```
Florida Senate - 2025 CS for CS for CS for SB 1240 By the Committee on Rules; the Appropriations Committee on Health and Human Services; the Committee on Children, Families, and Elder Affairs; and Senator Calatayud 595-03801-25 20251240c3 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. 394.463, F.S.; providing that 13 a designated facility that has received the transfer 14 of a patient outside a specified timeframe or that 15 does not receive timely notification of a transfer may 16 not release such patient or be ordered by a court to 17 release such patient under specified circumstances; 18 amending s. 394.4655, F.S.; providing a cross 19 reference for specified criteria relating to orders to 20 involuntary outpatient placement; amending s. 394.467, 21 F.S.; revising the definition of the term court; 22 providing that orders entered by administrative law 23 judges for continued involuntary placement for 24 patients at certain mental health facilities are final 25 and subject to judicial review; requiring that 26 hearings on petitions for certain continued 27 involuntary services be scheduled immediately; 28 requiring the clerk of the Division of Administrative 29 Hearings to provide copies of petitions and 30 individualized plans for continued services to the 31 Department of Children and Families and other 32 specified individuals; requiring the court or the 33 administrative law judge to make certain 34 determinations before waiving a patients attendance 35 at a hearing for continued involuntary placement; 36 authorizing an administrative law judge to issue an 37 order for involuntary services if the patient meets 38 certain criteria; amending s. 394.67, F.S.; defining 39 the term 988 suicide and crisis lifeline call 40 center; revising the definition of the term crisis 41 services to include a 988 suicide and crisis lifeline 42 call center; creating s. 394.9088, F.S.; requiring the 43 department to authorize and provide oversight of the 44 988 suicide and crisis lifeline call centers; 45 authorizing the department to take certain actions for 46 failure to comply with certain provisions; requiring 47 the department to adopt specified rules; amending s. 48 397.427, F.S.; deleting requirements relating to 49 providers of medication-assisted treatment services 50 for opiate addiction; amending s. 916.111, F.S.; 51 revising training requirements for mental health 52 professionals; amending s. 916.115, F.S.; requiring 53 certain court-appointed experts to have completed 54 specified training and continued education; amending 55 s. 916.12, F.S.; providing requirements for an 56 examining expert to determine acceptable treatments 57 available in a community; amending ss. 394.674, 58 394.74, and 397.68141, F.S.; conforming cross 59 references; providing an effective date. 60 61 Be It Enacted by the Legislature of the State of Florida: 62 63 Section 1.Paragraph (d) of subsection (2) of section 64 394.4573, Florida Statutes, is amended to read: 65 394.4573Coordinated system of care; annual assessment; 66 essential elements; measures of performance; system improvement 67 grants; reports.On or before December 1 of each year, the 68 department shall submit to the Governor, the President of the 69 Senate, and the Speaker of the House of Representatives an 70 assessment of the behavioral health services in this state. The 71 assessment shall consider, at a minimum, the extent to which 72 designated receiving systems function as no-wrong-door models, 73 the availability of treatment and recovery services that use 74 recovery-oriented and peer-involved approaches, the availability 75 of less-restrictive services, and the use of evidence-informed 76 practices. The assessment shall also consider the availability 77 of and access to coordinated specialty care programs and 78 identify any gaps in the availability of and access to such 79 programs in the state. The departments assessment shall 80 consider, at a minimum, the needs assessments conducted by the 81 managing entities pursuant to s. 394.9082(5). The department 82 shall compile and include in the report all plans submitted by 83 managing entities pursuant to s. 394.9082(8) and the 84 departments evaluation of each plan. 85 (2)The essential elements of a coordinated system of care 86 include: 87 (d)Crisis services, including the 988 suicide and crisis 88 lifeline call center, mobile response teams, crisis 89 stabilization units, addiction receiving facilities, and 90 detoxification facilities. 91 Section 2.Subsection (8) of section 394.4598, Florida 92 Statutes, is amended to read: 93 394.4598Guardian advocate. 94 (8)The guardian advocate shall be discharged when the 95 patient is discharged from an order for involuntary outpatient 96 services placement or involuntary inpatient placement or when 97 the patient is transferred from involuntary to voluntary status. 98 The court or a hearing officer shall consider the competence of 99 the patient pursuant to subsection (1) and may consider an 100 involuntarily placed patients competence to consent to 101 treatment at any hearing. Upon sufficient evidence, the court 102 may restore, or the hearing officer may recommend that the court 103 restore, the patients competence. A copy of the order restoring 104 competence or the certificate of discharge containing the 105 restoration of competence shall be provided to the patient and 106 the guardian advocate. 107 Section 3.Subsection (5) of section 394.4625, Florida 108 Statutes, is amended to read: 109 394.4625Voluntary admissions. 110 (5)TRANSFER TO INVOLUNTARY STATUS.When a voluntary 111 patient, or an authorized person on the patients behalf, makes 112 a request for discharge, the request for discharge, unless 113 freely and voluntarily rescinded, must be communicated to a 114 physician, a clinical psychologist with at least 3 years of 115 clinical postdoctoral experience in the practice of clinical 116 psychology, or a psychiatrist as quickly as possible, but not 117 later than 12 hours after the request is made. If the patient 118 meets the criteria for involuntary placement, the administrator 119 of the facility must file with the court a petition for 120 involuntary placement, within 2 court working days after the 121 request for discharge is made. If the petition is not filed 122 within 2 court working days, the patient must be discharged. 123 Pending the filing of the petition, the patient may be held and 124 emergency treatment rendered in the least restrictive manner, 125 upon the order of a physician or a psychiatric nurse practicing 126 within the framework of an established protocol with a 127 psychiatrist, if it is determined that such treatment is 128 necessary for the safety of the patient or others. 129 Section 4.Paragraph (i) of subsection (2) of section 130 394.463, Florida Statutes, is amended to read: 131 394.463Involuntary examination. 132 (2)INVOLUNTARY EXAMINATION. 133 (i)One of the following must occur within 12 hours after 134 the patients attending physician documents that the patients 135 medical condition has stabilized or that an emergency medical 136 condition does not exist: 137 1.The patient must be examined by a facility and released; 138 or 139 2.The patient must be transferred to a designated facility 140 in which appropriate medical treatment is available. However, 141 the facility must be notified of the transfer within 2 hours 142 after the patients condition has been stabilized or after 143 determination that an emergency medical condition does not 144 exist. If a physician at the designated facility to which the 145 patient was transferred examines the patient and documents that 146 the patient still poses a threat to himself or herself or to 147 others, the designated facility may not release or be ordered by 148 a court to release the patient based solely on a failure to meet 149 either the 12-hour transfer requirement or the 2-hour notice 150 requirement of this section, unless the patients 72-hour 151 examination period has ended. 152 Section 5.Subsection (2) of section 394.4655, Florida 153 Statutes, is amended, and subsection (3) is added to that 154 section, to read: 155 394.4655Orders to involuntary outpatient placement. 156 (2)A court or a county court may order an individual to 157 involuntary outpatient placement under s. 394.467. The criteria 158 for ordering a person to involuntary outpatient placement, as 159 well as all of the requirements and processes for placement, 160 including, but not limited to, recommendations for involuntary 161 outpatient placement, petitions, appointment of counsel, and 162 hearings on involuntary outpatient placement, are provided in s. 163 394.467. 164 (3)When recommending an order to involuntary outpatient 165 placement, the petitioner, as defined in s. 394.467(4), shall 166 prepare a services plan for the patient in accordance with s. 167 394.467. 168 Section 6.Paragraph (a) of subsection (1) and subsection 169 (11) of section 394.467, Florida Statutes, are amended to read: 170 394.467Involuntary inpatient placement and involuntary 171 outpatient services. 172 (1)DEFINITIONS.As used in this section, the term: 173 (a)Court means a circuit court or, for commitments only 174 to involuntary outpatient services as defined in s. 394.4655, a 175 county court. 176 (11)PROCEDURE FOR CONTINUED INVOLUNTARY SERVICES. 177 (a)A petition for continued involuntary services must be 178 filed if the patient continues to meet meets the criteria for 179 involuntary services. 180 (b)1.If a patient receiving involuntary outpatient 181 services continues to meet the criteria for involuntary 182 outpatient services, the service provider must file in the court 183 that issued the initial order for involuntary outpatient 184 services a petition for continued involuntary outpatient 185 services. 186 2.If a patient in involuntary inpatient placement 187 continues to meet the criteria for involuntary services and is 188 being treated at a receiving facility, the administrator must, 189 before the expiration of the period the receiving facility is 190 authorized to retain the patient, file in the court that issued 191 the initial order for involuntary inpatient placement, a 192 petition requesting authorization for continued involuntary 193 services. The administrator may petition for inpatient or 194 outpatient services. 195 3.If a patient in involuntary inpatient placement 196 continues to meet the criteria for involuntary services and is 197 being treated at a treatment facility, the administrator must, 198 before expiration of the period the treatment facility is 199 authorized to retain the patient, file a petition requesting 200 authorization for continued involuntary services. The 201 administrator may petition for inpatient or outpatient services. 202 Hearings on petitions for continued involuntary services of an 203 individual placed at any treatment facility are administrative 204 hearings and must be conducted in accordance with s. 120.57(1), 205 except that any order entered by the administrative law judge is 206 final and subject to judicial review in accordance with s. 207 120.68. Orders concerning patients committed after successfully 208 pleading not guilty by reason of insanity are governed by s. 209 916.15. 210 4.The court shall immediately schedule A hearing on the 211 petition shall to be scheduled immediately and held within 15 212 days after the petition is filed. 213 5.The existing involuntary services order shall remain in 214 effect until disposition on the petition for continued 215 involuntary services. 216 (c)The petition must be accompanied by a statement from 217 the patients physician, psychiatrist, psychiatric nurse, or 218 clinical psychologist justifying the request, a brief 219 description of the patients treatment during the time he or she 220 was receiving involuntary services, and an individualized plan 221 of continued treatment developed in consultation with the 222 patient or the patients guardian advocate, if applicable. If 223 the petition is for involuntary outpatient services, it must 224 comply with the requirements of subparagraph (4)(d)3. When the 225 petition has been filed, the clerk of the court or the clerk of 226 the Division of Administrative Hearings, as applicable, shall 227 provide copies of the petition and the individualized plan of 228 continued services to the department, the patient, the patients 229 guardian advocate, the state attorney, and the patients private 230 counsel or the public defender. 231 (d)The court shall appoint counsel to represent the person 232 who is the subject of the petition for continued involuntary 233 services in accordance with the provisions set forth in 234 subsection (5), unless the person is otherwise represented by 235 counsel or ineligible. 236 (e)Hearings on petitions for continued involuntary 237 outpatient services must be before the court that issued the 238 order for involuntary outpatient services. However, the patient 239 and the patients attorney may agree to a period of continued 240 outpatient services without a court hearing. 241 (f)Hearings on petitions for continued involuntary 242 inpatient placement in receiving facilities, or involuntary 243 outpatient services following involuntary inpatient services, 244 must be held in the county or the facility, as appropriate, 245 where the patient is located. 246 (g)The court may appoint a magistrate to preside at the 247 hearing. The procedures for obtaining an order pursuant to this 248 paragraph must meet the requirements of subsection (7). 249 (h)Notice of the hearing must be provided as set forth in 250 s. 394.4599. 251 (i)If a patients attendance at the hearing is voluntarily 252 waived, the court or the administrative law judge must determine 253 that the patient knowingly, intelligently, and voluntarily 254 waived his or her right to be present, before waiving the 255 presence of the patient from all or a portion of the hearing. 256 Alternatively, if at the hearing the court or the administrative 257 law judge finds that attendance at the hearing is not consistent 258 with the best interests of the patient, the court or the 259 administrative law judge may waive the presence of the patient 260 from all or any portion of the hearing, unless the patient, 261 through counsel, objects to the waiver of presence. The 262 testimony in the hearing must be under oath, and the proceedings 263 must be recorded. 264 (j)If at a hearing it is shown that the patient continues 265 to meet the criteria for involuntary services, the court or the 266 administrative law judge shall issue an order for continued 267 involuntary outpatient services, involuntary inpatient 268 placement, or a combination of involuntary services for up to 6 269 months. The same procedure shall be repeated before the 270 expiration of each additional period the patient is retained. 271 (k)If the patient has been ordered to undergo involuntary 272 services and has previously been found incompetent to consent to 273 treatment, the court shall consider testimony and evidence 274 regarding the patients competence. If the patients competency 275 to consent to treatment is restored, the discharge of the 276 guardian advocate is governed by s. 394.4598. If the patient has 277 been ordered to undergo involuntary inpatient placement only and 278 the patients competency to consent to treatment is restored, 279 the administrative law judge may issue a recommended order, to 280 the court that found the patient incompetent to consent to 281 treatment, that the patients competence be restored and that 282 any guardian advocate previously appointed be discharged. 283 (l)If continued involuntary inpatient placement is 284 necessary for a patient in involuntary inpatient placement who 285 was admitted while serving a criminal sentence, but his or her 286 sentence is about to expire, or for a minor involuntarily 287 placed, but who is about to reach the age of 18, the 288 administrator shall petition the administrative law judge for an 289 order authorizing continued involuntary inpatient placement. 290 291 The procedure required in this subsection must be followed 292 before the expiration of each additional period the patient is 293 involuntarily receiving services. 294 Section 7.Present subsections (1) through (25) of section 295 394.67, Florida Statutes, are redesignated as subsections (2) 296 through (26), respectively, a new subsection (1) is added to 297 that section, and present subsection (4) of that section is 298 amended, to read: 299 394.67Definitions.As used in this part, the term: 300 (1)988 suicide and crisis lifeline call center means a 301 call center meeting national accreditation and recognized by the 302 department to receive 988 calls, texts, or other forms of 303 communication in this state. 304 (5)(4)Crisis services means short-term evaluation, 305 stabilization, and brief intervention services provided to a 306 person who is experiencing an acute mental or emotional crisis, 307 as defined in subsection (19) (18), or an acute substance abuse 308 crisis, as defined in subsection (20) (19), to prevent further 309 deterioration of the persons mental health. Crisis services are 310 provided in settings such as a crisis stabilization unit, an 311 inpatient unit, a short-term residential treatment program, a 312 detoxification facility, or an addictions receiving facility; at 313 the site of the crisis by a mobile crisis response team; or at a 314 hospital on an outpatient basis; or telephonically by a 988 315 suicide and crisis lifeline call center. 316 Section 8.Section 394.9088, Florida Statutes, is created 317 to read: 318 394.9088988 suicide and crisis lifeline call center. 319 (1)The department shall authorize and provide oversight to 320 988 suicide and crisis lifeline call centers. Unless authorized 321 by the department, call centers are not permitted to conduct 988 322 suicide and crisis lifeline services. The department may 323 implement a corrective action plan, suspension, or revocation of 324 authorization for failure to comply with this section and rules 325 adopted under this section. 326 (2)The department shall adopt rules relating to: 327 (a)The process for authorization of 988 suicide and crisis 328 lifeline call centers. 329 (b)Minimum standards for 988 suicide and crisis lifeline 330 call centers to be authorized, including but not limited to, 331 service delivery, quality of care, and performance outcomes. 332 (c)The adequacy and consistency of 988 suicide and crisis 333 lifeline call centers personnel certifications, accreditations, 334 quality assurance standards, and minimum training standards. 335 (d)Implementation of a cohesive statewide plan for 988 336 suicide and crisis lifeline call centers to achieve statewide 337 interoperability with the 911 system and to provide individuals 338 with rapid and direct access to the appropriate care. 339 Section 9.Present subsections (3) through (9) of section 340 397.427, Florida Statutes, are redesignated as subsections (2) 341 through (8), respectively, and present subsections (2) and (5) 342 of that section are amended, to read: 343 397.427Medication-assisted treatment service providers; 344 rehabilitation program; needs assessment and provision of 345 services; persons authorized to issue takeout medication; 346 unlawful operation; penalty. 347 (2)The department shall determine the need for 348 establishing providers of medication-assisted treatment services 349 for opiate addiction. 350 (a)Providers of medication-assisted treatment services for 351 opiate addiction may be established only in response to the 352 departments determination and publication of need for 353 additional medication treatment services. 354 (b)If needs assessment is required, the department shall 355 annually conduct the assessment and publish a statement of 356 findings which identifies each substate entitys need. 357 (c)Notwithstanding paragraphs (a) and (b), the license for 358 medication-assisted treatment programs for opiate addiction 359 licensed before October 1, 1990, may not be revoked solely 360 because of the departments determination concerning the need 361 for medication-assisted treatment services for opiate addiction. 362 (4)(5)The department shall also determine the need for 363 establishing medication-assisted treatment for substance use 364 disorders other than opiate dependence. Service providers within 365 the publicly funded system shall be funded for provision of 366 these services based on the availability of funds. 367 Section 10.Section 916.111, Florida Statutes, is amended 368 to read: 369 916.111Training of mental health experts.The evaluation 370 of defendants for competency to proceed or for sanity at the 371 time of the commission of the offense shall be conducted in such 372 a way as to ensure uniform application of the criteria 373 enumerated in Rules 3.210 and 3.216, Florida Rules of Criminal 374 Procedure. The department shall develop, and may contract with 375 accredited institutions: 376 (1)To provide: 377 (a)A plan for training mental health professionals to 378 perform forensic evaluations and to standardize the criteria and 379 procedures to be used in these evaluations; 380 (b)Clinical protocols and procedures based upon the 381 criteria of Rules 3.210 and 3.216, Florida Rules of Criminal 382 Procedure; and 383 (c)Training for mental health professionals in the 384 application of these protocols and procedures in performing 385 forensic evaluations and providing reports to the courts. 386 Training must include, but not be limited to, information on 387 statutes and rules related to competency restoration, evidence 388 based practices, and least restrictive treatment alternatives 389 and placement options as described in s. 916.12(4)(c); and 390 (2)To compile and maintain the necessary information for 391 evaluating the success of this program, including the number of 392 persons trained, the cost of operating the program, and the 393 effect on the quality of forensic evaluations as measured by 394 appropriateness of admissions to state forensic facilities and 395 to community-based care programs. 396 Section 11.Subsection (1) of section 916.115, Florida 397 Statutes, is amended to read: 398 916.115Appointment of experts. 399 (1)The court shall appoint no more than three experts to 400 determine the mental condition of a defendant in a criminal 401 case, including competency to proceed, insanity, involuntary 402 placement, and treatment. The experts may evaluate the defendant 403 in jail or in another appropriate local facility or in a 404 facility of the Department of Corrections. 405 (a)The court-appointed To the extent possible, The 406 appointed experts shall: 407 1.have completed forensic evaluator training approved by 408 the department, and each shall Be a psychiatrist, licensed 409 psychologist, or physician. 410 2.Have completed initial and ongoing forensic evaluator 411 training, provided by the department. 412 3.If performing juvenile evaluations, annually complete 413 juvenile forensic competency evaluation training approved by the 414 department. 415 (b)Existing evaluators shall complete department-provided 416 continuing education training by July 1, 2026, to remain active 417 on the list. 418 (c)(b)The department shall maintain and annually provide 419 the courts with a list of available mental health professionals 420 who have completed the initial and annual approved training as 421 experts. 422 Section 12.Paragraph (d) of subsection (4) of section 423 916.12, Florida Statutes, is amended to read: 424 916.12Mental competence to proceed. 425 (4)If an expert finds that the defendant is incompetent to 426 proceed, the expert shall report on any recommended treatment 427 for the defendant to attain competence to proceed. In 428 considering the issues relating to treatment, the examining 429 expert shall specifically report on: 430 (d)The availability of acceptable treatment and, if 431 treatment is available in the community, the expert shall so 432 state in the report. In determining what acceptable treatments 433 are available in the community, the expert shall, at a minimum, 434 use current information or resources on less restrictive 435 treatment alternatives, as described in paragraph (c), and those 436 obtained from training and continuing education approved by the 437 department. 438 439 The examining experts report to the court shall include a full 440 and detailed explanation regarding why the alternative treatment 441 options referenced in the evaluation are insufficient to meet 442 the needs of the defendant. 443 Section 13.Paragraph (a) of subsection (1) of section 444 394.674, Florida Statutes, is amended to read: 445 394.674Eligibility for publicly funded substance abuse and 446 mental health services; fee collection requirements. 447 (1)To be eligible to receive substance abuse and mental 448 health services funded by the department, an individual must be 449 a member of at least one of the departments priority 450 populations approved by the Legislature. The priority 451 populations include: 452 (a)For adult mental health services: 453 1.Adults who have severe and persistent mental illness, as 454 designated by the department using criteria that include 455 severity of diagnosis, duration of the mental illness, ability 456 to independently perform activities of daily living, and receipt 457 of disability income for a psychiatric condition. Included 458 within this group are: 459 a.Older adults in crisis. 460 b.Older adults who are at risk of being placed in a more 461 restrictive environment because of their mental illness. 462 c.Persons deemed incompetent to proceed or not guilty by 463 reason of insanity under chapter 916. 464 d.Other persons involved in the criminal justice system. 465 e.Persons diagnosed as having co-occurring mental illness 466 and substance abuse disorders. 467 2.Persons who are experiencing an acute mental or 468 emotional crisis as defined in s. 394.67 s. 394.67(18). 469 Section 14.Subsection (3) of section 394.74, Florida 470 Statutes, is amended to read: 471 394.74Contracts for provision of local substance abuse and 472 mental health programs. 473 (3)Contracts shall include, but are not limited to: 474 (a)A provision that, within the limits of available 475 resources, substance abuse and mental health crisis services, as 476 defined in s. 394.67 s. 394.67(4), shall be available to any 477 individual residing or employed within the service area, 478 regardless of ability to pay for such services, current or past 479 health condition, or any other factor; 480 (b)A provision that such services be available with 481 priority of attention being given to individuals who exhibit 482 symptoms of chronic or acute substance abuse or mental illness 483 and who are unable to pay the cost of receiving such services; 484 (c)A provision that every reasonable effort to collect 485 appropriate reimbursement for the cost of providing substance 486 abuse and mental health services to persons able to pay for 487 services, including first-party payments and third-party 488 payments, shall be made by facilities providing services 489 pursuant to this act; 490 (d)A program description and line-item operating budget by 491 program service component for substance abuse and mental health 492 services, provided the entire proposed operating budget for the 493 service provider will be displayed; 494 (e)A provision that client demographic, service, and 495 outcome information required for the departments Mental Health 496 and Substance Abuse Data System be submitted to the department 497 by a date specified in the contract. The department may not pay 498 the provider unless the required information has been submitted 499 by the specified date; and 500 (f)A requirement that the contractor must conform to 501 department rules and the priorities established thereunder. 502 Section 15.Subsection (3) of section 397.68141, Florida 503 Statutes, is amended to read: 504 397.68141Contents of petition for involuntary treatment 505 services.A petition for involuntary services must contain the 506 name of the respondent; the name of the petitioner; the 507 relationship between the respondent and the petitioner; the name 508 of the respondents attorney, if known; and the factual 509 allegations presented by the petitioner establishing the need 510 for involuntary services for substance abuse impairment. 511 (3)If there is an emergency, the petition must also 512 describe the respondents exigent circumstances and include a 513 request for an ex parte assessment and stabilization order that 514 must be executed pursuant to s. 397.6818 s. 397.68151. 515 Section 16.This act shall take effect July 1, 2025.
```