Florida Senate - 2025 CS for SB 1240 By the Committee on Children, Families, and Elder Affairs; and Senator Calatayud 586-02608-25 20251240c1 1 A bill to be entitled 2 An act relating to substance abuse and mental health 3 care; amending s. 394.4573, F.S.; expanding mental 4 health crisis services to include the 988 suicide and 5 crisis lifeline call center; amending s. 394.4598, 6 F.S.; authorizing the guardian advocate to be 7 discharged when a patient is discharged from 8 involuntary outpatient services; amending s. 394.4625, 9 F.S.; requiring clinical psychologists who make 10 determinations of involuntary placement at certain 11 mental health facilities to have specified clinical 12 experience; amending s. 394.4655, F.S.; providing 13 cross-reference for specified criteria relating to 14 orders to involuntary outpatient placement; amending 15 s. 394.467, F.S.; providing that orders entered by 16 administrative law judges for continued involuntary 17 placement for patients at certain mental health 18 facilities are final and subject to judicial review; 19 requiring hearings to be scheduled immediately; 20 requiring the clerk of the Division of Administrative 21 Hearings to provide copies of petitions and 22 individualized plans for continued services to the 23 Department of Children and Families and other 24 specified individuals; requiring the court or the 25 administrative law judge to make certain 26 determinations before waiving a patients attendance 27 at a hearing for continued involuntary placement; 28 authorizing an administrative law judge to issue an 29 order for involuntary services if the patient meets 30 certain criteria; amending s. 394.67, F.S.; revising 31 the definition of crisis services to include a 988 32 suicide and crisis lifeline call center and defining 33 the term 988 suicide and crisis lifeline call 34 center; creating s. 394.9088, F.S.; requiring the 35 Department of Children and Families to authorize and 36 provide oversight of the 988 suicide and crisis 37 lifeline call centers and adopt specified rules; 38 amending s. 397.427, F.S.; removing requirements 39 relating to providers of medication-assisted treatment 40 services for opiate addiction; amending s. 916.111, 41 F.S.; revising training requirements for mental health 42 professionals; amending s. 916.115, F.S.; requiring 43 court appointed experts to have completed specified 44 training and continued education; amending s. 916.12, 45 F.S.; providing requirements for an expert to 46 determine acceptable treatments available in a 47 community; amending ss. 394.674, 394.74, and 397.68141 48 F.S.; conforming cross-references; providing an 49 effective date. 50 51 Be It Enacted by the Legislature of the State of Florida: 52 53 Section 1.Paragraph (d) of subsection (2) of section 54 394.4573, Florida Statutes, is amended to read: 55 394.4573Coordinated system of care; annual assessment; 56 essential elements; measures of performance; system improvement 57 grants; reports.On or before December 1 of each year, the 58 department shall submit to the Governor, the President of the 59 Senate, and the Speaker of the House of Representatives an 60 assessment of the behavioral health services in this state. The 61 assessment shall consider, at a minimum, the extent to which 62 designated receiving systems function as no-wrong-door models, 63 the availability of treatment and recovery services that use 64 recovery-oriented and peer-involved approaches, the availability 65 of less-restrictive services, and the use of evidence-informed 66 practices. The assessment shall also consider the availability 67 of and access to coordinated specialty care programs and 68 identify any gaps in the availability of and access to such 69 programs in the state. The departments assessment shall 70 consider, at a minimum, the needs assessments conducted by the 71 managing entities pursuant to s. 394.9082(5). The department 72 shall compile and include in the report all plans submitted by 73 managing entities pursuant to s. 394.9082(8) and the 74 departments evaluation of each plan. 75 (2)The essential elements of a coordinated system of care 76 include: 77 (d)Crisis services, including the 988 suicide and crisis 78 lifeline call center, mobile response teams, crisis 79 stabilization units, addiction receiving facilities, and 80 detoxification facilities. 81 Section 2.Subsection (8) of section 394.4598, Florida 82 Statutes, are amended to read: 83 394.4598Guardian advocate. 84 (8)The guardian advocate shall be discharged when the 85 patient is discharged from an order for involuntary outpatient 86 services placement or involuntary inpatient placement or when 87 the patient is transferred from involuntary to voluntary status. 88 The court or a hearing officer shall consider the competence of 89 the patient pursuant to subsection (1) and may consider an 90 involuntarily placed patients competence to consent to 91 treatment at any hearing. Upon sufficient evidence, the court 92 may restore, or the hearing officer may recommend that the court 93 restore, the patients competence. A copy of the order restoring 94 competence or the certificate of discharge containing the 95 restoration of competence shall be provided to the patient and 96 the guardian advocate. 97 Section 3.Subsection (5) of section 394.4625, Florida 98 Statutes, is amended to read: 99 394.4625Voluntary admissions. 100 (5)TRANSFER TO INVOLUNTARY STATUS.When a voluntary 101 patient, or an authorized person on the patients behalf, makes 102 a request for discharge, the request for discharge, unless 103 freely and voluntarily rescinded, must be communicated to a 104 physician, a clinical psychologist with at least 3 years of 105 clinical postdoctoral experience in the practice of clinical 106 psychology, or a psychiatrist as quickly as possible, but not 107 later than 12 hours after the request is made. If the patient 108 meets the criteria for involuntary placement, the administrator 109 of the facility must file with the court a petition for 110 involuntary placement, within 2 court working days after the 111 request for discharge is made. If the petition is not filed 112 within 2 court working days, the patient must be discharged. 113 Pending the filing of the petition, the patient may be held and 114 emergency treatment rendered in the least restrictive manner, 115 upon the order of a physician or a psychiatric nurse practicing 116 within the framework of an established protocol with a 117 psychiatrist, if it is determined that such treatment is 118 necessary for the safety of the patient or others. 119 Section 4.Subsection (2) of section 394.4655, Florida 120 Statutes, is amended to read: 121 394.4655Orders to involuntary outpatient placement. 122 (2)A court or a county court may order an individual to 123 involuntary outpatient placement under s. 394.467. The criteria 124 for ordering a person to involuntary outpatient placement, as 125 well as all of the requirements and processes for placement, 126 including, but not limited to, recommendations for involuntary 127 outpatient placement, petitions, appointment of counsel, and 128 hearings on involuntary outpatient placement are provided in s. 129 394.467. 130 (3)When recommending an order to involuntary outpatient 131 placement, the petitioner, as defined 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 subsection 135 (11) of section 394.467, Florida Statutes, are amended to read: 136 394.467Involuntary inpatient placement and involuntary 137 outpatient services. 138 (1)DEFINITIONS.As used in this section, the term: 139 (a)Court means a circuit court or, for commitments only 140 to involuntary outpatient services as defined in s. 394.4655, a 141 county court. 142 (11)PROCEDURE FOR CONTINUED INVOLUNTARY SERVICES. 143 (a)A petition for continued involuntary services must be 144 filed if the patient continues to meet meets the criteria for 145 involuntary services. 146 (b)1.If a patient receiving involuntary outpatient 147 services continues to meet the criteria for involuntary 148 outpatient services, the service provider must file in the court 149 that issued the initial order for involuntary outpatient 150 services a petition for continued involuntary outpatient 151 services. 152 2.If a patient in involuntary inpatient placement 153 continues to meet the criteria for involuntary services and is 154 being treated at a receiving facility, the administrator must, 155 before the expiration of the period the receiving facility is 156 authorized to retain the patient, file in the court that issued 157 the initial order for involuntary inpatient placement, a 158 petition requesting authorization for continued involuntary 159 services. The administrator may petition for inpatient or 160 outpatient services. 161 3.If a patient in involuntary inpatient placement 162 continues to meet the criteria for involuntary services and is 163 being treated at a treatment facility, the administrator must, 164 before expiration of the period the treatment facility is 165 authorized to retain the patient, file a petition requesting 166 authorization for continued involuntary services. The 167 administrator may petition for inpatient or outpatient services. 168 Hearings on petitions for continued involuntary services of an 169 individual placed at any treatment facility are administrative 170 hearings and must be conducted in accordance with s. 120.57(1), 171 except that any order entered by the administrative law judge is 172 final and subject to judicial review in accordance with s. 173 120.68. Orders concerning patients committed after successfully 174 pleading not guilty by reason of insanity are governed by s. 175 916.15. 176 4.The court shall immediately schedule A hearing on the 177 petition shall to be scheduled immediately and held within 15 178 days after the petition is filed. 179 5.The existing involuntary services order shall remain in 180 effect until disposition on the petition for continued 181 involuntary services. 182 (c)The petition must be accompanied by a statement from 183 the patients physician, psychiatrist, psychiatric nurse, or 184 clinical psychologist justifying the request, a brief 185 description of the patients treatment during the time he or she 186 was receiving involuntary services, and an individualized plan 187 of continued treatment developed in consultation with the 188 patient or the patients guardian advocate, if applicable. If 189 the petition is for involuntary outpatient services, it must 190 comply with the requirements of subparagraph (4)(d)3. When the 191 petition has been filed, the clerk of the court or the clerk of 192 the Division of Administrative Hearings, as applicable, shall 193 provide copies of the petition and the individualized plan of 194 continued services to the department, the patient, the patients 195 guardian advocate, the state attorney, and the patients private 196 counsel or the public defender. 197 (d)The court shall appoint counsel to represent the person 198 who is the subject of the petition for continued involuntary 199 services in accordance with the provisions set forth in 200 subsection (5), unless the person is otherwise represented by 201 counsel or ineligible. 202 (e)Hearings on petitions for continued involuntary 203 outpatient services must be before the court that issued the 204 order for involuntary outpatient services. However, the patient 205 and the patients attorney may agree to a period of continued 206 outpatient services without a court hearing. 207 (f)Hearings on petitions for continued involuntary 208 inpatient placement in receiving facilities, or involuntary 209 outpatient services following involuntary inpatient services, 210 must be held in the county or the facility, as appropriate, 211 where the patient is located. 212 (g)The court may appoint a magistrate to preside at the 213 hearing. The procedures for obtaining an order pursuant to this 214 paragraph must meet the requirements of subsection (7). 215 (h)Notice of the hearing must be provided as set forth in 216 s. 394.4599. 217 (i)If a patients attendance at the hearing is voluntarily 218 waived, the court or the administrative law judge must determine 219 that the patient knowingly, intelligently, and voluntarily 220 waived his or her right to be present, before waiving the 221 presence of the patient from all or a portion of the hearing. 222 Alternatively, if at the hearing the court or the administrative 223 law judge finds that attendance at the hearing is not consistent 224 with the best interests of the patient, the court or the 225 administrative law judge may waive the presence of the patient 226 from all or any portion of the hearing, unless the patient, 227 through counsel, objects to the waiver of presence. The 228 testimony in the hearing must be under oath, and the proceedings 229 must be recorded. 230 (j)If at a hearing it is shown that the patient continues 231 to meet the criteria for involuntary services, the court or the 232 administrative law shall issue an order for continued 233 involuntary outpatient services, involuntary inpatient 234 placement, or a combination of involuntary services for up to 6 235 months. The same procedure shall be repeated before the 236 expiration of each additional period the patient is retained. 237 (k)If the patient has been ordered to undergo involuntary 238 services and has previously been found incompetent to consent to 239 treatment, the court shall consider testimony and evidence 240 regarding the patients competence. If the patients competency 241 to consent to treatment is restored, the discharge of the 242 guardian advocate is governed by s. 394.4598. If the patient has 243 been ordered to undergo involuntary inpatient placement only and 244 the patients competency to consent to treatment is restored, 245 the administrative law judge may issue a recommended order, to 246 the court that found the patient incompetent to consent to 247 treatment, that the patients competence be restored and that 248 any guardian advocate previously appointed be discharged. 249 (l)If continued involuntary inpatient placement is 250 necessary for a patient in involuntary inpatient placement who 251 was admitted while serving a criminal sentence, but his or her 252 sentence is about to expire, or for a minor involuntarily 253 placed, but who is about to reach the age of 18, the 254 administrator shall petition the administrative law judge for an 255 order authorizing continued involuntary inpatient placement. 256 257 The procedure required in this subsection must be followed 258 before the expiration of each additional period the patient is 259 involuntarily receiving services. 260 Section 6.Present subsections (1) through (25) of section 261 394.67, Florida Statutes, are redesignated as subsections (2) 262 through (26), respectively, subsection (4) is amended, and a new 263 subsection (1) is added to that section, to read: 264 394.67Definitions.As used in this part, the term: 265 (1)988 suicide and crisis lifeline call center means a 266 call center meeting national accreditation and recognized by the 267 department to receive 988 calls, texts, or other forms of 268 communication in this state. 269 (4)Crisis services means short-term evaluation, 270 stabilization, and brief intervention services provided to a 271 person who is experiencing an acute mental or emotional crisis, 272 as defined in subsection (19) (18), or an acute substance abuse 273 crisis, as defined in subsection (20) (19), to prevent further 274 deterioration of the persons mental health. Crisis services are 275 provided in settings such as a crisis stabilization unit, an 276 inpatient unit, a short-term residential treatment program, a 277 detoxification facility, or an addictions receiving facility; at 278 the site of the crisis by a mobile crisis response team; or at a 279 hospital on an outpatient basis; or telephonically by a 988 280 suicide and crisis lifeline call center. 281 Section 7.Section 394.9088, Florida Statutes, is created 282 to read: 283 394.9088988 suicide and crisis lifeline call center. 284 (1)The department shall authorize and provide oversight to 285 988 suicide and crisis lifeline call centers. Unless authorized 286 by the department, call centers are not permitted to conduct 988 287 suicide and crisis lifeline services. The department may 288 implement a corrective action plan, suspension, or revocation of 289 authorization for failure to comply with this section and rules 290 adopted under this section. 291 (2)The department shall adopt rules relating to: 292 (a)The process for authorization of 988 suicide and crisis 293 lifeline call centers. 294 (b)Minimum standards for 988 suicide and crisis lifeline 295 call centers to be authorized, including but not limited to, 296 service delivery, quality of care, and performance outcomes. 297 (c)The adequacy and consistency of 988 suicide and crisis 298 lifeline call centers personnel certifications, accreditations, 299 quality assurance standards, and minimum training standards. 300 (d)Implementation of a cohesive statewide plan for 988 301 suicide and crisis lifeline call centers to achieve statewide 302 interoperability with the 911 system and to provide individuals 303 with rapid and direct access to the appropriate care. 304 Section 8.Present subsections (3) through (9) of section 305 397.427, Florida Statutes, are redesignated as subsections (2) 306 through (8), respectively, and present subsections (2) and (5) 307 of that section are amended, to read: 308 397.427Medication-assisted treatment service providers; 309 rehabilitation program; needs assessment and provision of 310 services; persons authorized to issue takeout medication; 311 unlawful operation; penalty. 312 (2)The department shall determine the need for 313 establishing providers of medication-assisted treatment services 314 for opiate addiction. 315 (a)Providers of medication-assisted treatment services for 316 opiate addiction may be established only in response to the 317 departments determination and publication of need for 318 additional medication treatment services. 319 (b)If needs assessment is required, the department shall 320 annually conduct the assessment and publish a statement of 321 findings which identifies each substate entitys need. 322 (c)Notwithstanding paragraphs (a) and (b), the license for 323 medication-assisted treatment programs for opiate addiction 324 licensed before October 1, 1990, may not be revoked solely 325 because of the departments determination concerning the need 326 for medication-assisted treatment services for opiate addiction. 327 (4)(5)The department shall also determine the need for 328 establishing medication-assisted treatment for substance use 329 disorders other than opiate dependence. Service providers within 330 the publicly funded system shall be funded for provision of 331 these services based on the availability of funds. 332 Section 9.Subsection (3) of section 397.68141, Florida 333 Statutes, is amended to read: 334 397.68141Contents of petition for involuntary treatment 335 services.A petition for involuntary services must contain the 336 name of the respondent; the name of the petitioner; the 337 relationship between the respondent and the petitioner; the name 338 of the respondents attorney, if known; and the factual 339 allegations presented by the petitioner establishing the need 340 for involuntary services for substance abuse impairment. 341 (3)If there is an emergency, the petition must also 342 describe the respondents exigent circumstances and include a 343 request for an ex parte assessment and stabilization order that 344 must be executed pursuant to s. 397.6818 s. 397.68151. 345 Section 10.Section 916.111, Florida Statutes, is amended 346 to read: 347 916.111Training of mental health experts.The evaluation 348 of defendants for competency to proceed or for sanity at the 349 time of the commission of the offense shall be conducted in such 350 a way as to ensure uniform application of the criteria 351 enumerated in Rules 3.210 and 3.216, Florida Rules of Criminal 352 Procedure. The department shall develop, and may contract with 353 accredited institutions: 354 (1)To provide: 355 (a)A plan for training mental health professionals to 356 perform forensic evaluations and to standardize the criteria and 357 procedures to be used in these evaluations; 358 (b)Clinical protocols and procedures based upon the 359 criteria of Rules 3.210 and 3.216, Florida Rules of Criminal 360 Procedure; and 361 (c)Training for mental health professionals in the 362 application of these protocols and procedures in performing 363 forensic evaluations and providing reports to the courts. 364 Training must include, but is not limited to, information on 365 statutes and rules related to competency restoration, evidence 366 based practices, least restrictive treatment alternatives and 367 placement options as described in s. 916.12(4)(c); and 368 (2)To compile and maintain the necessary information for 369 evaluating the success of this program, including the number of 370 persons trained, the cost of operating the program, and the 371 effect on the quality of forensic evaluations as measured by 372 appropriateness of admissions to state forensic facilities and 373 to community-based care programs. 374 Section 11.Subsection (1) of section 916.115, Florida 375 Statutes, is amended to read: 376 916.115Appointment of experts. 377 (1)The court shall appoint no more than three experts to 378 determine the mental condition of a defendant in a criminal 379 case, including competency to proceed, insanity, involuntary 380 placement, and treatment. The experts may evaluate the defendant 381 in jail or in another appropriate local facility or in a 382 facility of the Department of Corrections. 383 (a)The court To the extent possible, The appointed experts 384 shall: 385 1.have completed forensic evaluator training approved by 386 the department, and each shall Be a psychiatrist, licensed 387 psychologist, or physician. 388 2.Have completed initial and ongoing forensic evaluator 389 training, provided by the department. 390 3.If performing juvenile evaluations, complete annually, 391 juvenile forensic competency evaluation training approved by the 392 department. 393 (b)Existing evaluators shall complete department-provided 394 continuing education training by July 1, 2026, to remain active 395 on the list. 396 (c)(b)The department shall maintain and annually provide 397 the courts with a list of available mental health professionals 398 who have completed the initial and annual approved training as 399 experts. 400 Section 12.Paragraph (d) of subsection (4) of section 401 916.12, Florida Statutes, is amended to read: 402 916.12Mental competence to proceed. 403 (4)If an expert finds that the defendant is incompetent to 404 proceed, the expert shall report on any recommended treatment 405 for the defendant to attain competence to proceed. In 406 considering the issues relating to treatment, the examining 407 expert shall specifically report on: 408 (d)The availability of acceptable treatment and, if 409 treatment is available in the community, the expert shall so 410 state in the report. In determining what acceptable treatments 411 are available in the community, the expert shall, at a minimum, 412 use current information or resources on less restrictive 413 treatment alternatives, as described in paragraph (c) and those 414 obtained from training and continuing education approved by the 415 department. 416 417 The examining experts report to the court shall include a full 418 and detailed explanation regarding why the alternative treatment 419 options referenced in the evaluation are insufficient to meet 420 the needs of the defendant. 421 Section 13.Paragraph (a) of subsection (1) of section 422 394.674, Florida Statutes, is amended to read: 423 394.674Eligibility for publicly funded substance abuse and 424 mental health services; fee collection requirements. 425 (1)To be eligible to receive substance abuse and mental 426 health services funded by the department, an individual must be 427 a member of at least one of the departments priority 428 populations approved by the Legislature. The priority 429 populations include: 430 (a)For adult mental health services: 431 1.Adults who have severe and persistent mental illness, as 432 designated by the department using criteria that include 433 severity of diagnosis, duration of the mental illness, ability 434 to independently perform activities of daily living, and receipt 435 of disability income for a psychiatric condition. Included 436 within this group are: 437 a.Older adults in crisis. 438 b.Older adults who are at risk of being placed in a more 439 restrictive environment because of their mental illness. 440 c.Persons deemed incompetent to proceed or not guilty by 441 reason of insanity under chapter 916. 442 d.Other persons involved in the criminal justice system. 443 e.Persons diagnosed as having co-occurring mental illness 444 and substance abuse disorders. 445 2.Persons who are experiencing an acute mental or 446 emotional crisis as defined in s. 394.67 s. 394.67(18). 447 Section 14.Paragraph (a) of subsection (3) of section 448 394.74, Florida Statutes, is amended to read: 449 394.74Contracts for provision of local substance abuse and 450 mental health programs. 451 (3)Contracts shall include, but are not limited to: 452 (a)A provision that, within the limits of available 453 resources, substance abuse and mental health crisis services, as 454 defined in s. 394.67 s. 394.67(4), shall be available to any 455 individual residing or employed within the service area, 456 regardless of ability to pay for such services, current or past 457 health condition, or any other factor; 458 Section 15.This act shall take effect July 1, 2025.