, the patient's guardian advocate agrees, the 1074
1592-service provider shall send notice of the modification to the 1075
1593-
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1601-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
1602-
1603-
1604-
1605-court. Any material modificat ions of the treatment plan which 1076
1606-are contested by the patient or the patient's guardian advocate, 1077
1607-if applicable, must be approved or disapproved by the court 1078
1608-consistent with subsection (4). 1079
1609- (10) NONCOMPLIANCE WITH INVOLUNTARY OUTPATIENT SERVICES. —1080
1610-If, in the clinical judgment of a physician, a patient receiving 1081
1611-involuntary outpatient services has failed or has refused to 1082
1612-comply with the treatment plan ordered by the court, and, in the 1083
1613-clinical judgment of the physician, efforts were made to solicit 1084
1614-compliance, and the patient may meet the criteria for 1085
1615-involuntary examination, the patient may be brought to a 1086
1616-receiving facility pursuant to s. 394.463. If, after 1087
1617-examination, the patient does not meet the criteria for 1088
1618-involuntary inpatient placement under this section, the patient 1089
1619-must be discharged from the facility. The involuntary outpatient 1090
1620-services order shall remain in effect unless the service 1091
1621-provider determines that the patient no longer meets the 1092
1622-criteria for involuntary outpatient services or until th e order 1093
1623-expires. The service provider must determine whether 1094
1624-modifications should be made to the existing treatment plan and 1095
1625-must attempt to continue to engage the patient in treatment. For 1096
1626-any material modification of the treatment plan to which the 1097
1627-patient or the patient's guardian advocate, if applicable, 1098
1628-agrees, the service provider shall send notice of the 1099
1629-modification to the court. Any material modifications of the 1100
1630-
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1639-
1640-
1641-
1642-treatment plan which are contested by the patient or the 1101
1643-patient's guardian advocate, i f applicable, must be approved or 1102
1644-disapproved by the court consistent with subsection (4). 1103
1645- (11)(7) PROCEDURE FOR CONTINUED INVOLUNTARY SERVICES 1104
1646-INPATIENT PLACEMENT.— 1105
1647- (a) A petition for continued involuntary services shall be 1106
1648-filed if the patient contin ues to meets the criteria for 1107
1649-involuntary services. 1108
1650- (b)1. If a patient receiving involuntary outpatient 1109
1651-services continues to meet the criteria for involuntary 1110
1652-outpatient services, the service provider shall file in the 1111
1653-court that issued the order for in voluntary outpatient services 1112
1654-a petition for continued involuntary outpatient services. 1113
1655- 2. If the patient in involuntary inpatient placement 1114
1656- (a) Hearings on petitions for continued involuntary 1115
1657-inpatient placement of an individual placed at any treatmen t 1116
1658-facility are administrative hearings and must be conducted in 1117
1659-accordance with s. 120.57(1), except that any order entered by 1118
1660-the administrative law judge is final and subject to judicial 1119
1661-review in accordance with s. 120.68. Orders concerning patients 1120
1662-committed after successfully pleading not guilty by reason of 1121
1663-insanity are governed by s. 916.15. 1122
1664- (b) If the patient continues to meet the criteria for 1123
1665-involuntary inpatient placement and is being treated at a 1124
1666-treatment facility, the administrator shall, before the 1125
1667-
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1675-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
1676-
1677-
1678-
1679-expiration of the period the treatment facility is authorized to 1126
1680-retain the patient, file a petition reque sting authorization for 1127
1681-continued involuntary inpatient placement. 1128
1682- 3. The court shall immediately schedule a hearing on the 1129
1683-petition to be held within 15 days after the petition is filed. 1130
1684- 4. The existing involuntary services order shall remain in 1131
1685-effect until disposition on the petition for continued 1132
1686-involuntary services. 1133
1687- (c) A certificate for continued involuntary services must 1134
1688-be attached to the petition and shall include The request must 1135
1689-be accompanied by a statement from the patient's physician, 1136
1690-psychiatrist, psychiatric nurse, or clinical psychologist 1137
1691-justifying the request, a brief description of the patient's 1138
1692-treatment during the time he or she was receiving involuntary 1139
1693-services involuntarily placed , and, if requesting involuntary 1140
1694-outpatient services, an individualized plan of continued 1141
1695-treatment. The individualized plan of continued treatment shall 1142
1696-be developed in consultation with the patient or the patient's 1143
1697-guardian advocate, if applicable. When the petition has been 1144
1698-filed, the clerk of th e court shall provide copies of the 1145
1699-certificate and the individualized plan of continued services to 1146
1700-the department, the patient, the patient's guardian advocate, 1147
1701-the state attorney, and the patient's private counsel or the 1148
1702-public defender. 1149
1703- (d) The court shall appoint counsel to represent the 1150
1704-
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1712-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
1713-
1714-
1715-
1716-person who is the subject of the petition for continued 1151
1717-involuntary services in accordance with subsection (5), unless 1152
1718-the person is otherwise represented by counsel or ineligible. 1153
1719- (e) Hearings on petitions for con tinued involuntary 1154
1720-outpatient services must be before the court that issued the 1155
1721-order for involuntary outpatient services. However, the patient 1156
1722-and the patient's attorney may agree to a period of continued 1157
1723-outpatient services without a court hearing. 1158
1724- (f) Hearings on petitions for continued involuntary 1159
1725-inpatient placement must be held in the county or the facility, 1160
1726-as appropriate, where the patient is located. 1161
1727- (g) The court may appoint a magistrate to preside at the 1162
1728-hearing. The procedures for obtaining an order pursuant to this 1163
1729-paragraph must meet the requirements of subsection (7). 1164
1730- (h) Notice of the hearing must be provided as set forth 1165
1731-provided in s. 394.4599. 1166
1732- (i) If a patient's attendance at the hearing is 1167
1733-voluntarily waived, the administrative law judge must determine 1168
1734-that the patient knowingly, intelligently, and voluntarily 1169
1735-waived his or her right to be present waiver is knowing and 1170
1736-voluntary before waiving the presence of the patient from all or 1171
1737-a portion of the hearing. Alternatively, if at th e hearing the 1172
1738-administrative law judge finds that attendance at the hearing is 1173
1739-not consistent with the best interests of the patient, the 1174
1740-administrative law judge may waive the presence of the patient 1175
1741-
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1749-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
1750-
1751-
1752-
1753-from all or any portion of the hearing, unless the pati ent, 1176
1754-through counsel, objects to the waiver of presence. The 1177
1755-testimony in the hearing must be under oath, and the proceedings 1178
1756-must be recorded. 1179
1757- (j) Hearings on petitions for continued involuntary 1180
1758-inpatient placement of an individual placed at any treatme nt 1181
1759-facility are administrative hearings and must be conducted in 1182
1760-accordance with s. 120.57(1), except that any order entered by 1183
1761-the judge is final and subject to judicial review in accordance 1184
1762-with s. 120.68. Orders concerning patients committed after 1185
1763-successfully pleading not guilty by reason of insanity are 1186
1764-governed by s. 916.15. 1187
1765- (c) Unless the patient is otherwise represented or is 1188
1766-ineligible, he or she shall be represented at the hearing on the 1189
1767-petition for continued involuntary inpatient placement by the 1190
1768-public defender of the circuit in which the facility is located. 1191
1769- (k)(d) If at a hearing it is shown that the patient 1192
1770-continues to meet the criteria for involuntary services 1193
1771-inpatient placement, the court administrative law judge shall 1194
1772-issue an sign the order for continued involuntary services 1195
1773-inpatient placement for up to 90 days. However, any order for 1196
1774-involuntary inpatient placement or mental health services in a 1197
1775-combination of involuntary services treatment facility may be 1198
1776-for up to 6 months. The s ame procedure shall be repeated before 1199
1777-the expiration of each additional period the patient is 1200
1778-
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1786-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
1787-
1788-
1789-
1790-retained. 1201
1791- (l) If the patient has been ordered to undergo involuntary 1202
1792-services and has previously been found incompetent to consent to 1203
1793-treatment, the court shal l consider testimony and evidence 1204
1794-regarding the patient's competence. If the patient's competency 1205
1795-to consent to treatment is restored, the discharge of the 1206
1796-guardian advocate shall be governed by s. 394.4598. If the 1207
1797-patient has been ordered to undergo invol untary inpatient 1208
1798-placement only and the patient's competency to consent to 1209
1799-treatment is restored, the administrative law judge may issue a 1210
1800-recommended order, to the court that found the patient 1211
1801-incompetent to consent to treatment, that the patient's 1212
1802-competence be restored and that any guardian advocate previously 1213
1803-appointed be discharged. 1214
1804- (m)(e) If continued involuntary inpatient placement is 1215
1805-necessary for a patient in involuntary inpatient placement who 1216
1806-was admitted while serving a criminal sentence, but his or her 1217
1807-sentence is about to expire, or for a minor involuntarily 1218
1808-placed, but who is about to reach the age of 18, the 1219
1809-administrator shall petition the administrative law judge for an 1220
1810-order authorizing continued involuntary inpatient placement. 1221
1811- (n)(f) If the patient has been previously found 1222
1812-incompetent to consent to treatment, the administrative law 1223
1813-judge shall consider testimony and evidence regarding the 1224
1814-patient's competence. If the administrative law judge finds 1225
1815-
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1823-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
1824-
1825-
1826-
1827-evidence that the patient is now com petent to consent to 1226
1828-treatment, the administrative law judge may issue a recommended 1227
1829-order to the court that found the patient incompetent to consent 1228
1830-to treatment that the patient's competence be restored and that 1229
1831-any guardian advocate previously appointed be discharged. 1230
1832- (o)(g) If the patient has been ordered to undergo 1231
1833-involuntary inpatient placement and has previously been found 1232
1834-incompetent to consent to treatment, the court shall consider 1233
1835-testimony and evidence regarding the patient's incompetence. If 1234
1836-the patient's competency to consent to treatment is restored, 1235
1837-the discharge of the guardian advocate shall be governed by s. 1236
1838-394.4598. 1237
1839- 1238
1840-The procedure required in this section subsection must be 1239
1841-followed before the expiration of each additional period the 1240
1842-patient is involuntarily receiving services. 1241
1843- (12)(8) RETURN TO FACILITY.—If a patient has been ordered 1242
1844-to undergo involuntary inpatient placement involuntarily held at 1243
1845-a treatment facility under this part leaves the facility without 1244
1846-the administrator's au thorization, the administrator may 1245
1847-authorize a search for the patient and his or her return to the 1246
1848-facility. The administrator may request the assistance of a law 1247
1849-enforcement agency in this regard. 1248
1850- (13) DISCHARGE.—The patient shall be discharged upon 1249
1851-expiration of the court order or at any time that the patient no 1250
1852-
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1860-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
1861-
1862-
1863-
1864-longer meets the criteria for involuntary services, unless the 1251
1865-patient has transferred to voluntary status. Upon discharge, the 1252
1866-service provider or facility shall send a certificate of 1253
1867-discharge to the court. 1254
1868- Section 6. Subsections (5) and (6) of section 394.492, 1255
1869-Florida Statutes, are amended to read: 1256
1870- 394.492 Definitions. —As used in ss. 394.490 -394.497, the 1257
1871-term: 1258
1872- (5) "Child or adolescent who has an emotional disturbance" 1259
1873-means a person under 18 years of age who is diagnosed with a 1260
1874-mental, emotional, or behavioral disorder of sufficient duration 1261
1875-to meet one of the diagnostic categories specified in the most 1262
1876-recent edition of the Diagnostic and Statistical Manual of the 1263
1877-American Psychiatric Association, but who does not exhibit 1264
1878-behaviors that substantially interfere with or limit his or her 1265
1879-role or ability to function in the family, school, or community. 1266
1880-The emotional disturbance must not be considered to be a 1267
1881-temporary response to a stressfu l situation. The term does not 1268
1882-include a child or adolescent who meets the criteria for 1269
1883-involuntary placement under s. 394.467 s. 394.467(1). 1270
1884- (6) "Child or adolescent who has a serious emotional 1271
1885-disturbance or mental illness" means a person under 18 years of 1272
1886-age who: 1273
1887- (a) Is diagnosed as having a mental, emotional, or 1274
1888-behavioral disorder that meets one of the diagnostic categories 1275
1889-
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1897-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
1898-
1899-
1900-
1901-specified in the most recent edition of the Diagnostic and 1276
1902-Statistical Manual of Mental Disorders of the American 1277
1903-Psychiatric Association; and 1278
1904- (b) Exhibits behaviors that substantially interfere with 1279
1905-or limit his or her role or ability to function in the family, 1280
1906-school, or community, which behaviors are not considered to be a 1281
1907-temporary response to a stressful situation. 1282
1908- 1283
1909-The term includes a child or adolescent who meets the criteria 1284
1910-for involuntary placement under s. 394.467 s. 394.467(1). 1285
1911- Section 7. Paragraphs (a) and (c) of subsection (3) of 1286
1912-section 394.495, Florida Statutes, are amended to read: 1287
1913- 394.495 Child and adolescent mental health system of care; 1288
1914-programs and services. — 1289
1915- (3) Assessments must be performed by: 1290
1916- (a) A clinical psychologist, clinical social worker, 1291
1917-physician, psychiatric nurse, or psychiatrist, as those terms 1292
1918-are defined in s. 394.455 professional as defined in s. 1293
1919-394.455(5), (7), (33), (36), or (37) ; 1294
1920- (c) A person who is under the direct supervision of a 1295
1921-clinical psychologist, clinical social worker, physician, 1296
1922-psychiatric nurse, or psychiatrist, as those terms are defined 1297
1923-in s. 394.455, qualified professional as defined in s. 1298
1924-394.455(5), (7), (33), (36), or (37) or a professional licensed 1299
1925-under chapter 491. 1300
1926-
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1934-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
1935-
1936-
1937-
1938- Section 8. Subsection (5) of section 394.496, Florida 1301
1939-Statutes, is amended to read: 1302
1940- 394.496 Service planning. — 1303
1941- (5) A clinical psychologist, clinical social worker, 1304
1942-physician, psychiatric nurse, or psychiatrist, as those terms 1305
1943-are defined in s. 394.455, professional as defined in s. 1306
1944-394.455(5), (7), (33), (36), or (37) or a professional licensed 1307
1945-under chapter 491 must be included amo ng those persons 1308
1946-developing the services plan. 1309
1947- Section 9. Subsection (6) of section 394.9085, Florida 1310
1948-Statutes, is amended to read: 1311
1949- 394.9085 Behavioral provider liability. — 1312
1950- (6) For purposes of this section, the terms 1313
1951-"detoxification services," "addictions receiving facility," and 1314
1952-"receiving facility" have the same meanings as those provided in 1315
1953-ss. 397.311(26)(a)4. 397.311(26)(a)3., 397.311(26)(a)1., and 1316
1954-394.455 394.455(40), respectively. 1317
1955- Section 10. Paragraph (b) of subsection (1) of section 1318
1956-409.972, Florida Statutes, is amended to read: 1319
1957- 409.972 Mandatory and voluntary enrollment. — 1320
1958- (1) The following Medicaid -eligible persons are exempt 1321
1959-from mandatory managed care enrollment required by s. 409.965, 1322
1960-and may voluntarily choose to participate in the managed medical 1323
1961-assistance program: 1324
1962- (b) Medicaid recipients residing in residential commitment 1325
1963-
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1971-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
1972-
1973-
1974-
1975-facilities operated through the Department of Juvenile Justice 1326
1976-or a treatment facility as defined in s. 394.455 s. 394.455(49). 1327
1977- Section 11. Paragraph ( e) of subsection (4) of section 1328
1978-464.012, Florida Statutes, is amended to read: 1329
1979- 464.012 Licensure of advanced practice registered nurses; 1330
1980-fees; controlled substance prescribing. — 1331
1981- (4) In addition to the general functions specified in 1332
1982-subsection (3), an a dvanced practice registered nurse may 1333
1983-perform the following acts within his or her specialty: 1334
1984- (e) A psychiatric nurse, who meets the requirements in s. 1335
1985-394.455 s. 394.455(36), within the framework of an established 1336
1986-protocol with a psychiatrist, may presc ribe psychotropic 1337
1987-controlled substances for the treatment of mental disorders. 1338
1988- Section 12. Subsection (7) of section 744.2007, Florida 1339
1989-Statutes, is amended to read: 1340
1990- 744.2007 Powers and duties. — 1341
1991- (7) A public guardian may not commit a ward to a treat ment 1342
1992-facility, as defined in s. 394.455 s. 394.455(49), without an 1343
1993-involuntary placement proceeding as provided by law. 1344
1994- Section 13. This act shall take effect July 1, 2024. 1345
754+or exempt status when transferred to the department. 501
755+ Section 15. This act shall ta ke effect July 1, 2024. 502