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A bill to be entitled 1
An act relating to substance abuse and mental health 2
care; amending s. 394.4573, F.S.; expanding mental 3
health crisis services to include the 988 suicide and 4
crisis lifeline call center; amending s. 394.4598, 5
F.S.; authorizing a guardian advocate to be dis charged 6
when a patient is discharged from involuntary 7
outpatient services; amending s. 394.4625, F.S.; 8
requiring clinical psychologists who make 9
determinations of involuntary placement at certain 10
mental health facilities to have specified clinical 11
experience; amending s. 394.4655, F.S.; providing 12
specified criteria relating to orders to involuntary 13
outpatient placement; amending s. 394.467, F.S.; 14
revising the definition of the term "court"; providing 15
that orders entered by an administrative law judge for 16
continued involuntary placement for patients at 17
certain mental health facilities are final and subject 18
to judicial review; requiring a patient to be 19
represented by the public defender of the circuit in 20
which the patient is receiving services at hearings 21
for continued involuntary services under certain 22
circumstances; requiring the court or the 23
administrative law judge to make certain 24
determinations before waiving a patient's attendance 25
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at a hearing for continued involuntary placement; 26
authorizing an administra tive law judge to issue an 27
order for involuntary services if the patient meets 28
certain criteria; amending s. 394.67, F.S.; revising 29
the definition of "crisis services" to include a 988 30
suicide and crisis lifeline call center and defining 31
the term "988 suicide and crisis lifeline call 32
center"; creating s. 394.9088, F.S.; requiring the 33
Department of Children and Families to authorize and 34
provide oversight of the 988 suicide and crisis 35
lifeline call centers and adopt specified rules; 36
amending s. 397.427, F.S.; removing requirements 37
relating to providers of medication -assisted treatment 38
services for opiate addiction; amending s. 916.111, 39
F.S.; revising training requirements for mental health 40
professionals; amending s. 916.115, F.S.; requiring 41
court appointed experts to have completed specified 42
training and continued education; amending s. 916.12, 43
F.S.; providing requirements for an expert to 44
determine acceptable treatments available in a 45
community; amending ss. 394.674, 397.68141, and 46
394.74, F.S.; conforming cro ss-references; providing 47
an effective date. 48
49
Be It Enacted by the Legislature of the State of Florida: 50
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51
Section 1. Paragraph (d) of subsection (2) of section 52
394.4573, Florida Statutes, is amended to read: 53
394.4573 Coordinated system of care; ann ual assessment; 54
essential elements; measures of performance; system improvement 55
grants; reports.—On or before December 1 of each year, the 56
department shall submit to the Governor, the President of the 57
Senate, and the Speaker of the House of Representatives an 58
assessment of the behavioral health services in this state. The 59
assessment shall consider, at a minimum, the extent to which 60
designated receiving systems function as no -wrong-door models, 61
the availability of treatment and recovery services that use 62
recovery-oriented and peer-involved approaches, the availability 63
of less-restrictive services, and the use of evidence -informed 64
practices. The assessment shall also consider the availability 65
of and access to coordinated specialty care programs and 66
identify any gaps in the availability of and access to such 67
programs in the state. The department's assessment shall 68
consider, at a minimum, the needs assessments conducted by the 69
managing entities pursuant to s. 394.9082(5). The department 70
shall compile and include in the report all plans submitted by 71
managing entities pursuant to s. 394.9082(8) and the 72
department's evaluation of each plan. 73
(2) The essential elements of a coordinated system of care 74
include: 75
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(d) Crisis services, including the 988 suicide and crisi s 76
lifeline call center, mobile response teams, crisis 77
stabilization units, addiction receiving facilities, and 78
detoxification facilities. 79
Section 2. Subsection (8) of section 394.4598, Florida 80
Statutes, is amended to read: 81
394.4598 Guardian advocate. — 82
(8) The guardian advocate shall be discharged when the 83
patient is discharged from an order for involuntary outpatient 84
services placement or involuntary inpatient placement or when 85
the patient is transferred from involuntary to voluntary status. 86
The court or a hearing officer shall consider the competence of 87
the patient pursuant to subsection (1) and may consider an 88
involuntarily placed patient's competence to consent to 89
treatment at any hearing. Upon sufficient evidence, the court 90
may restore, or the he aring officer may recommend that the court 91
restore, the patient's competence. A copy of the order restoring 92
competence or the certificate of discharge containing the 93
restoration of competence shall be provided to the patient and 94
the guardian advocate. 95
Section 3. Subsection (5) of section 394.4625, Florida 96
Statutes, is amended to read: 97
394.4625 Voluntary admissions. — 98
(5) TRANSFER TO INVOLUNTARY STATUS. —When a voluntary 99
patient, or an authorized person on the patient's behalf, makes 100
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a request for discharge, the request for discharge, unless 101
freely and voluntarily rescinded, must be communicated to a 102
physician, a clinical psychologist with at least 3 years of 103
clinical postdoctoral experience in the practice of clinical 104
psychology, or a psychiatrist as q uickly as possible, but not 105
later than 12 hours after the request is made. If the patient 106
meets the criteria for involuntary placement, the administrator 107
of the facility must file with the court a petition for 108
involuntary placement, within 2 court working days after the 109
request for discharge is made. If the petition is not filed 110
within 2 court working days, the patient must be discharged. 111
Pending the filing of the petition, the patient may be held and 112
emergency treatment rendered in the least restrictive ma nner, 113
upon the order of a physician or a psychiatric nurse practicing 114
within the framework of an established protocol with a 115
psychiatrist, if it is determined that such treatment is 116
necessary for the safety of the patient or others. 117
Section 4. Section 394.4655, Florida Statutes, is amended 118
to read: 119
394.4655 Orders to involuntary outpatient placement. — 120
(1) As used in this section, the term "involuntary 121
outpatient placement" means involuntary outpatient services as 122
defined in s. 394.467. 123
(2) A court or a county court may order an individual to 124
involuntary outpatient placement in accordance with the criteria 125
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for ordering a person to involuntary outpatient placement, and 126
the requirements and processes for placement, including, but not 127
limited to, recommendations for involuntary outpatient 128
placement, petitions, appointment of counsel, and hearings on 129
involuntary outpatient placement as provided under s. 394.467. 130
(3) When recommending an order to involuntary outpatient 131
placement, the petitio ner, as described in s. 394.467(4), shall 132
prepare a services plan for the patient in accordance with s. 133
394.467. 134
Section 5. Paragraph (a) of subsection (1) and paragraphs 135
(b), (d), (i), and (j) of subsection (11) of section 394.467, 136
Florida Statutes, are amended to read: 137
394.467 Involuntary inpatient placement and involuntary 138
outpatient services. — 139
(1) DEFINITIONS.—As used in this section, the term: 140
(a) "Court" means a circuit court or, for commitments only 141
to involuntary outpatient services as def ined in paragraph (c) 142
s. 394.4655, a county court. 143
(11) PROCEDURE FOR CONTINUED INVOLUNTARY SERVICES. — 144
(b)1. If a patient receiving involuntary outpatient 145
services continues to meet the criteria for involuntary 146
outpatient services, the service provider must file in the court 147
that issued the initial order for involuntary outpatient 148
services a petition for continued involuntary outpatient 149
services. 150
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2. If a patient in involuntary inpatient placement 151
continues to meet the criteria for involuntary services and is 152
being treated at a receiving facility, the administrator must, 153
before the expiration of the period the receiving facility is 154
authorized to retain the patient, file in the court that issued 155
the initial order for involuntary inpatient placement, a 156
petition requesting authorization for continued involuntary 157
services. The administrator may petition for inpatient or 158
outpatient services. 159
3. If a patient in involuntary inpatient placement 160
continues to meet the criteria for involuntary services and is 161
being treated at a treatment facility, the administrator must, 162
before expiration of the period the treatment facility is 163
authorized to retain the patient, file a petition requesting 164
authorization for continued involuntary services. The 165
administrator may petit ion for inpatient or outpatient services. 166
Hearings on petitions for continued involuntary services of an 167
individual placed at any treatment facility are administrative 168
hearings and must be conducted in accordance with s. 120.57(1), 169
except that any order en tered by the administrative law judge is 170
final and subject to judicial review in accordance with s. 171
120.68. Orders concerning patients committed after successfully 172
pleading not guilty by reason of insanity are governed by s. 173
916.15. 174
4. The court shall im mediately schedule a hearing on the 175
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petition to be held within 15 days after the petition is filed. 176
5. The existing involuntary services order shall remain in 177
effect until disposition on the petition for continued 178
involuntary services. 179
(d) Unless a patient is otherwise represented or is 180
ineligible, the public defender of the circuit in which the 181
patient is receiving services shall represent the patient at the 182
hearing on the petition for continued involuntary services The 183
court shall appoint counsel to r epresent the person who is the 184
subject of the petition for continued involuntary services in 185
accordance with the provisions set forth in subsection (5), 186
unless the person is otherwise represented by counsel or 187
ineligible. 188
(i) If a patient's attendance at the hearing is 189
voluntarily waived, the court or the administrative law judge 190
must determine that the patient knowingly, intelligently, and 191
voluntarily waived his or her right to be present, before 192
waiving the presence of the patient from all or a portion of the 193
hearing. Alternatively, if at the hearing the court or the 194
administrative law judge finds that attendance at the hearing is 195
not consistent with the best interests of the patient, the court 196
or the administrative law judge may waive the presence of th e 197
patient from all or any portion of the hearing, unless the 198
patient, through counsel, objects to the waiver of presence. The 199
testimony in the hearing must be under oath, and the proceedings 200
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must be recorded. 201
(j) If at a hearing it is shown that the pati ent continues 202
to meet the criteria for involuntary services, the court or the 203
administrative law judge shall issue an order for continued 204
involuntary outpatient services, involuntary inpatient 205
placement, or a combination of involuntary services for up to 6 206
months, as applicable. The same procedure shall be repeated 207
before the expiration of each additional period the patient is 208
retained. 209
210
The procedure required in this subsection must be followed 211
before the expiration of each additional period the patient is 212
involuntarily receiving services. 213
Section 6. Subsections (1) through (25) of section 394.67, 214
Florida Statutes, are renumbered as subsections (2) through 215
(26), respectively, present subsection (4) is amended, and a new 216
subsection (1) is added to that s ection, to read: 217
394.67 Definitions. —As used in this part, the term: 218
(1) "988 suicide and crisis lifeline call center" means a 219
call center meeting national accreditation and recognized by the 220
department to receive 988 calls, texts, or other forms of 221
communication in this state. 222
(5)(4) "Crisis services" means short -term evaluation, 223
stabilization, and brief intervention services provided to a 224
person who is experiencing an acute mental or emotional crisis, 225
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as defined in subsection (19) (18), or an acute substance abuse 226
crisis, as defined in subsection (20) (19), to prevent further 227
deterioration of the person's mental health. Crisis services are 228
provided in settings such as a crisis stabilization unit, an 229
inpatient unit, a short -term residential treatment program, a 230
detoxification facility, or an addictions receiving facility; at 231
the site of the crisis by a mobile crisis response team; or at a 232
hospital on an outpatient basis ; or telephonically by a 988 233
suicide and crisis lifeline call center . 234
Section 7. Section 394.9088, Florida Statutes, is created 235
to read: 236
394.9088 988 suicide and crisis lifeline call center. — 237
(1) The department shall authorize and provide oversight 238
of 988 suicide and crisis lifeline call centers. Unless 239
authorized by the departmen t, call centers are not permitted to 240
conduct 988 suicide and crisis lifeline services. The department 241
may implement a corrective action plan, suspension or revocation 242
of authorization for failure to comply with this section and 243
rules adopted under this sec tion. 244
(2) The department shall adopt rules relating to minimum 245
standards for 988 suicide and crisis lifeline call centers to be 246
authorized, including, but not limited to: 247
(a) Service delivery, quality of care, and performance 248
outcomes; quality assuranc e standards; the adequacy and 249
consistency of personnel certifications; and minimum training 250
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standards for personnel. 251
(b) The process for authorization of 988 suicide and 252
crisis lifeline call centers. 253
(3) Authorized 988 suicide and crisis lifeline call 254
centers shall implement a cohesive statewide plan for 988 255
suicide and crisis lifeline call centers to achieve statewide 256
interoperability with the 911 system and to provide individuals 257
with rapid and direct access to the appropriate care. The 258
department may adopt rules to implement this subsection. 259
Section 8. Subsections (3) through (9) of section 397.427, 260
Florida Statutes, are renumbered as subsections (2) through (8), 261
respectively, and present subsections (2) and (5) are amended, 262
to read: 263
397.427 Medication-assisted treatment service providers; 264
rehabilitation program; needs assessment and provision of 265
services; persons authorized to issue takeout medication; 266
unlawful operation; penalty. — 267
(2) The department shall determine the need for 268
establishing providers of medication -assisted treatment services 269
for opiate addiction. 270
(a) Providers of medication -assisted treatment services 271
for opiate addiction may be established only in response to the 272
department's determination and publication of need for 273
additional medication treatment services. 274
(b) If needs assessment is required, the department shall 275
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annually conduct the assessment and publish a statement of 276
findings which identifies each substate entity's need. 277
(c) Notwithstanding paragraphs (a) and (b ), the license 278
for medication-assisted treatment programs for opiate addiction 279
licensed before October 1, 1990, may not be revoked solely 280
because of the department's determination concerning the need 281
for medication-assisted treatment services for opiate ad diction. 282
(4)(5) The department shall also determine the need for 283
establishing medication -assisted treatment for substance use 284
disorders other than opiate dependence. Service providers within 285
the publicly funded system shall be funded for provision of 286
these services based on the availability of funds. 287
Section 9. Paragraph (c) of subsection (1) of section 288
916.111, Florida Statutes, is amended to read: 289
916.111 Training of mental health experts. —The evaluation 290
of defendants for competency to proceed or for sanity at the 291
time of the commission of the offense shall be conducted in such 292
a way as to ensure uniform application of the criteria 293
enumerated in Rules 3.210 and 3.216, Florida Rules of Criminal 294
Procedure. The department shall develop, and may contra ct with 295
accredited institutions: 296
(1) To provide: 297
(c) Training for mental health professionals in the 298
application of these protocols and procedures in performing 299
forensic evaluations and providing reports to the courts . 300
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Training must include, but is not limited to, information on 301
statutes and rules related to competency restoration, evidence -302
based practices, least restrictive treatment alternatives and 303
placement options as described in s. 916.12(4)(c) ; and 304
Section 10. Subsection (1) of section 916.11 5, Florida 305
Statutes, is amended to read: 306
916.115 Appointment of experts. — 307
(1) The court shall appoint no more than three experts to 308
determine the mental condition of a defendant in a criminal 309
case, including competency to proceed, insanity, involuntary 310
placement, and treatment. The experts may evaluate the defendant 311
in jail or in another appropriate local facility or in a 312
facility of the Department of Corrections. 313
(a) The court To the extent possible, The appointed 314
experts shall: 315
1. have completed forensic evaluator training approved by 316
the department, and each shall Be a psychiatrist, licensed 317
psychologist, or physician. 318
2. Have completed initial and annual forensic evaluator 319
training, provided by the department. 320
3. If performing juvenile evalua tions, have completed 321
initial and annual juvenile forensic competency evaluation 322
training provided by the department. 323
(b) Existing evaluators as of July 1, 2024, shall complete 324
department-provided annual forensic evaluator training by July 325
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1, 2026, to remain active on the list described in paragraph 326
(c). 327
(c)(b) The department shall maintain and annually provide 328
the courts with a list of available mental health professionals 329
who have completed the initial and annual approved training as 330
experts. 331
Section 11. Paragraph (d) of subsection (4) of section 332
916.12, Florida Statutes, is amended to read: 333
916.12 Mental competence to proceed. — 334
(4) If an expert finds that the defendant is incompetent 335
to proceed, the expert shall report on any recommended treat ment 336
for the defendant to attain competence to proceed. In 337
considering the issues relating to treatment, the examining 338
expert shall specifically report on: 339
(d) The availability of acceptable treatment and, if 340
treatment is available in the community, the expert shall so 341
state in the report. In determining what acceptable treatments 342
are available in the community, the expert shall, at a minimum, 343
use current information or resources on less restrictive 344
treatment alternatives, as described in paragraph (c) an d those 345
obtained from forensic evaluators training provided by the 346
department. 347
348
The examining expert's report to the court shall include a full 349
and detailed explanation regarding why the alternative treatment 350
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options referenced in the evaluation are insuff icient to meet 351
the needs of the defendant. 352
Section 12. Paragraph (a) of subsection (1) of section 353
394.674, Florida Statutes, is amended to read: 354
394.674 Eligibility for publicly funded substance abuse 355
and mental health services; fee collection requir ements.— 356
(1) To be eligible to receive substance abuse and mental 357
health services funded by the department, an individual must be 358
a member of at least one of the department's priority 359
populations approved by the Legislature. The priority 360
populations include: 361
(a) For adult mental health services: 362
1. Adults who have severe and persistent mental illness, 363
as designated by the department using criteria that include 364
severity of diagnosis, duration of the mental illness, ability 365
to independently perform activities of daily living, and receipt 366
of disability income for a psychiatric condition. Included 367
within this group are: 368
a. Older adults in crisis. 369
b. Older adults who are at risk of being placed in a more 370
restrictive environment because of their ment al illness. 371
c. Persons deemed incompetent to proceed or not guilty by 372
reason of insanity under chapter 916. 373
d. Other persons involved in the criminal justice system. 374
e. Persons diagnosed as having co -occurring mental illness 375
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and substance abuse disor ders. 376
2. Persons who are experiencing an acute mental or 377
emotional crisis as defined in s. 394.67 s. 394.67(18). 378
Section 13. Subsection (3) of section 397.68141, Florida 379
Statutes, is amended to read: 380
397.68141 Contents of petition for involuntary treatment 381
services.—A petition for involuntary services must contain the 382
name of the respondent; the name of the petitioner; the 383
relationship between the respondent and the petitioner; the name 384
of the respondent's attorney, if known; and the factual 385
allegations presented by the petitioner establishing the need 386
for involuntary services for substance abuse impairment. 387
(3) If there is an emergency, the petition must also 388
describe the respondent's exigent circumstances and include a 389
request for an ex parte as sessment and stabilization order that 390
must be executed pursuant to s. 397.6818 s. 397.68151. 391
Section 14. Paragraph (a) of subsection (3) of section 392
394.74, Florida Statutes, is amended to read: 393
394.74 Contracts for provision of local substance abuse 394
and mental health programs. — 395
(3) Contracts shall include, but are not limited to: 396
(a) A provision that, within the limits of available 397
resources, substance abuse and mental health crisis services, as 398
defined in s. 394.67 s. 394.67(4), shall be available to any 399
individual residing or employed within the service area, 400
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regardless of ability to pay for such services, current or past 401
health condition, or any other factor; 402
Section 15. This act shall take effect July 1, 2025. 403