Bill Text: FL H1213 | 2010 | Regular Session | Introduced

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Bill Title: Mental Health

Sponsorship: Partisan Bill (Democrat 1)

Status: (Failed) 2010-04-30 - Died in Committee on Health Care Services Policy (HFPC), companion bill(s) passed, see CS/HB 7069 (Ch. 2010-114), SB 1166 (Ch. 2010-193), CS/CS/SB 1412 (Ch. 2010-102) [H1213 Detail]

Download: Florida-2010-H1213-Introduced.html

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HB 1213

1	A bill to be entitled
2	An act relating to mental health; revising part I of ch.
3	394, F.S., relating to the Florida Mental Health Act, to
4	substitute the term "individual" for the terms "person,"
5	"patient," or "client"; amending s. 394.453, F.S.;
6	conforming terms; amending s. 394.455, F.S.; redefining
7	terms, defining new terms, and deleting terms; amending s.
8	394.457, F.S.; conforming terms; amending s. 394.4572,
9	F.S.; conforming terms; deleting certain background
10	screening requirements and exemptions for certain mental
11	health professionals; amending s. 394.4573, F.S.;
12	conforming terms; deleting a report requirement relating
13	to the implementation of staffing standards in state
14	treatment facilities; amending ss. 394.4574 and 394.458,
15	F.S.; conforming terms; amending s. 394.459, F.S.;
16	conforming terms; revising requirements for a physical
17	examination and psychiatric evaluation and requiring the
18	examination to be documented in the clinical record;
19	requiring facilities to provide procedures for reporting
20	events that place individuals receiving services at risk
21	of harm; requiring facilities to provide information and
22	assist individuals with advance directives; amending ss.
23	394.4593 and 394.4595, F.S.; conforming terms; amending s.
24	394.4597, F.S.; conforming terms; adding a health care
25	surrogate to list of persons to be noted in the clinical
26	record; specifying the rights, authority, and
27	responsibilities of a representative; amending s.
28	394.4598, F.S.; conforming terms; requiring a guardian
29	advocate to make every effort to make the decision the
30	individual would have made; amending s. 394.4599, F.S.;
31	conforming terms; adding the health care surrogate or
32	proxy to list of persons to receive notice of involuntary
33	admission; repealing s. 394.460, F.S., relating to the
34	rights of professionals; amending s. 394.461, F.S.;
35	conforming terms; specifying that only governmental
36	facilities and other facilities designated by the
37	Department of Children and Family Services may serve as
38	receiving and treatment facilities; revising facility data
39	that must be submitted to the Agency for Health Care
40	Administration; amending s. 394.4615, F.S.; conforming
41	terms; adding a health care surrogate or proxy to list of
42	persons that may waive confidentiality of a clinical
43	record; providing additional grounds for releasing a
44	clinical record; amending s. 394.462, F.S.; conforming
45	terms; providing that a law enforcement officer acting in
46	good faith may not be held liable for false imprisonment;
47	specifying when a county or law enforcement agency may be
48	reimbursed for transportation expenses; authorizing the
49	Department of Corrections to transport an individual under
50	certain circumstances; amending s. 394.4625, F.S.;
51	conforming terms; requiring a minor's assent to voluntary
52	admission; requiring an individual who has been
53	voluntarily admitted and charged with a crime to be
54	returned to the custody of a law enforcement agency after
55	discharge; amending s. 394.463, F.S.; conforming terms;
56	requiring an ex parte order for involuntary examination to
57	be based on specific facts and have occurred within the
58	last 14 days; providing that a certificate for involuntary
59	examination is valid only until the individual is
60	delivered to a receiving facility or for 7 days after the
61	certificate is executed; providing notification
62	requirements to guardians of minors who are involuntarily
63	examined; revising the procedures for holding a person for
64	involuntary examination and for emergency situations;
65	requiring an individual charged with a crime who has been
66	voluntarily or involuntarily admitted to be returned to
67	the custody of a law enforcement agency after discharge;
68	amending s. 394.4655, F.S.; conforming terms; revising
69	criteria for requesting a continuance for a hearing on
70	involuntary outpatient placement; amending s. 394.467,
71	F.S.; conforming terms; requiring a facility to send a
72	copy of the petition for involuntary inpatient placement
73	to the Agency for Health Care Administration; requiring an
74	attorney representing an individual in involuntary
75	placement to represent the individual's expressed desires
76	and be present at all hearings; requiring the state
77	attorney to participate in all hearings on involuntary
78	placement; prohibiting continuance requests from parties
79	other than the individual; requiring the court to also
80	conduct a hearing on capacity to consent to treatment;
81	providing for the appointment of a guardian advocate if an
82	individual is found incompetent; requiring the court to
83	determine that an individual has knowingly waived his or
84	her attendance at the hearing; requiring the court to
85	allow certain testimony at hearings on involuntary
86	placement if a continuance is granted; requiring the
87	Division of Administrative Hearings to inform an
88	individual of his or her right to an independent expert
89	examination; amending ss. 394.46715 and 394.4672, F.S.;
90	conforming terms; repealing s. 394.4674, F.S., relating to
91	a plan and report on the deinstitutionalization of
92	patients in treatment facilities; amending s. 394.4685,
93	F.S.; conforming terms; authorizing a public facility to
94	request the transfer of an individual to a private
95	facility; amending s. 394.469, F.S.; conforming terms;
96	requiring a discharged individual who is charged with a
97	crime to be returned to the custody of a law enforcement
98	agency; amending ss. 394.473, 394.475, 394.4785, 394.4786,
99	394.47865, 394.4787, 394.4788, and 394.4789, F.S.;
100	conforming terms; amending ss. 39.407, 394.495, 394.496,
101	394.9085, 419.001, and 744.704, F.S.; conforming cross-
102	references; providing an effective date.
103
104	Be It Enacted by the Legislature of the State of Florida:
105
106	Section 1. Section 394.453, Florida Statutes, is amended
107	to read:
108	394.453 Legislative intent.-It is the intent of the
109	Legislature to authorize and direct the Department of Children
110	and Family Services to evaluate, research, plan, and recommend
111	to the Governor and the Legislature programs designed to reduce
112	the occurrence, severity, duration, and disabling aspects of
113	mental, emotional, and behavioral disorders. It is the intent of
114	the Legislature that treatment programs for such disorders shall
115	include, but not be limited to, comprehensive health, social,
116	educational, and rehabilitative services for individuals to
117	persons requiring intensive short-term and continued treatment
118	in order to encourage them to assume responsibility for their
119	treatment and recovery. It is intended that such individuals
120	persons be provided with emergency service and temporary
121	detention for evaluation if when required; that they be admitted
122	to treatment facilities if on a voluntary basis when extended or
123	continuing care is needed and unavailable in the community; that
124	involuntary placement be provided only if when expert evaluation
125	determines that it is necessary; that any involuntary treatment
126	or examination be accomplished in a setting that which is
127	clinically appropriate and most likely to facilitate the
128	individual's person's return to the community as soon as
129	possible; and that individual dignity and human rights be
130	guaranteed to all individuals persons who are admitted to mental
131	health facilities or who are being held under s. 394.463. It is
132	the further intent of the Legislature that the least restrictive
133	means of intervention be employed based on the individual's
134	individual needs of each person, within the scope of available
135	services. It is the policy of this state that the use of
136	restraint and seclusion on clients is justified only as an
137	emergency safety measure to be used in response to imminent
138	danger to the individual client or others. It is, therefore, the
139	intent of the Legislature to achieve an ongoing reduction in the
140	use of restraint and seclusion in programs and facilities
141	serving individuals who have persons with mental illness.
142	Section 2. Section 394.455, Florida Statutes, is amended
143	to read:
144	394.455 Definitions.-As used in this part, unless the
145	context clearly requires otherwise, the term:
146	(1) "Administrator" means the chief administrative officer
147	of a receiving or treatment facility or his or her designee.
148	(2) "Adult" means an individual who is 18 years of age or
149	older or who has had the disability of nonage removed pursuant
150	to s. 743.01 or s. 743.015.
151	(3) "Advance directive" has the same meaning as in s.
152	765.101.
153	(4)(2) "Clinical psychologist" means a psychologist as
154	defined in s. 490.003 490.003(7) with 3 years of postdoctoral
155	experience in the practice of clinical psychology, inclusive of
156	the experience required for licensure, or a psychologist
157	employed by a facility operated by the United States Department
158	of Veterans Affairs or the United States Department of Defense
159	that qualifies as a receiving or treatment facility under this
160	part.
161	(5)(3) "Clinical record" means all parts of the record
162	required to be maintained and includes all medical records,
163	progress notes, charts, and admission and discharge data, and
164	all other information recorded by a facility staff which
165	pertains to an individual's the patient's hospitalization or
166	treatment.
167	(6)(4) "Clinical social worker" has the same meaning as in
168	s. 491.003 means a person licensed as a clinical social worker
169	under chapter 491.
170	(7)(5) "Community facility" means a any community service
171	provider contracting with the department to furnish substance
172	abuse or mental health services under part IV of this chapter.
173	(8)(6) "Community mental health center or clinic" means a
174	publicly funded, not-for-profit center that which contracts with
175	the department for the provision of inpatient, outpatient, day
176	treatment, or emergency services.
177	(9)(7) "Court," unless otherwise specified, means the
178	circuit court.
179	(10)(8) "Department" means the Department of Children and
180	Family Services.
181	(11) "Electronic means" means a form of telecommunication
182	that requires all parties to maintain visual as well as audio
183	communication.
184	(12)(9) "Express and informed consent" means consent
185	voluntarily given in writing, by a competent individual person,
186	after sufficient explanation and disclosure of the subject
187	matter involved to enable the individual person to make a
188	knowing and willful decision without any element of force,
189	fraud, deceit, duress, or other form of constraint or coercion.
190	(13)(10) "Facility" means a any hospital, community
191	facility, public or private facility, or receiving or treatment
192	facility providing for the evaluation, diagnosis, care,
193	treatment, training, or hospitalization of individuals persons
194	who appear to have a mental illness or who have been diagnosed
195	as having a mental illness. The term "Facility" does not include
196	a any program or entity licensed under pursuant to chapter 400
197	or chapter 429.
198	(14) "Government facility" means a facility owned,
199	operated, or administered by the Department of Corrections or
200	the United States Department of Veterans Affairs.
201	(15)(11) "Guardian" means the natural guardian of a minor,
202	or a person appointed by a court to act on behalf of a ward's
203	person if the ward is a minor or has been adjudicated
204	incapacitated.
205	(16)(12) "Guardian advocate" means a person appointed by a
206	court to make decisions regarding mental health treatment on
207	behalf of an individual a patient who has been found incompetent
208	to consent to treatment pursuant to this part. The guardian
209	advocate may be granted specific additional powers by written
210	order of the court, as provided in this part.
211	(17)(13) "Hospital" means a hospital facility as defined
212	in s. 395.002 and licensed under chapter 395 and part II of
213	chapter 408.
214	(18)(14) "Incapacitated" means that an individual a person
215	has been adjudicated incapacitated pursuant to part V of chapter
216	744 and a guardian of the person has been appointed.
217	(19)(15) "Incompetent to consent to treatment" means that
218	an individual's a person's judgment is so affected by his or her
219	mental illness that he or she the person lacks the capacity to
220	make a well-reasoned, willful, and knowing decision concerning
221	his or her medical or mental health treatment.
222	(20) "Involuntary examination" means an examination
223	performed under s. 394.463 to determine if an individual
224	qualifies for involuntary inpatient treatment under s. 394.467
225	or involuntary outpatient treatment under s. 394.4655.
226	(21) "Involuntary placement" means involuntary outpatient
227	treatment pursuant to s. 394.4655 or involuntary inpatient
228	treatment pursuant to s. 394.467.
229	(22)(16) "Law enforcement officer" has the same meaning as
230	means a law enforcement officer as defined in s. 943.10.
231	(23) "Marriage and family therapist" has the same meaning
232	as in s. 491.003.
233	(24) "Mental health counselor" has the same meaning as in
234	s. 491.003.
235	(25)(17) "Mental health overlay program" means a mobile
236	service that which provides an independent examination for
237	voluntary admission admissions and a range of supplemental
238	onsite services to an individual who has persons with a mental
239	illness in a residential setting such as a nursing home,
240	assisted living facility, adult family-care home, or a
241	nonresidential setting such as an adult day care center.
242	Independent examinations provided pursuant to this part through
243	a mental health overlay program must only be provided only under
244	contract with the department for this service or be attached to
245	a public receiving facility that is also a community mental
246	health center.
247	(26)(18) "Mental illness" means an impairment of the
248	mental or emotional processes that exercise conscious control of
249	one's actions or of the ability to perceive or understand
250	reality, which impairment substantially interferes with the a
251	person's ability to meet the ordinary demands of living,
252	regardless of etiology. For the purposes of this part, the term
253	does not include a retardation or developmental disability as
254	defined in chapter 393, intoxication, brain injury, dementia, or
255	conditions manifested only by antisocial behavior or substance
256	abuse impairment.
257	(27) "Minor" means an individual who is 17 years of age or
258	younger and who has not had the disabilities of nonage removed
259	pursuant to s. 743.01 or s. 743.015.
260	(28)(19) "Mobile crisis response service" means a
261	nonresidential crisis service attached to a public receiving
262	facility and available 24 hours a day, 7 days a week, through
263	which provides immediate intensive assessments and
264	interventions, including screening for admission into a
265	receiving facility, take place for the purpose of identifying
266	appropriate treatment services.
267	(20) "Patient" means any person who is held or accepted
268	for mental health treatment.
269	(29)(21) "Physician" means a medical practitioner licensed
270	under chapter 458 or chapter 459 who has experience in the
271	diagnosis and treatment of mental and nervous disorders or a
272	physician employed by a facility operated by the United States
273	Department of Veterans Affairs or the United States Department
274	of Defense which qualifies as a receiving or treatment facility
275	under this part.
276	(30) "Physician assistant" means a person licensed as a
277	physician assistant under chapter 458 or chapter 459.
278	(31)(22) "Private facility" means any hospital or facility
279	operated by a for-profit or not-for-profit corporation or
280	association that provides mental health services and is not a
281	public facility.
282	(32)(23) "Psychiatric nurse" means an advanced a
283	registered nurse practitioner licensed under part I of chapter
284	464 who has a national advanced practice certification from an
285	approved nursing specialty board and a collaborative practice
286	agreement with a psychiatrist on file with the Board of Nursing
287	master's degree or a doctorate in psychiatric nursing and 2
288	years of post-master's clinical experience under the supervision
289	of a physician.
290	(33)(24) "Psychiatrist" means a medical practitioner
291	licensed under chapter 458 or chapter 459 who has primarily
292	diagnosed and treated mental and nervous disorders for at least
293	a period of not less than 3 years, inclusive of psychiatric
294	residency.
295	(34)(25) "Public facility" means any facility that has
296	contracted with the department to provide mental health services
297	to all individuals persons, regardless of their ability to pay,
298	and is receiving state funds for such purpose.
299	(35)(26) "Receiving facility" means any public or private
300	facility expressly designated by the department to receive and
301	hold individuals involuntarily involuntary patients under
302	emergency conditions or for psychiatric evaluation and to
303	provide short-term treatment. The term does not include a county
304	jail.
305	(36)(27) "Representative" means a person selected pursuant
306	to s. 394.4597(2) to receive notice of proceedings during the
307	time a patient is held in or admitted to a receiving or
308	treatment facility.
309	(37)(28)(a) "Restraint" means a physical device, method,
310	or drug used to control behavior.
311	(a) A physical restraint is any manual method or physical
312	or mechanical device, material, or equipment attached or
313	adjacent to an the individual's body so that he or she cannot
314	easily remove the restraint and which restricts freedom of
315	movement or normal access to one's body.
316	(b) A drug used as a restraint is a medication used to
317	control an individual's the person's behavior or to restrict his
318	or her freedom of movement and is not part of the standard
319	treatment regimen for an individual having of a person with a
320	diagnosed mental illness who is a client of the department.
321	Physically holding an individual a person during a procedure to
322	forcibly administer psychotropic medication is a physical
323	restraint.
324	(c) Restraint does not include physical devices, such as
325	orthopedically prescribed appliances, surgical dressings and
326	bandages, supportive body bands, or other physical holding when
327	necessary for routine physical examinations and tests; or for
328	purposes of orthopedic, surgical, or other similar medical
329	treatment; when used to provide support for the achievement of
330	functional body position or proper balance; or when used to
331	protect an individual a person from falling out of bed.
332	(38)(29) "Seclusion" means the physical segregation of a
333	person in any fashion or involuntary isolation of an individual
334	a person in a room or area from which the individual person is
335	prevented from leaving. The prevention may be by physical
336	barrier or by a staff member who is acting in a manner, or who
337	is physically situated, so as to prevent the individual person
338	from leaving the room or area. For purposes of this chapter, the
339	term does not mean isolation due to an individual's a person's
340	medical condition or symptoms.
341	(39)(30) "Secretary" means the Secretary of Children and
342	Family Services.
343	(40) "Service provider" means a public or private
344	receiving facility, an entity under contract with the department
345	to provide mental health services, a community mental health
346	center or clinic, a clinical psychologist, a clinical social
347	worker, a marriage and family therapist, a mental health
348	counselor, a physician, or a psychiatric nurse.
349	(41)(31) "Transfer evaluation" means the process, as
350	approved by the appropriate district office of the department,
351	during which an individual whereby a person who is being
352	considered for placement in a state treatment facility is first
353	evaluated for appropriateness of admission to a state treatment
354	the facility by a community-based public receiving facility or
355	by a community mental health center or clinic if the public
356	receiving facility is not a community mental health center or
357	clinic.
358	(42)(32) "Treatment facility" means a any state-owned,
359	state-operated, or state-supported hospital, or a community
360	mental health center, or clinic, designated by the department
361	for extended treatment and hospitalization of individuals who
362	have a mental illness, beyond that provided for by a receiving
363	facility or a, of persons who have a mental illness, including
364	facilities of the United States Government, and any private
365	facility designated by the department when rendering such
366	services to a person pursuant to the provisions of this part.
367	Patients treated in facilities of the United States Government
368	shall be solely those whose care is the responsibility of the
369	United States Department of Veterans Affairs.
370	(33) "Service provider" means any public or private
371	receiving facility, an entity under contract with the department
372	of Children and Family Services to provide mental health
373	services, a clinical psychologist, a clinical social worker, a
374	marriage and family therapist, a mental health counselor, a
375	physician, a psychiatric nurse as defined in subsection (23), or
376	a community mental health center or clinic as defined in this
377	part.
378	(34) "Involuntary examination" means an examination
379	performed under s. 394.463 to determine if an individual
380	qualifies for involuntary inpatient treatment under s.
381	394.467(1) or involuntary outpatient treatment under s.
382	394.4655(1).
383	(35) "Involuntary placement" means either involuntary
384	outpatient treatment pursuant to s. 394.4655 or involuntary
385	inpatient treatment pursuant to s. 394.467.
386	(36) "Marriage and family therapist" means a person
387	licensed as a marriage and family therapist under chapter 491.
388	(37) "Mental health counselor" means a person licensed as
389	a mental health counselor under chapter 491.
390	(38) "Electronic means" means a form of telecommunication
391	that requires all parties to maintain visual as well as audio
392	communication.
393	Section 3. Section 394.457, Florida Statutes, is amended
394	to read:
395	394.457 Operation and administration.-
396	(1) ADMINISTRATION.-The Department of Children and Family
397	Services is designated the "Mental Health Authority" of Florida.
398	The department and the Agency for Health Care Administration
399	shall exercise executive and administrative supervision over all
400	mental health facilities, programs, and services.
401	(2) RESPONSIBILITIES OF THE DEPARTMENT.-The department is
402	responsible for:
403	(a) The planning, evaluation, and implementation of a
404	complete and comprehensive statewide program of mental health,
405	including community services, receiving and treatment
406	facilities, child services, research, and training as authorized
407	and approved by the Legislature, based on the annual program
408	budget of the department. The department is also responsible for
409	the coordination of efforts with other departments and divisions
410	of the state government, county and municipal governments, and
411	private agencies concerned with and providing mental health
412	services. It is responsible for establishing standards,
413	providing technical assistance, and supervising exercising
414	supervision of mental health programs of, and the treatment of
415	individuals patients at, community facilities, other facilities
416	serving individuals for persons who have a mental illness, and
417	any agency or facility providing services under to patients
418	pursuant to this part.
419	(b) The publication and distribution of an information
420	handbook to facilitate the understanding of this part, the
421	policies and procedures involved in the implementation of this
422	part, and the responsibilities of the various service providers
423	of services under this part. The department It shall stimulate
424	research by public and private agencies, institutions of higher
425	learning, and hospitals in the interest of the elimination and
426	amelioration of mental illness.
427	(3) POWER TO CONTRACT.-The department may contract to
428	provide, and be provided with, services and facilities in order
429	to carry out its responsibilities under this part with respect
430	to the following agencies: public and private hospitals;
431	receiving and treatment facilities; clinics; laboratories;
432	departments, divisions, and other units of state government; the
433	state colleges and universities; the community colleges; private
434	colleges and universities; counties, municipalities, and any
435	other political subdivisions governmental unit, including
436	facilities of the United States Government; and any other public
437	or private entity that which provides or needs facilities or
438	services. Baker Act funds for community inpatient, crisis
439	stabilization, short-term residential treatment, and screening
440	services under this part must be allocated to each county
441	pursuant to the department's funding allocation methodology.
442	Notwithstanding the provisions of s. 287.057(5)(f), contracts
443	for community-based Baker Act services for inpatient, crisis
444	stabilization, short-term residential treatment, and screening
445	provided under this part, other than those with other units of
446	government, to be provided for the department must be awarded
447	using competitive solicitation if sealed bids when the county
448	commission of the county receiving the services makes a request
449	to the department's circuit district office by January 15 of the
450	contracting year. The office may district shall not enter into a
451	competitively bid contract under this provision if such action
452	will result in increases of state or local expenditures for
453	Baker Act services within the circuit district. Contracts for
454	these Baker Act services using competitive solicitation are
455	sealed bids will be effective for 3 years. The department shall
456	adopt rules establishing minimum standards for such contracted
457	services and facilities and shall make periodic audits and
458	inspections to assure that the contracted services are provided
459	and meet the standards of the department.
460	(4) APPLICATION FOR AND ACCEPTANCE OF GIFTS AND GRANTS.-
461	The department may apply for and accept any funds, grants,
462	gifts, or services made available to it by any agency or
463	department of the Federal Government or any other public or
464	private agency or person individual in aid of mental health
465	programs. All such moneys must shall be deposited in the State
466	Treasury and shall be disbursed as provided by law.
467	(5) RULES.-The department shall adopt rules:
468	(a) The department shall adopt rules Establishing forms
469	and procedures relating to the rights and privileges of
470	individuals receiving patients seeking mental health examination
471	or treatment from facilities under this part.
472	(b) The department shall adopt rules Necessary for the
473	implementation and administration of the provisions of this
474	part., and A program subject to the provisions of this part may
475	shall not be permitted to operate unless rules designed to
476	ensure the protection of the health, safety, and welfare of the
477	individuals examined and patients treated under through such
478	program have been adopted. Such rules adopted under this
479	subsection must include provisions governing the use of
480	restraint and seclusion which are consistent with recognized
481	best practices and professional judgment; prohibit inherently
482	dangerous restraint or seclusion procedures; establish
483	limitations on the use and duration of restraint and seclusion;
484	establish measures to ensure the safety of program participants
485	and staff during an incident of restraint or seclusion;
486	establish procedures for staff to follow before, during, and
487	after incidents of restraint or seclusion; establish
488	professional qualifications of and training for staff who may
489	order or be engaged in the use of restraint or seclusion; and
490	establish mandatory reporting, data collection, and data
491	dissemination procedures and requirements. Such rules adopted
492	under this subsection must require that each instance of the use
493	of restraint or seclusion be documented in the clinical record
494	of the individual who has been restrained or secluded patient.
495	(c) The department shall adopt rules Establishing minimum
496	standards for services provided by a mental health overlay
497	program or a mobile crisis response service.
498	(6) PERSONNEL.-
499	(a) The department shall, by rule, establish minimum
500	standards of education and experience for professional and
501	technical personnel employed in mental health programs,
502	including members of a mobile crisis response service.
503	(b) The department shall design and distribute appropriate
504	materials for the orientation and training of persons actively
505	engaged in implementing the provisions of this part relating to
506	the involuntary examination and placement of individuals persons
507	who are believed to have a mental illness.
508	(7) PAYMENT FOR CARE OF PATIENTS.-Fees and fee collections
509	for individuals receiving treatment or services patients in
510	state-owned, state-operated, or state-supported treatment
511	facilities must shall be in accordance with according to s.
512	402.33.
513	Section 4. Section 394.4572, Florida Statutes, is amended
514	to read:
515	394.4572 Screening of mental health personnel.-
516	(1)(a) The department and the Agency for Health Care
517	Administration shall require employment screening for mental
518	health personnel using the standards for level 2 screening
519	standards provided in s. 435.04 set forth in chapter 435.
520	"Mental health personnel" includes all program directors,
521	professional clinicians, staff members, and volunteers working
522	in public or private mental health programs and facilities who
523	have direct contact with individuals held for examination or
524	admitted for mental health treatment unmarried patients under
525	the age of 18 years. For purposes of this chapter, employment
526	screening of mental health personnel shall also include, but is
527	not limited to, employment screening as provided under chapter
528	435.
529	(a)(b) Students in the health care professions who are
530	interning in a mental health facility licensed under chapter
531	395, where the primary purpose of the facility is not the
532	treatment of minors, are exempt from the fingerprinting and
533	screening requirements if, provided they are under direct
534	supervision in the actual physical presence of a licensed health
535	care professional.
536	(c) Mental health personnel working in a facility licensed
537	under chapter 395 who have less than 15 hours per week of direct
538	contact with patients or who are health care professionals
539	licensed by the Agency for Health Care Administration or a board
540	thereunder are exempt from the fingerprinting and screening
541	requirements, except for persons working in mental health
542	facilities where the primary purpose of the facility is the
543	treatment of minors.
544	(b)(d) A volunteer who assists on an intermittent basis
545	for less than 40 hours per month is exempt from the
546	fingerprinting and screening requirements if, provided the
547	volunteer is under direct and constant supervision by persons
548	who meet the screening requirements of this section paragraph
549	(a).
550	(2) The department or the Agency for Health Care
551	Administration may grant exemptions from disqualification as
552	provided in s. 435.07 435.06.
553	(3) Prospective mental health personnel who have
554	previously been fingerprinted or screened pursuant to this
555	chapter, chapter 393, chapter 397, chapter 402, or chapter 409,
556	or teachers who have been fingerprinted pursuant to chapter
557	1012, who have not been unemployed for more than 90 days
558	thereafter, and who under the penalty of perjury attest to the
559	completion of such fingerprinting or screening and to compliance
560	with the provisions of this section and the standards for level
561	1 screening under contained in chapter 435, are shall not be
562	required to be refingerprinted or rescreened in order to comply
563	with the any screening requirements of this part.
564	Section 5. Section 394.4573, Florida Statutes, is amended
565	to read:
566	394.4573 Continuity of care management system; measures of
567	performance; reports.-
568	(1) For the purposes of this section:
569	(a) "Case management" means those activities aimed at
570	assessing the client needs, planning services, linking the
571	service system to a client, coordinating the various system
572	components, monitoring service delivery, and evaluating the
573	effect of service delivery for individuals eligible for publicly
574	funded mental health services.
575	(b) "Case manager" means a person an individual who works
576	with individuals who are eligible for publicly funded mental
577	health services clients, and their families and significant
578	others, to provide case management.
579	(c) "Client manager" means an employee of the department
580	who is assigned to specific provider agencies and geographic
581	areas to ensure that the full range of needed services is
582	available to individuals who are eligible for publicly funded
583	mental health services clients.
584	(d) "Continuity of care management system" means a system
585	that assures, within available resources, that individuals who
586	are eligible for publicly funded mental health services clients
587	have access to the full array of services within the mental
588	health services delivery system.
589	(2) The department shall is directed to implement a
590	continuity of care management system for the provision of mental
591	health care, through the provision of client and case
592	management, including individuals clients referred from state
593	treatment facilities to community mental health facilities. Such
594	system must shall include a statewide network of client managers
595	and case managers throughout the state designed to:
596	(a) Reduce the possibility of an individual's a client's
597	admission or readmission to a state treatment facility.
598	(b) Provide for the creation or designation of an agency
599	in each county to provide single intake services for each
600	individual person seeking mental health services. Such agency
601	shall provide information and referral services necessary to
602	ensure that such individuals clients receive the most
603	appropriate and least restrictive form of care, based on the
604	individual's individual needs of the person seeking treatment.
605	Such agency shall have a single telephone number, operating 24
606	hours per day, 7 days per week, if where practicable, at a
607	central location, where each individual receiving mental health
608	services has client will have a client central record.
609	(c) Advocate on behalf of the individual receiving mental
610	health services client to ensure that all appropriate services
611	are provided afforded to the client in a timely and dignified
612	manner.
613	(d) Require a that any public receiving facility
614	initiating an individual's a patient transfer to a licensed
615	hospital for acute care mental health services not accessible
616	through the public receiving facility to shall notify the
617	hospital of the such transfer and send all records relating to
618	the emergency psychiatric or medical condition.
619	(3) The department shall is directed to develop and
620	include performance measures in contracts with service providers
621	relating to measures of performance with regard to goals and
622	objectives as specified in the state plan. Such measures shall
623	use, To the extent practical, such measures must use existing
624	data collection methods and reports and may shall not require,
625	as a result of this subsection, additional reports on the part
626	of service providers. The department shall plan monitoring
627	visits of community mental health facilities with other state,
628	federal, and local governmental and private agencies charged
629	with monitoring such facilities.
630	(4) The department is directed to submit a report to the
631	Legislature, prior to April 1 of each year, outlining
632	departmental progress towards the implementation of the minimum
633	staffing patterns' standards in state mental health treatment
634	facilities. The report shall contain, by treatment facility,
635	information regarding goals and objectives and departmental
636	performance toward meeting each such goal and objective.
637	Section 6. Paragraph (a) of subsection (2) and subsection
638	(3) of section 394.4574, Florida Statutes, are amended to read:
639	394.4574 Department responsibilities for a mental health
640	resident who resides in an assisted living facility that holds a
641	limited mental health license.-
642	(2) The department must ensure that:
643	(a) A mental health resident has been assessed by a
644	psychiatrist, clinical psychologist, clinical social worker, or
645	psychiatric nurse, or an individual who is supervised by one of
646	these professionals, and determined to be appropriate to reside
647	in an assisted living facility. The documentation must be
648	provided to the administrator of the facility within 30 days
649	after the mental health resident has been admitted to the
650	facility. An evaluation completed upon discharge from a state
651	mental health treatment facility hospital meets the requirements
652	of this subsection related to appropriateness for placement as a
653	mental health resident if it was completed within 90 days before
654	prior to admission to the facility.
655	(3) The secretary of Children and Family Services, in
656	consultation with the Agency for Health Care Administration,
657	shall annually require each circuit district administrator to
658	develop, with community input, detailed plans that demonstrate
659	how the circuit district will ensure the provision of state-
660	funded mental health and substance abuse treatment services to
661	residents of assisted living facilities that hold a limited
662	mental health license. These plans must be consistent with the
663	substance abuse and mental health circuit district plan
664	developed pursuant to s. 394.75 and must address case management
665	services; access to consumer-operated drop-in centers; access to
666	services during evenings, weekends, and holidays; supervision of
667	the clinical needs of the residents; and access to emergency
668	psychiatric care.
669	Section 7. Subsection (1) of section 394.458, Florida
670	Statutes, is amended to read:
671	394.458 Introduction or removal of certain articles
672	unlawful; penalty.-
673	(1)(a) Except as authorized by law or as specifically
674	authorized by the person in charge of a receiving or treatment
675	facility each hospital providing mental health services under
676	this part, it is unlawful to:
677	(a) Introduce into or upon the grounds of such facility
678	hospital, or to take or attempt to take or send from the
679	facility therefrom, any of the following articles, which are
680	hereby declared to be contraband for the purposes of this
681	section:
682	1. An Any intoxicating beverage or beverage that which
683	causes or may cause an intoxicating effect;
684	2. A Any controlled substance as defined in chapter 893;
685	or
686	3. A firearm Any firearms or deadly weapon.
687	(b) It is unlawful to Transmit to, or attempt to transmit
688	to, or cause or attempt to cause to be transmitted to, or
689	received by, any individual receiving mental health services
690	from a receiving or treatment facility patient of any hospital
691	providing mental health services under this part any article or
692	thing declared by this section to be contraband, at any place
693	which is outside of the grounds of such facility hospital,
694	except as authorized by law or as specifically authorized by the
695	person in charge of such hospital.
696	Section 8. Section 394.459, Florida Statutes, is amended
697	to read:
698	394.459 Rights of individuals receiving treatment and
699	services patients.-
700	(1) RIGHT TO INDIVIDUAL DIGNITY.-It is the policy of this
701	state that the individual dignity of all individuals held for
702	examination or admitted for mental health treatment the patient
703	shall be respected at all times and upon all occasions,
704	including any occasion when the individual patient is taken into
705	custody, held, or transported. Procedures, facilities, vehicles,
706	and restraining devices used utilized for criminals or those
707	accused of a crime may shall not be used in connection with
708	individuals persons who have a mental illness, except for the
709	protection of that individual the patient or others. Individuals
710	Persons who have a mental illness but who are not charged with a
711	criminal offense may shall not be detained or incarcerated in
712	the jails of this state. An individual A person who is receiving
713	treatment for mental illness may shall not be deprived of any
714	constitutional rights. However, if such individual a person is
715	adjudicated incapacitated, his or her rights may be limited to
716	the same extent that the rights of any incapacitated person are
717	limited by law.
718	(2) RIGHT TO TREATMENT.-Each individual held for
719	examination or admitted for mental health treatment:
720	(a) May A person shall not be denied treatment for mental
721	illness, and services may shall not be delayed at a receiving or
722	treatment facility because of inability to pay. However, every
723	reasonable effort to collect appropriate reimbursement for the
724	cost of providing mental health services from individuals to
725	persons able to pay for services, including insurance or third-
726	party payers payments, shall be made by facilities providing
727	services under pursuant to this part.
728	(b) Shall be provided It is further the policy of the
729	state that the least restrictive appropriate available
730	treatment, be utilized based on the individual's individual
731	needs and best interests, of the patient and consistent with the
732	optimum improvement of the individual's patient's condition.
733	(c) Each person who remains at a receiving or treatment
734	facility for more than 12 hours Shall be given a physical
735	examination and psychiatric evaluation by a health practitioners
736	practitioner authorized by law to give such examinations, within
737	24 hours after arrival at such facility if they have not been
738	released or discharged pursuant to s. 394.463(2)(h) or s.
739	394.469. The physical examination and psychiatric evaluation
740	must be documented in the clinical record.
741	(d) Every patient in a facility Shall be afforded the
742	opportunity to participate in activities designed to enhance
743	self-image and the beneficial effects of other treatments, as
744	determined by the facility.
745	(e) Not more than 5 days after admission to a facility,
746	each patient Shall have and receive an individualized treatment
747	plan in writing, which the individual patient has had an
748	opportunity to assist in preparing and to review prior to its
749	implementation, within 5 days after admission to a facility. The
750	plan must shall include a space for the individual's patient's
751	comments and signature.
752	(3) RIGHT TO EXPRESS AND INFORMED PATIENT CONSENT.-
753	(a)1. Each individual patient entering treatment shall be
754	asked to give express and informed consent for admission or
755	treatment.
756	1. If the individual patient has been adjudicated
757	incapacitated or found to be incompetent to consent to
758	treatment, express and informed consent must to treatment shall
759	be sought instead from his or her the patient's guardian or
760	guardian advocate. If the individual patient is a minor, express
761	and informed consent for admission or treatment must be obtained
762	shall also be requested from the patient's guardian. Express and
763	informed consent for admission or treatment of a patient under
764	18 years of age shall be required from the minor's patient's
765	guardian, unless the minor is seeking outpatient crisis
766	intervention services under s. 394.4784. Express and informed
767	consent for admission or treatment given by a patient who is
768	under 18 years of age shall not be a condition of admission when
769	the patient's guardian gives express and informed consent for
770	the patient's admission pursuant to s. 394.463 or s. 394.467.
771	2. Before giving express and informed consent, the
772	following information shall be provided and explained in plain
773	language to the individual patient, or to his or her the
774	patient's guardian if the individual patient is an adult 18
775	years of age or older and has been adjudicated incapacitated, or
776	to his or her the patient's guardian advocate if the individual
777	patient has been found to be incompetent to consent to
778	treatment, or to both the individual patient and the guardian if
779	the individual patient is a minor: the reason for admission or
780	treatment; the proposed treatment; the purpose of the treatment
781	to be provided; the common risks, benefits, and side effects
782	thereof; the specific dosage range for the medication, when
783	applicable; alternative treatment modalities; the approximate
784	length of care; the potential effects of stopping treatment; how
785	treatment will be monitored; and that any consent given for
786	treatment may be revoked orally or in writing before or during
787	the treatment period by the individual receiving the treatment
788	patient or by a person who is legally authorized to make health
789	care decisions on the individual's behalf of the patient.
790	(b) Before performing a medical procedure In the case of
791	medical procedures requiring the use of a general anesthetic or
792	electroconvulsive treatment, and prior to performing the
793	procedure, express and informed consent must shall be obtained
794	from the individual subject to the procedure patient if the
795	individual patient is legally competent, from the guardian of a
796	minor patient, from the guardian of an individual a patient who
797	has been adjudicated incapacitated, or from the individual's
798	guardian advocate of the patient if the guardian advocate has
799	been given express court authority to consent to medical
800	procedures or electroconvulsive treatment as provided under s.
801	394.4598.
802	(c) If When the department is the legal guardian of a
803	patient, or is the custodian of an individual a patient whose
804	physician is unwilling to perform a medical procedure, including
805	an electroconvulsive treatment, based solely on the individual's
806	patient's consent and whose guardian or guardian advocate is
807	unknown or unlocatable, the court shall hold a hearing to
808	determine the medical necessity of the medical procedure. The
809	individual subject to the procedure must patient shall be
810	physically present, unless his or her the patient's medical
811	condition precludes such presence, represented by counsel, and
812	provided the right and opportunity to be confronted with, and to
813	cross-examine, all witnesses alleging the medical necessity of
814	such procedure. In such proceedings, the burden of proof by
815	clear and convincing evidence is shall be on the party alleging
816	the medical necessity of the procedure.
817	(d) The administrator of a receiving or treatment facility
818	may, upon the recommendation of an individual's the patient's
819	attending physician, authorize emergency medical treatment,
820	including a surgical procedure, if such treatment is deemed
821	lifesaving, or if the situation threatens serious bodily harm to
822	the individual patient, and the permission of the individual
823	patient or his or her the patient's guardian or guardian
824	advocate cannot be obtained.
825	(4) QUALITY OF TREATMENT.-
826	(a) Each individual held for examination or admitted for
827	mental health treatment, or receiving involuntary outpatient
828	treatment patient shall receive services, including, for a
829	patient placed under s. 394.4655, shall receive those services
830	that are included in the court order which are suited to his or
831	her needs, and which shall be administered skillfully, safely,
832	and humanely with full respect for the individual's patient's
833	dignity and personal integrity. Each individual must patient
834	shall receive such medical, vocational, social, educational, and
835	rehabilitative services as his or her condition requires in
836	order to live successfully in the community. In order to achieve
837	this goal, the department shall is directed to coordinate its
838	mental health programs with all other programs of the department
839	and other state agencies.
840	(b) Facilities shall develop and maintain, in a form
841	accessible to and readily understandable by individuals held for
842	examination or admitted for mental health treatment, patients
843	and consistent with rules adopted by the department, the
844	following:
845	1. Criteria, procedures, and required staff training for
846	the any use of close or elevated levels of supervision;, of
847	restraint, seclusion, or isolation;, or of emergency treatment
848	orders;, and for the use of bodily control and physical
849	management techniques.
850	2. Procedures for documenting, monitoring, and requiring
851	clinical review of all uses of the procedures described in
852	subparagraph 1. and for documenting and requiring review of any
853	incidents resulting in injury to individuals receiving services
854	patients.
855	3. A system for investigating, tracking, managing, and
856	responding to complaints by individuals persons receiving
857	services or persons individuals acting on their behalf.
858	4. Procedures for reporting events that place individuals
859	receiving services at risk of harm. Such events must be reported
860	to the department in accordance with department operating
861	procedures after discovery and include, but are not limited to:
862	a. An individual whose life terminates due to a natural,
863	unnatural, expected, or unexpected cause while in the facility
864	or within 72 hours after release.
865	b. An injury sustained, or allegedly sustained, due to an
866	accident, act of abuse, neglect, or suicide attempt requiring
867	medical treatment by a licensed health care practitioner in an
868	acute care medical facility.
869	c. The unauthorized departure or absence of an individual
870	from a facility in which he or she has been held for involuntary
871	examination or involuntary placement.
872	d. An unusual occurrence or circumstance precipitated by
873	something uncommon, abnormal, or out of the ordinary, such as a
874	tornado, kidnapping, riot, or hostage situation that jeopardizes
875	the health, safety, or welfare of the individual.
876	e. An allegation of sexual battery upon the individual.
877	(c) A facility may not use seclusion or restraint for
878	punishment, to compensate for inadequate staffing, or for the
879	convenience of staff. Facilities shall ensure that all staff are
880	made aware of these restrictions on the use of seclusion and
881	restraint and shall make and maintain records that which
882	demonstrate that this information has been conveyed to each
883	individual staff member members.
884	(5) COMMUNICATION, ABUSE REPORTING, AND VISITS.-
885	(a) Each individual held for examination or admitted for
886	mental health treatment person receiving services in a facility
887	providing mental health services under this part has the right
888	to communicate freely and privately with persons outside the
889	facility unless it is determined that such communication is
890	likely to be harmful to the individual person or others. Each
891	facility shall make available as soon as reasonably possible to
892	persons receiving services a telephone that allows for free
893	local calls and access to a long-distance service available to
894	the individual as soon as reasonably possible. A facility is not
895	required to pay the costs of the individual's a patient's long-
896	distance calls. The telephone must shall be readily accessible
897	to the patient and shall be placed so that the individual
898	patient may use it to communicate privately and confidentially.
899	The facility may establish reasonable rules for the use of this
900	telephone which, provided that the rules do not interfere with
901	an individual's a patient's access to a telephone to report
902	abuse pursuant to paragraph (e).
903	(b) Each individual patient admitted to a facility under
904	the provisions of this part shall be allowed to receive, send,
905	and mail sealed, unopened correspondence; and the individual's
906	no patient's incoming or outgoing correspondence may not shall
907	be opened, delayed, held, or censored by the facility unless
908	there is reason to believe that it contains items or substances
909	that which may be harmful to the individual patient or others,
910	in which case the administrator may direct reasonable
911	examination of such mail and may regulate the disposition of
912	such items or substances.
913	(c) Each facility shall allow must permit immediate access
914	to an individual held for examination or admitted for mental
915	health treatment any patient, subject to the patient's right to
916	deny or withdraw consent at any time, by the individual, or by
917	the individual's patient's family members, guardian, guardian
918	advocate, representative, Florida statewide or local advocacy
919	council, or attorney, unless such access would be detrimental to
920	the individual patient. If the a patient's right to communicate
921	or to receive visitors is restricted by the facility, written
922	notice of such restriction and the reasons for the restriction
923	shall be served on the individual and patient, the individual's
924	patient's attorney, and the patient's guardian, guardian
925	advocate, or representative,; and such restriction, and the
926	reasons for the restriction, must shall be recorded in on the
927	patient's clinical record with the reasons therefor. The
928	restriction must of a patient's right to communicate or to
929	receive visitors shall be reviewed at least every 7 days. The
930	right to communicate or receive visitors may shall not be
931	restricted as a means of punishment. Nothing in This paragraph
932	does not shall be construed to limit the provisions of paragraph
933	(d).
934	(d) Each facility shall establish reasonable rules
935	governing visitors, visiting hours, and the use of telephones by
936	individuals held for examination or admitted for mental health
937	treatment patients in the least restrictive possible manner. An
938	individual has Patients shall have the right to contact and to
939	receive communication from his or her attorney their attorneys
940	at any reasonable time.
941	(e) Each individual held for examination or admitted for
942	patient receiving mental health treatment in any facility shall
943	have ready access to a telephone in order to report an alleged
944	abuse. The facility staff shall orally and in writing inform
945	each individual patient of the procedure for reporting abuse and
946	shall make every reasonable effort to present the information in
947	a language the individual patient understands. A written copy of
948	that procedure, including the telephone number of the central
949	abuse hotline and reporting forms, must shall be posted in plain
950	view.
951	(f) The department shall adopt rules providing a procedure
952	for reporting abuse. Facility staff shall be required, as a
953	condition of employment, must to become familiar with the
954	requirements and procedures for the reporting of abuse.
955	(6) CARE AND CUSTODY OF PERSONAL EFFECTS OF PATIENTS.-The
956	rights of an individual held for examination or admitted for
957	mental health treatment A patient's right to the possession of
958	his or her clothing and personal effects shall be respected. The
959	facility may take temporary custody of such effects if when
960	required for medical and safety reasons. The A patient's
961	clothing and personal effects shall be inventoried upon their
962	removal into temporary custody. Copies of this inventory shall
963	be given to the individual patient and to his or her the
964	patient's guardian, guardian advocate, or representative and
965	shall be recorded in the patient's clinical record. This
966	inventory may be amended upon the request of the individual
967	patient or his or her the patient's guardian, guardian advocate,
968	or representative. The inventory and any amendments to it must
969	be witnessed by two members of the facility staff and by the
970	individual patient, if he or she is able. All of the a patient's
971	clothing and personal effects held by the facility must shall be
972	returned to the individual patient immediately upon his or her
973	the discharge or transfer of the patient from the facility,
974	unless such return would be detrimental to the individual
975	patient. If personal effects are not returned to the patient,
976	the reason must be documented in the clinical record along with
977	the disposition of the clothing and personal effects, which may
978	be given instead to the individual's patient's guardian,
979	guardian advocate, or representative. As soon as practicable
980	after an emergency transfer of a patient, the individual's
981	patient's clothing and personal effects shall be transferred to
982	the individual's patient's new location, together with a copy of
983	the inventory and any amendments, unless an alternate plan is
984	approved by the individual patient, if he or she is able, and by
985	his or her the patient's guardian, guardian advocate, or
986	representative.
987	(7) VOTING IN PUBLIC ELECTIONS.-An individual held for
988	examination or admitted for mental health treatment A patient
989	who is eligible to vote according to the laws of the state has
990	the right to vote in the primary and general elections. The
991	department shall establish rules to enable such individuals
992	patients to obtain voter registration forms, applications for
993	absentee ballots, and absentee ballots.
994	(8) HABEAS CORPUS.-
995	(a) At any time, and without notice, an individual a
996	person held for examination in a receiving or treatment
997	facility, or a relative, friend, guardian, guardian advocate,
998	representative, or attorney, or the department, on behalf of
999	such individual person, may petition for a writ of habeas corpus
1000	to question the cause and legality of such detention and request
1001	that the court order a return to the writ in accordance with
1002	chapter 79. Each individual patient held in a facility shall
1003	receive a written notice of the right to petition for a writ of
1004	habeas corpus.
1005	(b) At any time, and without notice, an individual
1006	admitted for mental health treatment a person who is a patient
1007	in a receiving or treatment facility, or a relative, friend,
1008	guardian, guardian advocate, representative, or attorney, or the
1009	department, on behalf of such individual person, may file a
1010	petition in the circuit court in the county where the individual
1011	patient is being held alleging that he or she the patient is
1012	being unjustly denied a right or privilege granted under this
1013	section herein or that a procedure authorized under this section
1014	herein is being abused. Upon the filing of such a petition, the
1015	court may shall have the authority to conduct a judicial inquiry
1016	and to issue an any order needed to correct an abuse of the
1017	provisions of this part.
1018	(c) The administrator of any receiving or treatment
1019	facility receiving a petition under this subsection shall file
1020	the petition with the clerk of the court on the next court
1021	working day.
1022	(d) A No fee may not shall be charged for the filing of a
1023	petition under this subsection.
1024	(9) VIOLATIONS.-The department shall report to the Agency
1025	for Health Care Administration any violation of the rights or
1026	privileges of individuals patients, or of any procedures
1027	provided under this part, by any facility or professional
1028	licensed or regulated by the agency. The agency may is
1029	authorized to impose any sanction authorized for violation of
1030	this part, based solely on the investigation and findings of the
1031	department.
1032	(10) LIABILITY FOR VIOLATIONS.-Any person who violates or
1033	abuses the any rights or privileges of individuals held for
1034	examination or admitted for mental health treatment patients
1035	provided under by this part is liable for damages as determined
1036	by law. Any person who acts reasonably, in good faith, and
1037	without negligence in compliance with the provisions of this
1038	part is immune from civil or criminal liability for his or her
1039	actions in connection with the preparation or execution of
1040	petitions, applications, certificates, reports, or other
1041	documents initiating admission to a facility or the
1042	apprehension, detention, transportation, examination, admission,
1043	diagnosis, treatment, or discharge of an individual a patient to
1044	or from a facility. However, this section does not relieve any
1045	person from liability if such person commits negligence.
1046	(11) RIGHT TO PARTICIPATE IN TREATMENT AND DISCHARGE
1047	PLANNING.-An individual held for examination or admitted for
1048	mental health treatment The patient shall have the opportunity
1049	to participate in treatment and discharge planning and shall be
1050	notified in writing of his or her right, upon discharge from the
1051	facility, to seek treatment from the professional or agency of
1052	the individual's patient's choice.
1053	(12) ADVANCE DIRECTIVES.-All receiving and treatment
1054	facilities and other service providers shall provide information
1055	concerning advance directives and assist individuals who are
1056	competent and willing to complete an advance directive. The
1057	directive may include instructions regarding mental health care.
1058	Receiving and treatment facilities and service providers must
1059	honor the advance directive of an individual admitted to or
1060	served by the facility or provider.
1061	(13)(12) POSTING OF NOTICE OF RIGHTS OF PATIENTS.-Each
1062	facility shall post a notice, which lists and describes in
1063	listing and describing, in the language and terminology that the
1064	individual persons to whom the notice is addressed can
1065	understand, of the rights provided under in this section. This
1066	notice must shall include a statement that provisions of the
1067	federal Americans with Disabilities Act apply and the name and
1068	telephone number of a person to contact for further information.
1069	The This notice must shall be posted in a place readily
1070	accessible to patients and in a format easily seen by the
1071	individuals served patients. The This notice must shall include
1072	the telephone numbers of the Florida local advocacy council and
1073	Advocacy Center for Persons with Disabilities, Inc.
1074	Section 9. Subsections (1), (2), (3), and (4) of section
1075	394.4593, Florida Statutes, are amended to read:
1076	394.4593 Sexual misconduct prohibited; reporting required;
1077	penalties.-
1078	(1) As used in this section, the term:
1079	(a) "Employee" includes any paid staff member, volunteer,
1080	or intern of the department; any person under contract with the
1081	department; and any person providing care or support to an
1082	individual a client on behalf of the department or its service
1083	providers.
1084	(b) "Sexual activity" means:
1085	1. Fondling the genital area, groin, inner thighs,
1086	buttocks, or breasts of an individual a person.
1087	2. The oral, anal, or vaginal penetration by or union with
1088	the sexual organ of another or the anal or vaginal penetration
1089	of another by any other object.
1090	3. Intentionally touching in a lewd or lascivious manner
1091	the breasts, genitals, the genital area, or buttocks, or the
1092	clothing covering them, of an individual a person, or forcing or
1093	enticing an individual a person to touch the perpetrator.
1094	4. Intentionally masturbating in the presence of another
1095	person.
1096	5. Intentionally exposing the genitals in a lewd or
1097	lascivious manner in the presence of another individual person.
1098	6. Intentionally committing any other sexual act that does
1099	not involve actual physical or sexual contact with another
1100	individual the victim, including, but not limited to,
1101	sadomasochistic abuse, sexual bestiality, or the simulation of
1102	any act involving sexual activity in the presence of the
1103	individual a victim.
1104	(c) "Sexual misconduct" means any sexual activity between
1105	an employee and an individual held for examination or admitted
1106	for mental health treatment a patient, regardless of the consent
1107	of that individual the patient. The term does not include an act
1108	done for a bona fide medical purpose or an internal search
1109	conducted in the lawful performance of duty by an employee.
1110	(2) An employee who engages in sexual misconduct with an
1111	individual a patient who:
1112	(a) Is in the custody of the department; or
1113	(b) Resides in a receiving facility or a treatment
1114	facility, as those terms are defined in s. 394.455,
1115
1116	commits a felony of the second degree, punishable as provided in
1117	s. 775.082, s. 775.083, or s. 775.084. An employee may be found
1118	guilty of violating this subsection without having committed the
1119	crime of sexual battery.
1120	(3) The consent of an individual held for examination or
1121	admitted for treatment the patient to the sexual activity is not
1122	a defense to prosecution under this section.
1123	(4) This section does not apply to an employee who:
1124	(a) Is legally married to the individual patient; or
1125	(b) Has no reason to believe that the person with whom the
1126	employee engaged in sexual misconduct is an individual a patient
1127	receiving services as described in subsection (2).
1128	Section 10. Section 394.4595, Florida Statutes, is amended
1129	to read:
1130	394.4595 Florida statewide and local advocacy councils;
1131	access to patients and records.-Any facility designated by the
1132	department as a receiving or treatment facility must allow
1133	access to any individual held for examination or admitted for
1134	mental health treatment patient and his or her the clinical and
1135	legal records of any patient admitted pursuant to the provisions
1136	of this act by members of the Florida statewide and local
1137	advocacy councils.
1138	Section 11. Section 394.4597, Florida Statutes, is amended
1139	to read:
1140	394.4597 Persons to be notified; appointment of a
1141	patient's representative.-
1142	(1) VOLUNTARY ADMISSION PATIENTS.-At the time an
1143	individual a patient is voluntarily admitted to a receiving or
1144	treatment facility, the identity and contact information of the
1145	a person to be notified in case of an emergency shall be entered
1146	in the patient's clinical record.
1147	(2) INVOLUNTARY ADMISSION PATIENTS.-
1148	(a) At the time an individual a patient is admitted to a
1149	facility for involuntary examination or placement, or when a
1150	petition for involuntary placement is filed, the names,
1151	addresses, and telephone numbers of the individual's patient's
1152	guardian or guardian advocate, or representative if he or she
1153	the patient has no guardian or guardian advocate, health care
1154	surrogate, and the patient's attorney shall be entered in the
1155	patient's clinical record.
1156	(a)(b) If the individual patient has no guardian or
1157	guardian advocate, he or she the patient shall be asked to
1158	designate a representative. If the individual patient is unable
1159	or unwilling to designate a representative, the facility shall
1160	select a representative.
1161	(b)(c) The individual patient shall be consulted with
1162	regard to the selection of a representative by the receiving or
1163	treatment facility and may shall have authority to request that
1164	the any such representative be replaced.
1165	(c)(d) If When the receiving or treatment facility selects
1166	a representative, first preference shall be given to a health
1167	care surrogate, if one has been previously selected by the
1168	patient. If the individual patient has not previously selected a
1169	health care surrogate, the selection, except for good cause
1170	documented in the patient's clinical record, shall be made from
1171	the following list in the order of listing:
1172	1. The individual's patient's spouse.
1173	2. An adult child of the individual patient.
1174	3. A parent of the individual patient.
1175	4. The adult next of kin of the individual patient.
1176	5. An adult friend of the individual patient.
1177	6. The appropriate Florida local advocacy council as
1178	provided in s. 402.166.
1179	(d)(e) A licensed professional providing services to the
1180	individual patient under this part, an employee of a facility
1181	providing direct services to the individual patient under this
1182	part, a department employee, a person providing other
1183	substantial services to the individual patient in a professional
1184	or business capacity, or a creditor of the individual may
1185	patient shall not be appointed as the patient's representative.
1186	(e) The representative selected by the individual or
1187	designated by the facility has the right, authority, and
1188	responsibility to:
1189	1. Receive notice of the individual's admission;
1190	2. Receive notice of proceedings affecting the individual;
1191	3. Have immediate access to the individual unless such
1192	access is documented to be detrimental to the individual;
1193	4. Receive notice of any restriction of the individual's
1194	right to communicate or receive visitors;
1195	5. Receive a copy of the inventory of personal effects
1196	upon the individual's admission and to request an amendment to
1197	the inventory at any time;
1198	6. Receive disposition of the individual's clothing and
1199	personal effects if not returned to the individual, or to
1200	approve an alternate plan;
1201	7. Petition on behalf of the individual for a writ of
1202	habeas corpus to question the cause and legality of the
1203	individual's detention or to allege that the individual is being
1204	unjustly denied a right or privilege granted under this section,
1205	or that a procedure authorized under this section is being
1206	abused;
1207	8. Apply for a change of venue for the individual's
1208	involuntary placement hearing for the convenience of the parties
1209	or witnesses or because of the individual's condition;
1210	9. Receive written notice of any restriction of the
1211	individual's right to inspect his or her clinical record;
1212	10. Receive notice of the release of the individual from a
1213	receiving facility where an involuntary examination was
1214	performed;
1215	11. Receive a copy of any petition for the individual's
1216	involuntary placement filed with the court; and
1217	12. Be informed by the court of the individual's right to
1218	an independent expert evaluation pursuant to involuntary
1219	placement procedures.
1220	Section 12. Section 394.4598, Florida Statutes, is amended
1221	to read:
1222	394.4598 Guardian advocate.-
1223	(1) The administrator may petition the court for the
1224	appointment of a guardian advocate based upon the opinion of a
1225	psychiatrist that an individual held for examination or admitted
1226	for mental health treatment the patient is incompetent to
1227	consent to treatment. If the court finds that the individual a
1228	patient is incompetent to consent to treatment and has not been
1229	adjudicated incapacitated and a guardian having with the
1230	authority to consent to mental health treatment has not been
1231	appointed, it shall appoint a guardian advocate. The individual
1232	patient has the right to have an attorney represent him or her
1233	at the hearing. If the individual person is indigent, the court
1234	shall appoint the office of the public defender to represent him
1235	or her at the hearing. The individual patient has the right to
1236	testify, cross-examine witnesses, and present witnesses. The
1237	proceeding must shall be recorded either electronically or
1238	stenographically, and testimony shall be provided under oath.
1239	One of the professionals authorized to give an opinion in
1240	support of a petition for involuntary placement, as described in
1241	s. 394.4655 or s. 394.467, must testify. The A guardian advocate
1242	must meet the qualifications of a guardian pursuant to contained
1243	in part IV of chapter 744., except that A professional providing
1244	services to the individual under referred to in this part, an
1245	employee of the facility providing direct services to the
1246	individual patient under this part, a departmental employee, a
1247	facility administrator, or a member of the Florida local
1248	advocacy council may shall not be appointed. A person who is
1249	appointed as a guardian advocate must agree to the appointment.
1250	(2) A facility requesting appointment of a guardian
1251	advocate must, prior to the appointment, provide the prospective
1252	guardian advocate with information concerning about the duties
1253	and responsibilities of guardian advocates, including the
1254	information about the ethics of medical decisionmaking. Before
1255	asking a guardian advocate to give consent to treatment for an
1256	individual held for examination or admitted for mental health
1257	treatment a patient, the facility must shall provide to the
1258	guardian advocate sufficient information so that the guardian
1259	advocate can decide whether to give express and informed consent
1260	to the treatment, including information that the treatment is
1261	essential to the care of the individual patient, and that the
1262	treatment does not present an unreasonable risk of serious,
1263	hazardous, or irreversible side effects. Before giving consent
1264	to treatment, the guardian advocate must meet and talk with the
1265	individual patient and the individual's patient's physician
1266	face-to-face in person, if at all possible, and by telephone, if
1267	not. The guardian advocate shall make every effort to make the
1268	mental health care decision that he or she believes the
1269	individual would have made under the circumstances if the
1270	individual were capable of making such decision. The decision of
1271	the guardian advocate may be reviewed by the court, upon
1272	petition of the individual's patient's attorney or, the
1273	patient's family, or the facility administrator.
1274	(3) Before Prior to a guardian advocate may exercise
1275	exercising his or her authority, the guardian advocate must
1276	complete shall attend a training course approved by the court.
1277	The This training course, of not less than 4 hours, must
1278	include, at minimum, information concerning individual about the
1279	patient rights, psychotropic medications, diagnosis of mental
1280	illness, the ethics of medical decisionmaking, and duties of
1281	guardian advocates. This training course shall take the place of
1282	the training required for guardians appointed under pursuant to
1283	chapter 744.
1284	(4) The information provided to be supplied to prospective
1285	guardian advocates before prior to their appointment and the
1286	training course for guardian advocates must be developed and
1287	completed through a course developed by the department and
1288	approved by the chief judge of the circuit court and taught by a
1289	court-approved organization. Court-approved organizations may
1290	include, but are not limited to, community or junior colleges,
1291	guardianship organizations, and the local bar association or The
1292	Florida Bar. The court may, in its discretion, waive some or all
1293	of the training requirements for guardian advocates or impose
1294	additional requirements. The court shall make its decision on a
1295	case-by-case basis and, in making its decision, shall consider
1296	the experience and education of the guardian advocate, the
1297	duties assigned to the guardian advocate, and the needs of the
1298	individual whom the guardian advocate represents patient.
1299	(5) In selecting a guardian advocate, the court shall give
1300	preference to a health care surrogate, if one has already been
1301	designated by the individual held for examination or admitted
1302	for mental health treatment patient. If the individual patient
1303	has not previously selected a health care surrogate, except for
1304	good cause documented in the court record, the selection shall
1305	be made from the following list in the order of listing:
1306	(a) The individual's patient's spouse.
1307	(b) An adult child of the individual patient.
1308	(c) A parent of the individual patient.
1309	(d) The adult next of kin of the individual patient.
1310	(e) An adult friend of the individual patient.
1311	(f) An adult trained and willing to serve as guardian
1312	advocate for the individual patient.
1313	(6) If a guardian having with the authority to consent to
1314	medical treatment has not already been appointed, or if the
1315	individual held for examination or admitted for mental health
1316	treatment patient has not already designated a health care
1317	surrogate, the court may authorize the guardian advocate to
1318	consent to medical treatment, as well as mental health
1319	treatment. Unless otherwise limited by the court, a guardian
1320	advocate that has with authority to consent to medical treatment
1321	shall have the same authority to make health care decisions and
1322	be subject to the same restrictions as a proxy appointed under
1323	part IV of chapter 765. Unless the guardian advocate has sought
1324	and received express court approval in proceeding separate from
1325	the proceeding to determine the competence of the patient to
1326	consent to medical treatment, the guardian advocate may not
1327	consent to:
1328	(a) Abortion.
1329	(b) Sterilization.
1330	(c) Electroconvulsive treatment.
1331	(d) Psychosurgery.
1332	(e) Experimental treatments that have not been approved by
1333	a federally approved institutional review board in accordance
1334	with 45 C.F.R. part 46 or 21 C.F.R. part 56.
1335
1336	The court shall must base its decision on evidence that the
1337	treatment or procedure is essential to the care of the
1338	individual patient and that the treatment does not present an
1339	unreasonable risk of serious, hazardous, or irreversible side
1340	effects. The court shall follow the procedures set forth in
1341	subsection (1) of this section.
1342	(7) The guardian advocate shall be discharged when the
1343	individual whom he or she represents patient is discharged from
1344	an order for involuntary outpatient placement or involuntary
1345	inpatient placement or when the individual patient
1346	transferred from involuntary to voluntary status. The court or a
1347	hearing officer shall consider the competence of the individual
1348	patient pursuant to subsection (1) and may consider an
1349	involuntarily placed individual's patient's competence to
1350	consent to treatment at any hearing. Upon sufficient evidence,
1351	the court may restore, or the magistrate hearing officer may
1352	recommend that the court restore, the individual's patient's
1353	competence. A copy of the order restoring competence or the
1354	certificate of discharge containing the restoration of
1355	competence shall be provided to the individual patient and the
1356	guardian advocate.
1357	Section 13. Section 394.4599, Florida Statutes, is amended
1358	to read:
1359	394.4599 Notice.-
1360	(1) VOLUNTARY ADMISSION PATIENTS.-Notice of an
1361	individual's a voluntary patient's admission shall only be given
1362	only at the individual's request of the patient, except that in
1363	an emergency, notice shall be given as determined by the
1364	facility.
1365	(2) INVOLUNTARY ADMISSION PATIENTS.-
1366	(a) If notice of involuntary admission Whenever notice is
1367	required to be given under this part, such notice shall be given
1368	to the individual admitted patient and his or her the patient's
1369	guardian, guardian advocate, attorney, and representative.
1370	1. If When notice is required to be given to an individual
1371	a patient, it shall be given both orally and in writing, in the
1372	language and terminology that the individual patient can
1373	understand, and, if needed, the facility shall provide an
1374	interpreter for the individual patient.
1375	2. Notice to an individual's a patient's guardian,
1376	guardian advocate, health care surrogate or proxy, attorney, and
1377	representative shall be given by United States mail and by
1378	registered or certified mail with the receipts attached to the
1379	patient's clinical record. Hand delivery by a facility employee
1380	may be used as an alternative, with delivery documented in the
1381	clinical record. If notice is given by a state attorney or an
1382	attorney for the department, a certificate of service is shall
1383	be sufficient to document service.
1384	(b) A receiving facility shall give prompt notice of the
1385	whereabouts of an individual a patient who is being
1386	involuntarily held for examination to the individual's guardian
1387	or representative, by telephone or in person within 24 hours
1388	after the individual's patient's arrival at the facility, unless
1389	the patient requests that no notification be made. Contact
1390	attempts must shall be documented in the individual's patient's
1391	clinical record and shall begin as soon as reasonably possible
1392	after the individual's patient's arrival. Notice that an
1393	individual is being involuntarily held must a patient is being
1394	admitted as an involuntary patient shall be given to the Florida
1395	local advocacy council by no later than the next working day
1396	after the individual patient is admitted.
1397	(c) The written notice of the filing of the petition for
1398	the involuntary placement of an individual being held must
1399	include contain the following:
1400	1. Notice that the petition has been filed with the
1401	circuit court in the county in which the individual patient is
1402	hospitalized and the court's address of such court.
1403	2. Notice that the office of the public defender has been
1404	appointed to represent the individual patient in the proceeding,
1405	if the individual patient is not otherwise represented by
1406	counsel.
1407	3. The date, time, and place of the hearing and the name
1408	of each examining expert and every other person expected to
1409	testify in support of continued detention.
1410	4. Notice that the individual patient, the individual's
1411	patient's guardian or representative, or the administrator may
1412	apply for a change of venue for the convenience of the parties
1413	or witnesses or because of the individual's condition of the
1414	patient.
1415	5. Notice that the individual patient is entitled to an
1416	independent expert examination and, if the individual patient
1417	cannot afford such an examination, that the court will provide
1418	for one.
1419	(d) A treatment facility shall provide notice of an
1420	individual's a patient's involuntary admission on the next
1421	regular working day after the individual's patient's arrival at
1422	the facility.
1423	(e) If an individual When a patient is to be transferred
1424	from one facility to another, notice shall be given by the
1425	facility where the individual patient is located before prior to
1426	the transfer.
1427	Section 14. Section 394.460, Florida Statutes, is
1428	repealed.
1429	Section 15. Section 394.461, Florida Statutes, is amended
1430	to read:
1431	394.461 Designation of receiving and treatment
1432	facilities.-The department may is authorized to designate and
1433	monitor receiving facilities and treatment facilities and may
1434	suspend or withdraw such designation for failure to comply with
1435	this part and rules adopted under this part. Only governmental
1436	facilities, and other facilities Unless designated by the
1437	department, may facilities are not permitted to hold or treat
1438	individuals on an involuntary basis patients under this part.
1439	(1) RECEIVING FACILITY.-The department may designate any
1440	community facility as a receiving facility. Any other facility
1441	within the state, including a private facility, as a receiving
1442	facility if or a federal facility, may be so designated by the
1443	department, provided that such designation is agreed to by the
1444	governing body or authority of the facility.
1445	(2) TREATMENT FACILITY.-The department may designate any
1446	state-owned, state-operated, or state-supported facility as a
1447	state treatment facility. An individual may A civil patient
1448	shall not be admitted to a civil state treatment facility
1449	without previously undergoing a transfer evaluation. Before a
1450	court hearing for involuntary placement in a state treatment
1451	facility, the court shall receive and consider the information
1452	documented in the transfer evaluation. Any other facility,
1453	including a private facility or a federal facility, may be
1454	designated as a treatment facility by the department if,
1455	provided that such designation is agreed to by the appropriate
1456	governing body or authority of the facility.
1457	(3) GOVERNMENTAL FACILITIES.-Governmental facilities may
1458	provide voluntary and involuntary mental health examination and
1459	treatment for individuals in their care and custody and must
1460	protect the rights of these individuals, pursuant to this part.
1461	(4)(3) PRIVATE FACILITIES.-Private facilities designated
1462	as receiving and treatment facilities by the department may
1463	provide examination and treatment of individuals on an of
1464	involuntary or patients, as well as voluntary basis patients,
1465	and are subject to all the provisions of this part.
1466	(5)(4) REPORT.-
1467	(a) A facility designated as a public receiving or
1468	treatment facility under this section shall annually report to
1469	the department on an annual basis the following data to the
1470	department, unless such these data are currently being submitted
1471	to the Agency for Health Care Administration:
1472	1. Number of licensed beds by payor class.
1473	2. Number of contract days by payor class.
1474	3. Number of persons served admissions by payor class and
1475	diagnoses.
1476	4. Number of bed days by payor class.
1477	5. Average length of stay by payor class.
1478	6. Total revenues by payor class.
1479	(b) For the purposes of this subsection, "payor class"
1480	means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private-
1481	pay health insurance, private-pay health maintenance
1482	organization, private preferred provider organization, the
1483	Department of Children and Family Services, other government
1484	programs, self-pay individuals patients, and charity care.
1485	(c) The data required under this subsection shall be
1486	submitted to the department within no later than 90 days after
1487	following the end of the facility's fiscal year. A facility
1488	designated as a public receiving or treatment facility shall
1489	submit its initial report for the 6-month period ending June 30,
1490	2008.
1491	(d) The department shall issue an annual report based on
1492	the data collected required pursuant to this subsection, which
1493	must. The report shall include individual facilities' data by
1494	facility, as well as statewide totals. The report shall be
1495	submitted to the Governor, the President of the Senate, and the
1496	Speaker of the House of Representatives.
1497	(6)(5) RULES.-The department shall adopt rules relating
1498	to:
1499	(a) Procedures and criteria for receiving and evaluating
1500	facility applications for designation as a receiving or
1501	treatment facility, which may include an onsite facility
1502	inspection and evaluation of an applicant's licensing status and
1503	performance history, as well as consideration of local service
1504	needs.
1505	(b) Minimum standards consistent with this part which that
1506	a facility must meet and maintain in order to be designated as a
1507	receiving or treatment facility, and procedures for monitoring
1508	continued adherence to such standards.
1509	(c) Procedures for receiving complaints against a
1510	designated facility and for initiating inspections and
1511	investigations of facilities alleged to have violated the
1512	provisions of this part or rules adopted under this part.
1513	(d) Procedures and criteria for the suspension or
1514	withdrawal of designation as a receiving or treatment facility.
1515	Section 16. Section 394.4615, Florida Statutes, is amended
1516	to read:
1517	394.4615 Clinical records; confidentiality.-
1518	(1) A clinical record shall be maintained for each
1519	individual held for examination or admitted for mental health
1520	treatment patient. The record must shall include data pertaining
1521	to admission and such other information as may be required under
1522	rules of the department. A clinical record is confidential and
1523	exempt from the provisions of s. 119.07(1). Unless waived by the
1524	express and informed consent of the individual, by the patient
1525	or by his or her the patient's guardian, or guardian advocate,
1526	health care surrogate or proxy, or, if the patient is deceased,
1527	by his or her the patient's personal representative or the
1528	family member who stands next in line of intestate succession,
1529	the confidential status of the clinical record is shall not be
1530	lost by either authorized or unauthorized disclosure to any
1531	person, organization, or agency.
1532	(2) The clinical record of an individual held for
1533	examination or admitted for mental health treatment shall be
1534	released if when:
1535	(a) The individual patient or the individual's patient's
1536	guardian, guardian advocate, or health care surrogate or proxy
1537	authorizes the release. The guardian, or guardian advocate, or
1538	surrogate shall be provided access to the appropriate clinical
1539	records of the patient. The individual patient or the
1540	individual's patient's guardian, or guardian advocate, or
1541	surrogate or proxy may authorize the release of information and
1542	clinical records to appropriate persons to ensure the continuity
1543	of the individual's patient's health care or mental health care.
1544	(b) The individual patient is represented by counsel and
1545	the records are needed by such the patient's counsel for
1546	adequate representation.
1547	(c) A petition for involuntary placement is filed and the
1548	records are needed by the state attorney to evaluate and confirm
1549	the allegations set forth in the petition or to prosecute the
1550	petition.
1551	(d)(c) The court orders such release. In determining
1552	whether there is good cause for disclosure, the court shall
1553	weigh the need for the information to be disclosed against the
1554	possible harm of disclosure to the individual person to whom
1555	such information pertains.
1556	(e)(d) The individual patient is committed to, or is to be
1557	returned to, the Department of Corrections from the Department
1558	of Children and Family Services, and the Department of
1559	Corrections requests such records. The These records shall be
1560	furnished without charge to the Department of Corrections.
1561	(3) Information from the clinical record may be released
1562	if in the following circumstances:
1563	(a) The individual When a patient has declared an
1564	intention to harm other persons. If When such declaration has
1565	been made, the administrator may authorize the release of
1566	sufficient information to provide adequate warning to the person
1567	threatened with harm by the patient.
1568	(b) When The administrator of the facility or secretary of
1569	the department deems that release to a qualified researcher as
1570	defined in administrative rule, an aftercare treatment provider,
1571	or an employee or agent of the department is necessary for
1572	treatment of the individual patient, maintenance of adequate
1573	records, compilation of treatment data, aftercare planning, or
1574	evaluation of programs.
1575	(c) The information is necessary for the purpose of
1576	determining whether an individual a person meets the criteria
1577	for involuntary outpatient placement or for preparing the
1578	proposed treatment plan pursuant to s. 394.4655, the clinical
1579	record may be released to the state attorney, the public
1580	defender or the individual's patient's private legal counsel,
1581	the court, and to the appropriate mental health professionals,
1582	including the service provider identified in s. 394.4655(6)(b)
1583	394.4655(6)(b)2., in accordance with state and federal law.
1584	(4) Information from clinical records may be used for
1585	statistical and research purposes if the information is
1586	abstracted in such a way as to protect the identity of
1587	individuals served and meets department policy.
1588	(5) Information from clinical records may be used by the
1589	Agency for Health Care Administration, the department, and the
1590	Florida advocacy councils for the purpose of monitoring facility
1591	activity and complaints concerning facilities.
1592	(6) Clinical records relating to a Medicaid recipient
1593	shall be furnished to the Medicaid Fraud Control Unit in the
1594	Department of Legal Affairs, upon request.
1595	(7) Any person, agency, or entity receiving information
1596	pursuant to this section shall maintain such information as
1597	confidential and exempt from the provisions of s. 119.07(1).
1598	(8) Any facility or private mental health practitioner who
1599	acts in good faith in releasing information pursuant to this
1600	section is not subject to civil or criminal liability for such
1601	release.
1602	(9) Nothing in This section does not is intended to
1603	prohibit the parent or next of kin of an individual a person who
1604	is held for examination in or admitted for treated under a
1605	mental health treatment facility or program from requesting and
1606	receiving information limited to a summary of that individual's
1607	person's treatment plan and current physical and mental
1608	condition. Release of such information must shall be in
1609	accordance with the code of ethics of the profession involved.
1610	(10) An adult individual Patients shall have reasonable
1611	access to his or her their clinical records, unless such access
1612	is determined by the individual's patient's physician to be
1613	harmful to the individual patient. If the individual's patient's
1614	right to inspect his or her clinical record is restricted by the
1615	facility, written notice of the such restriction must shall be
1616	given to the individual patient and to his or her the patient's
1617	guardian, guardian advocate, attorney, and representative. In
1618	addition, the restriction must shall be recorded in the clinical
1619	record, together with the reasons for it. The restriction
1620	expires of a patient's right to inspect his or her clinical
1621	record shall expire after 7 days but may be renewed, after
1622	review, for subsequent 7-day periods.
1623	(11) Any person who fraudulently alters, defaces, or
1624	falsifies the clinical record of an individual any person
1625	receiving mental health services in a facility subject to
1626	part, or causes or procures any of these offenses to be
1627	committed, commits a misdemeanor of the second degree,
1628	punishable as provided in s. 775.082 or s. 775.083.
1629	Section 17. Section 394.462, Florida Statutes, is amended
1630	to read:
1631	394.462 Transportation.-
1632	(1) TRANSPORTATION TO A RECEIVING FACILITY.-
1633	(a) Each county shall designate a single law enforcement
1634	agency within the county, or portions thereof, to take an
1635	individual a person into custody upon the entry of an ex parte
1636	order or the execution of a certificate for involuntary
1637	examination by an authorized professional and to transport that
1638	individual person to the nearest receiving facility, excluding a
1639	governmental facility, for examination. A law enforcement
1640	officer acting in good faith pursuant to this part may not be
1641	held criminally or civilly liable for false imprisonment. The
1642	designated law enforcement agency may decline to transport the
1643	individual person to a receiving facility only if:
1644	1. The county or jurisdiction designated by the county has
1645	contracted on an annual basis with an emergency medical
1646	transport service or private transport company for
1647	transportation of individuals persons to receiving facilities
1648	pursuant to this section at the sole cost of the county; and
1649	2. The law enforcement agency and the emergency medical
1650	transport service or private transport company agree that the
1651	continued presence of law enforcement personnel is not necessary
1652	for the safety of the individual being transported person or
1653	others.
1654	(b)3. If transportation for involuntary examination is
1655	provided by an emergency medical transport service or private
1656	transport company, the county or law enforcement agency The
1657	jurisdiction designated by the county may seek reimbursement for
1658	transportation expenses. The individual being transported is
1659	party responsible for payment for such transportation is the
1660	person receiving the transportation. The county shall seek
1661	reimbursement from the following sources in the following order:
1662	1.a. From an insurance company, health care corporation,
1663	or other source, if the individual being transported person
1664	receiving the transportation is covered by an insurance policy
1665	or subscribes to a health care corporation or other source for
1666	payment of such expenses.
1667	2.b. From the individual being transported person
1668	receiving the transportation.
1669	3.c. From a financial settlement for medical care,
1670	treatment, hospitalization, or transportation payable or
1671	accruing to the injured party.
1672	(c)(b) Any company that transports an individual a patient
1673	pursuant to this subsection is considered an independent
1674	contractor and is solely liable for the safe and dignified
1675	transportation of the individual patient. Such company must be
1676	insured and maintain at least provide no less than $100,000 in
1677	liability insurance with respect to such the transportation of
1678	patients.
1679	(d)(c) Any company that contracts with a governing board
1680	of a county to transport individuals for examination or
1681	treatment must patients shall comply with the applicable rules
1682	of the department to ensure their the safety and dignity of the
1683	patients.
1684	(e)(d) If When a law enforcement officer takes custody of
1685	an individual a person pursuant to this part, the officer may
1686	request assistance from emergency medical personnel if such
1687	assistance is needed for the safety of the officer or the
1688	individual person in custody.
1689	(f)(e) If When a member of a mental health overlay program
1690	or a mobile crisis response service who is a professional
1691	authorized to initiate an involuntary examination pursuant to s.
1692	394.463 and that professional evaluates an individual a person
1693	and determines that transportation to a receiving facility is
1694	needed, the service, at its discretion, may transport the
1695	individual person to the facility or may call on the law
1696	enforcement agency or other transportation arrangement best
1697	suited to the needs of the individual being transported patient.
1698	(g)(f) If a When any law enforcement officer has custody
1699	of an individual a person based on either noncriminal or minor
1700	criminal behavior that meets the statutory guidelines for
1701	involuntary examination under this part, the law enforcement
1702	officer shall transport the individual person to the nearest
1703	receiving facility for examination.
1704	(h)(g) If a When any law enforcement officer has arrested
1705	an adult individual a person for a felony and it appears that
1706	the individual person meets the statutory guidelines for
1707	involuntary examination or placement under this part, the
1708	individual such person shall first be processed in the same
1709	manner as any other criminal suspect. The law enforcement agency
1710	shall thereafter immediately notify the nearest public receiving
1711	facility, which shall be responsible for promptly arranging for
1712	the examination and treatment of the individual person. A
1713	receiving facility is not required to admit an individual a
1714	person charged with a crime for whom the facility determines and
1715	documents that it is unable to provide adequate security, but
1716	shall provide mental health examination and treatment to the
1717	individual person where he or she is held.
1718	(i)(h) If the appropriate law enforcement officer believes
1719	that an individual a person has an emergency medical condition
1720	as defined in s. 395.002, the individual person may be first
1721	transported to a hospital for emergency medical treatment,
1722	regardless of whether the hospital is a designated receiving
1723	facility.
1724	(j)(i) The costs of transportation, evaluation,
1725	hospitalization, and treatment incurred under this subsection by
1726	individuals persons who have been arrested for violations of any
1727	state law or county or municipal ordinance may be recovered as
1728	provided in s. 901.35.
1729	(k)(j) The nearest receiving facility must accept
1730	individuals persons brought by law enforcement officers for
1731	involuntary examination.
1732	(l)(k) Each law enforcement agency shall develop a
1733	memorandum of understanding with each receiving facility within
1734	the law enforcement agency's jurisdiction which reflects a
1735	single set of protocols for the safe and secure transportation
1736	of the person and transfer of custody of the person. These
1737	protocols must also address crisis intervention measures.
1738	(m)(l) If When a jurisdiction has entered into a contract
1739	with an emergency medical transport service or a private
1740	transport company for transportation of individuals persons to
1741	receiving facilities, such service or company shall be given
1742	preference for transportation of individuals persons from
1743	nursing homes, assisted living facilities, adult day care
1744	centers, or adult family-care homes, unless the behavior of the
1745	individual person being transported is such that transportation
1746	by a law enforcement officer is necessary.
1747	(n)(m) Nothing in This section does not shall be construed
1748	to limit emergency examination and treatment of incapacitated
1749	individuals persons provided in accordance with the provisions
1750	of s. 401.445.
1751	(2) TRANSPORTATION TO A TREATMENT FACILITY.-
1752	(a) If neither the individual held for examination or
1753	admitted for mental health treatment or patient nor any person
1754	legally obligated or responsible for the individual patient is
1755	not able to pay for the expense of transporting an individual a
1756	voluntary or involuntary patient to a treatment facility, the
1757	governing board of the county in which the individual patient is
1758	hospitalized shall arrange for the such required transportation
1759	and shall ensure the safe and dignified transportation of the
1760	individual patient. The governing board of each county may is
1761	authorized to contract with private transport companies for such
1762	the transportation of such patients to and from a treatment
1763	facility.
1764	(b) Any company that transports an individual a patient
1765	pursuant to this subsection is considered an
1766	contractor and is solely liable for the safe and
1767	transportation of the individual patient. Such company
1768	insured and provide at least no less than $100,000 in liability
1769	insurance for such with respect to the transportation of
1770	patients.
1771	(c) Any company that contracts with the governing board of
1772	a county to transport individuals must patients shall comply
1773	with the applicable rules of the department to ensure the safety
1774	and dignity of the individuals transported patients.
1775	(d) County or municipal law enforcement and correctional
1776	personnel and equipment may shall not be used to transport
1777	individuals patients adjudicated incapacitated or found by the
1778	court to meet the criteria for involuntary placement under
1779	pursuant to s. 394.467, except in small rural counties where
1780	there are no cost-efficient alternatives.
1781	(3) TRANSFER OF CUSTODY.-Custody of a person who is
1782	transported pursuant to this part, along with related
1783	documentation, shall be relinquished to a responsible individual
1784	at the appropriate receiving or treatment facility.
1785	(4) EXCEPTIONS.-
1786	(a) An exception to the requirements of this section may
1787	be granted by the secretary of the department for the purposes
1788	of improving service coordination or better meeting the special
1789	needs of individuals. A proposal for an exception shall must be
1790	submitted to the secretary by the circuit district administrator
1791	after being approved by the governing board of each affected
1792	county boards of any affected counties, prior to submission to
1793	the secretary.
1794	1.(a) A proposal for an exception must identify the
1795	specific provision from which an exception is requested,;
1796	describe how the proposal will be implemented by participating
1797	law enforcement agencies and transportation authorities,; and
1798	provide a plan for the coordination of services such as case
1799	management.
1800	2.(b) An The exception may be granted only for:
1801	a.1. An arrangement centralizing and improving the
1802	provision of services within a circuit district, which may
1803	include an exception to the requirement for transportation to
1804	the nearest receiving facility;
1805	b.2. An arrangement whereby by which a facility may
1806	provide, in addition to required psychiatric services, an
1807	environment and services that which are uniquely tailored to the
1808	needs of an identified group of individuals who have persons
1809	with special needs, such as persons who have with hearing
1810	impairments or visual impairments, or elderly persons who have
1811	with physical frailties; or
1812	c.3. A specialized transportation system that provides an
1813	efficient and humane method of transporting individuals patients
1814	to receiving facilities, among receiving facilities, and to
1815	treatment facilities.
1816	2.(c) Any exception approved pursuant to this subsection
1817	must shall be reviewed and approved every 5 years by the
1818	secretary.
1819	(b) The Department of Corrections may transport an
1820	individual who is being released from its custody to a receiving
1821	or treatment facility for involuntary examination or placement.
1822	Such transport shall be to a facility, specified by the
1823	department, which is able to meet the specific needs of the
1824	individual, or, if such specification cannot be made due to
1825	exigent circumstances, transport may be to the nearest receiving
1826	facility.
1827	Section 18. Section 394.4625, Florida Statutes, is amended
1828	to read:
1829	394.4625 Voluntary admissions.-
1830	(1) EXAMINATION AND TREATMENT AUTHORITY TO RECEIVE
1831	PATIENTS.-
1832	(a) A facility may receive for observation, diagnosis, or
1833	treatment an adult who makes any person 18 years of age or older
1834	making application by express and informed consent for admission
1835	or any minor person age 17 or under for whom such application is
1836	made by his or her guardian.
1837	1. If found to show evidence of mental illness, to be
1838	competent to provide express and informed consent, and to be
1839	suitable for treatment, an adult such person 18 years of age or
1840	older may be admitted to the facility.
1841	2. A minor person age 17 or under may be admitted only
1842	with the minor's assent, which must be obtained in conjunction
1843	with consent from the minor's guardian. The minor's assent means
1844	that the minor has affirmatively agreed to stay at the facility
1845	for examination or mental health treatment. Mere failure to
1846	object, absent affirmative agreement, is not assent. The minor's
1847	assent must be verified through a clinical assessment that is
1848	documented in the clinical record and conducted within 12 hours
1849	after admission by a licensed professional authorized to
1850	initiate an involuntary examination pursuant to s. 394.463. In
1851	verifying the minor's assent, the examining professional must
1852	first provide the minor with an explanation of why the minor
1853	will be examined and treated, what the minor can expect while in
1854	the facility, and when the minor may expect to be released,
1855	using language that is appropriate to the minor's age,
1856	experience, maturity, and condition. Unless the minor's assent
1857	is verified pursuant to this section, a petition for involuntary
1858	inpatient placement must be filed with the court within 1
1859	working day after admission or the minor must be released to his
1860	or her guardian within 24 hours after admission only after a
1861	hearing to verify the voluntariness of the consent.
1862	(b) A mental health overlay program, or a mobile crisis
1863	response service, or a licensed professional who is authorized
1864	to initiate an involuntary examination pursuant to s. 394.463
1865	and is employed by a community mental health center or clinic
1866	must, pursuant to circuit district procedure approved by the
1867	respective circuit district administrator, conduct an initial
1868	assessment of the ability of the following individuals persons
1869	to give express and informed consent to treatment before such
1870	individuals persons may be admitted voluntarily:
1871	1. An individual A person 60 years of age or older for
1872	whom transfer is being sought from a nursing home, assisted
1873	living facility, adult day care center, or adult family-care
1874	home, if when such person has been diagnosed as suffering from
1875	dementia.
1876	2. An individual A person 60 years of age or older for
1877	whom transfer is being sought from a nursing home pursuant to s.
1878	400.0255(11) 400.0255(12).
1879	3. An individual A person for whom all decisions
1880	concerning medical treatment are currently being lawfully made
1881	by a the health care surrogate or proxy designated under chapter
1882	765.
1883	(c) If When an initial assessment of the ability of an
1884	individual a person to give express and informed consent to
1885	treatment is required under this section, and a mobile crisis
1886	response service does not respond to a the request for an
1887	assessment within 2 hours after the request is made or informs
1888	the requesting facility that it will not be able to respond
1889	within 2 hours after the request is made, the requesting
1890	facility may arrange for assessment by a any licensed
1891	professional authorized to initiate an involuntary examination
1892	under pursuant to s. 394.463. The professional may not be who is
1893	not employed by or under contract with, or and does not have a
1894	financial interest in, either the facility initiating the
1895	transfer or the receiving facility to which the transfer may be
1896	made, and may not have a financial interest in the outcome of
1897	the assessment.
1898	(d) A facility may not admit an individual on as a
1899	voluntary status patient a person who has been adjudicated
1900	incapacitated, unless the condition of incapacity has been
1901	judicially removed. If a facility admits an individual on
1902	voluntary status as a voluntary patient a person who is later
1903	determined to have been adjudicated incapacitated, and the
1904	condition of incapacity had not been removed by the time of the
1905	admission, the facility must either discharge the patient or
1906	transfer the individual patient to involuntary status.
1907	(e) The health care surrogate or proxy of an individual on
1908	a voluntary status patient may not consent to the provision of
1909	mental health treatment for that individual the patient. An
1910	individual on voluntary status A voluntary patient who is
1911	unwilling or unable to provide express and informed consent to
1912	mental health treatment must either be discharged or transferred
1913	to involuntary status.
1914	(f) Within 24 hours after an individual's voluntary
1915	admission of a voluntary patient, the admitting physician shall
1916	document in the patient's clinical record that the individual
1917	patient is able to give express and informed consent for
1918	admission. If the individual patient is not able to give express
1919	and informed consent for admission, the facility must shall
1920	either discharge the patient or transfer the individual patient
1921	to involuntary status pursuant to subsection (5).
1922	(2) RELEASE OR DISCHARGE OF VOLUNTARY PATIENTS.-
1923	(a) A facility shall discharge an individual admitted on a
1924	voluntary status who patient:
1925	1. Who Has sufficiently improved so that retention in the
1926	facility is no longer desirable. The individual A patient may
1927	also be discharged to the care of a community facility.
1928	2. Who Has revoked revokes consent to admission or
1929	requests discharge. The individual A voluntary patient or his or
1930	her a relative, friend, or attorney of the patient may request
1931	discharge either orally or in writing at any time following
1932	admission to the facility. The individual patient must be
1933	discharged within 24 hours after of the request, unless the
1934	request is rescinded or the individual patient is transferred to
1935	involuntary status pursuant to this section. The 24-hour time
1936	period may be extended by a treatment facility if when necessary
1937	for adequate discharge planning, but may shall not exceed 3 days
1938	exclusive of weekends and holidays. If the individual patient,
1939	or another on his or her the patient's behalf, makes an oral
1940	request for discharge to a staff member, such request must shall
1941	be immediately entered in the patient's clinical record. If the
1942	request for discharge is made by a person other than the
1943	individual patient, the discharge may be conditioned upon the
1944	individual's express and informed consent of the patient.
1945	(b) An individual on A voluntary status patient who has
1946	been admitted to a facility and who refuses to consent to or
1947	revokes consent to treatment must shall be discharged within 24
1948	hours after such refusal or revocation, unless transferred to
1949	involuntary status pursuant to this section or unless the
1950	refusal or revocation is freely and voluntarily rescinded by the
1951	individual patient.
1952	(c) An individual on voluntary status who has been charged
1953	with a crime shall be returned to the custody of a law
1954	enforcement officer upon release or discharge from a facility.
1955	(3) NOTICE OF RIGHT TO DISCHARGE.-At the time of admission
1956	and at least every 6 months thereafter, an individual on a
1957	voluntary status patient shall be notified in writing of his or
1958	her right to apply for a discharge.
1959	(4) TRANSFER TO VOLUNTARY STATUS.-An individual on
1960	involuntary status patient who has been certified by a physician
1961	or psychologist as competent to provide express and informed
1962	consent and who applies to be transferred to voluntary status
1963	shall be transferred to voluntary status immediately, unless the
1964	individual patient has been charged with a crime, or has been
1965	involuntarily placed for treatment by a court pursuant to s.
1966	394.467 and continues to meet the criteria for involuntary
1967	placement. When transfer to voluntary status occurs, notice
1968	shall be given as provided in s. 394.4599.
1969	(5) TRANSFER TO INVOLUNTARY STATUS.-If an individual on
1970	When a voluntary status patient, or an authorized person on the
1971	individual's the patient's behalf, makes a request for
1972	discharge, the request for discharge, unless freely and
1973	voluntarily rescinded, must be communicated to a physician,
1974	clinical psychologist, or psychiatrist as quickly as possible,
1975	but within not later than 12 hours after the request is made. If
1976	the individual patient meets the criteria for involuntary
1977	placement, the administrator of the facility must file with the
1978	court a petition for involuntary placement, within 2 court
1979	working days after the request for discharge is made. If the
1980	petition is not filed within 2 court working days, the
1981	individual must patient shall be discharged. Pending the filing
1982	of the petition, the individual patient may be held and
1983	emergency treatment rendered in the least restrictive manner,
1984	upon the written order of a physician, if it is determined that
1985	such treatment is necessary for the safety of the individual
1986	patient or others.
1987	Section 19. Section 394.463, Florida Statutes, is amended
1988	to read:
1989	394.463 Involuntary examination.-
1990	(1) CRITERIA.-An individual A person may be taken to a
1991	receiving facility for involuntary examination if there is
1992	reason to believe that he or she the person has a mental illness
1993	and because of this his or her mental illness:
1994	(a)1. The individual person has refused voluntary
1995	examination after conscientious explanation and disclosure of
1996	the purpose of the examination; or
1997	2. The individual person is unable to determine for
1998	himself or herself whether examination is necessary; and
1999	(b)1. Without care or treatment:, the person
2000	1. The individual is likely to suffer from neglect or
2001	refuse to care for himself or herself; such neglect or refusal
2002	poses a real and present threat of substantial harm to his or
2003	her well-being; and it is not apparent that such harm may be
2004	avoided through the help of willing family members or friends or
2005	the provision of other services; or
2006	2. There is a substantial likelihood that without care or
2007	treatment the individual person will cause serious bodily harm
2008	to self himself or herself or others in the near future, as
2009	evidenced by recent behavior.
2010	(2) INVOLUNTARY EXAMINATION.-
2011	(a) An involuntary examination may be initiated by any one
2012	of the following means:
2013	1. A court may enter an ex parte order stating that an
2014	individual a person appears to meet the criteria for involuntary
2015	examination, giving the findings on which that conclusion is
2016	based. The ex parte order for involuntary examination must be
2017	based on sworn testimony, written or oral, which includes
2018	specific facts that support the finding that the criteria have
2019	been met. Any behavior relied on for the issuance of the ex
2020	parte order must have occurred within the preceding 14 days. If
2021	other less restrictive means are not available, such as
2022	voluntary appearance for outpatient evaluation, A law
2023	enforcement officer, or other designated agent of the court,
2024	shall take the individual person into custody and deliver him or
2025	her to the nearest receiving facility for involuntary
2026	examination. The order of the court order must shall be made a
2027	part of the patient's clinical record. A No fee may not shall be
2028	charged for the filing of an order under this subsection. Any
2029	receiving facility accepting the individual patient based on the
2030	this order must send a copy of the order to the Agency for
2031	Health Care Administration on the next working day. The order is
2032	shall be valid only until the individual is delivered to the
2033	receiving facility until executed or, if not executed, for the
2034	period specified in the order itself, whichever occurs first. If
2035	a no time limit is not specified in the order, the order is
2036	shall be valid for 7 days after the date it that the order was
2037	signed.
2038	2. A law enforcement officer shall take an individual a
2039	person who appears to meet the criteria for involuntary
2040	examination into custody and deliver or arrange for the delivery
2041	of the individual the person or have him or her delivered to the
2042	nearest receiving facility for examination. The officer shall
2043	complete execute a written report detailing the circumstances
2044	under which the individual person was taken into custody., and
2045	The report must shall be made a part of the patient's clinical
2046	record. Any receiving facility accepting the individual patient
2047	based on the this report must send a copy of the report to the
2048	Agency for Health Care Administration on the next working day.
2049	3. A physician, clinical psychologist, psychiatric nurse,
2050	mental health counselor, marriage and family therapist, or
2051	clinical social worker, or physician assistant may execute a
2052	certificate stating that he or she has examined the individual a
2053	person within the preceding 48 hours and finds that the
2054	individual person appears to meet the criteria for involuntary
2055	examination and stating the observations upon which that
2056	conclusion is based. If other less restrictive means are not
2057	available, such as voluntary appearance for outpatient
2058	evaluation, A law enforcement officer shall take the individual
2059	person named in the certificate into custody and deliver him or
2060	her to the nearest receiving facility for involuntary
2061	examination. The law enforcement officer shall complete execute
2062	a written report detailing the circumstances under which the
2063	individual person was taken into custody. The report and
2064	certificate shall be made a part of the patient's clinical
2065	record. Any receiving facility accepting the individual patient
2066	based on the this certificate must send a copy of the
2067	certificate to the Agency for Health Care Administration on the
2068	next working day. The certificate is valid only until the
2069	individual is delivered to the receiving facility or until 7
2070	calendar days after the certificate was executed, whichever
2071	occurs first.
2072	(b) A person who initiates an involuntary examination of a
2073	minor shall make and document immediate attempts to notify the
2074	minor's guardian of such examination. A receiving facility
2075	accepting a minor for involuntary examination must immediately
2076	notify the minor's guardian upon the minor's arrival.
2077	(c)(b) An individual may A person shall not be removed
2078	from a any program or residential placement licensed under
2079	chapter 400 or chapter 429 and transported to a receiving
2080	facility for involuntary examination unless an ex parte order, a
2081	professional certificate, or a law enforcement officer's report
2082	is first prepared. If the condition of the individual person is
2083	such that preparation of a law enforcement officer's report is
2084	not practicable before removal, the report must shall be
2085	completed as soon as possible after removal, but in any case
2086	before the individual person is transported to a receiving
2087	facility. A receiving facility admitting an individual a person
2088	for involuntary examination who is not accompanied by the
2089	required ex parte order, professional certificate, or law
2090	enforcement officer's report must shall notify the Agency for
2091	Health Care Administration of such admission by certified mail
2092	by no later than the next working day. The provisions of this
2093	paragraph do not apply when transportation is provided by the
2094	patient's family or guardian.
2095	(d)(c) A law enforcement officer acting in accordance with
2096	an ex parte order issued pursuant to this subsection may serve
2097	and execute such order on any day of the week, at any time of
2098	the day or night.
2099	(e)(d) A law enforcement officer acting in accordance with
2100	an ex parte order issued pursuant to this subsection may use
2101	such reasonable physical force if as is necessary to gain entry
2102	to the premises, and any dwellings, buildings, or other
2103	structures located on the premises, and to take custody of the
2104	individual person who is the subject of the ex parte order.
2105	(f)(e) The Agency for Health Care Administration shall
2106	receive and maintain the copies of ex parte orders, involuntary
2107	outpatient placement orders issued pursuant to s. 394.4655,
2108	involuntary inpatient placement orders issued pursuant to s.
2109	394.467, professional certificates, and law enforcement
2110	officers' reports. These documents shall be considered part of
2111	the clinical record, governed by the provisions of s. 394.4615.
2112	The agency shall prepare annual reports analyzing the data
2113	obtained from these documents, without information identifying
2114	individuals held for examination or admitted for mental health
2115	treatment patients, and shall provide copies of reports to the
2116	department, the President of the Senate, the Speaker of the
2117	House of Representatives, and the minority leaders of the Senate
2118	and the House of Representatives.
2119	(g)(f) An individual A patient shall be examined by a
2120	physician or clinical psychologist at a receiving facility
2121	without unnecessary delay to determine if the criteria for
2122	involuntary inpatient placement is met. Emergency treatment may
2123	be provided and may, upon the order of a physician, be given
2124	emergency treatment if it is determined that such treatment is
2125	necessary for the safety of the patient or others. The patient
2126	may not be released by the receiving facility or its contractor
2127	without the documented approval of a psychiatrist, a clinical
2128	psychologist, or, if the receiving facility is a hospital, the
2129	release may also be approved by an attending emergency
2130	department physician with experience in the diagnosis and
2131	treatment of mental and nervous disorders and after completion
2132	of an involuntary examination pursuant to this subsection.
2133	However, a patient may not be held in a receiving facility for
2134	involuntary examination longer than 72 hours.
2135	(h) An individual may not be held for involuntary
2136	examination for more than 72 hours. Based on the individual's
2137	needs, one of the following actions must be taken within the 72-
2138	hour period:
2139	1. The individual shall be released after the completion
2140	of the involuntary examination and with the documented approval
2141	of a psychiatrist or a clinical psychologist or, if the facility
2142	is a hospital, the release may be approved by an attending
2143	emergency department physician;
2144	2. The individual shall be asked to give express and
2145	informed consent for voluntary admission if a physician or
2146	clinical psychologist has determined that the individual is
2147	competent to consent to treatment; or
2148	3. A petition for involuntary placement shall be completed
2149	and filed in the circuit court if involuntary outpatient or
2150	inpatient treatment is deemed necessary. If the 72-hour period
2151	ends on a weekend or holiday, the petition must be filed by the
2152	next working day. If inpatient treatment is deemed necessary,
2153	the least restrictive treatment consistent with the optimum
2154	improvement of the individual's condition must be made
2155	available.
2156	(i) An individual released from a receiving or treatment
2157	facility on a voluntary or involuntary basis who is charged with
2158	a crime shall be returned to the custody of a law enforcement
2159	officer.
2160	(j)(g) If an individual A person for whom an involuntary
2161	examination has been initiated who is also being evaluated or
2162	treated at a hospital for an emergency medical condition
2163	specified in s. 395.002, must be examined by a receiving
2164	facility within 72 hours. the 72-hour period begins when the
2165	individual patient arrives at the hospital and ceases when the
2166	attending physician documents that the individual patient has an
2167	emergency medical condition. The 72-hour period resumes when the
2168	physician documents that the emergency medical condition has
2169	stabilized or does not exist. If the patient is examined at a
2170	hospital providing emergency medical services by a professional
2171	qualified to perform an involuntary examination and is found as
2172	a result of that examination not to meet the criteria for
2173	involuntary outpatient placement pursuant to s. 394.4655(1) or
2174	involuntary inpatient placement pursuant to s. 394.467(1), the
2175	patient may be offered voluntary placement, if appropriate, or
2176	released directly from the hospital providing emergency medical
2177	services. The finding by the professional that the patient has
2178	been examined and does not meet the criteria for involuntary
2179	inpatient placement or involuntary outpatient placement must be
2180	entered into the patient's clinical record. Nothing in this
2181	paragraph is intended to prevent A hospital providing emergency
2182	medical services may transfer an individual from appropriately
2183	transferring a patient to another hospital before prior to
2184	stabilization if, provided the requirements of s. 395.1041(3)(c)
2185	are have been met.
2186	(h) One of the following must occur within 12 hours after
2187	the patient's attending physician documents that the
2188	individual's patient's medical condition has stabilized or that
2189	an emergency medical condition does not exist:
2190	1. The individual shall be examined by a physician or
2191	clinical psychologist and, if found not to meet the criteria for
2192	involuntary examination pursuant to s. 394.463, shall be
2193	released directly from the hospital providing the emergency
2194	medical services. The results of the examination, including the
2195	final disposition, shall be entered into the clinical record; or
2196	2. The individual shall be transferred to a receiving
2197	facility for examination if appropriate medical and mental
2198	health treatment is available. However, the receiving facility
2199	must be notified of the transfer within 2 hours after the
2200	individual's condition has been stabilized or after
2201	determination that an emergency medical condition does not
2202	exist.
2203	1. The patient must be examined by a designated receiving
2204	facility and released; or
2205	2. The patient must be transferred to a designated
2206	receiving facility in which appropriate medical treatment is
2207	available. However, the receiving facility must be notified of
2208	the transfer within 2 hours after the patient's condition has
2209	been stabilized or after determination that an emergency medical
2210	condition does not exist.
2211	(i) Within the 72-hour examination period or, if the 72
2212	hours ends on a weekend or holiday, no later than the next
2213	working day thereafter, one of the following actions must be
2214	taken, based on the individual needs of the patient:
2215	1. The patient shall be released, unless he or she is
2216	charged with a crime, in which case the patient shall be
2217	returned to the custody of a law enforcement officer;
2218	2. The patient shall be released, subject to the
2219	provisions of subparagraph 1., for voluntary outpatient
2220	treatment;
2221	3. The patient, unless he or she is charged with a crime,
2222	shall be asked to give express and informed consent to placement
2223	as a voluntary patient, and, if such consent is given, the
2224	patient shall be admitted as a voluntary patient; or
2225	4. A petition for involuntary placement shall be filed in
2226	the circuit court when outpatient or inpatient treatment is
2227	deemed necessary. When inpatient treatment is deemed necessary,
2228	the least restrictive treatment consistent with the optimum
2229	improvement of the patient's condition shall be made available.
2230	When a petition is to be filed for involuntary outpatient
2231	placement, it shall be filed by one of the petitioners specified
2232	in s. 394.4655(3)(a). A petition for involuntary inpatient
2233	placement shall be filed by the facility administrator.
2234	(3) NOTICE OF RELEASE.-Notice of the release shall be
2235	given to the individual's patient's guardian or representative,
2236	to any person who executed a certificate admitting the
2237	individual patient to the receiving facility, and to any court
2238	that which ordered the individual's patient's evaluation.
2239	Section 20. Section 394.4655, Florida Statutes, is amended
2240	to read:
2241	394.4655 Involuntary outpatient placement.-
2242	(1) CRITERIA FOR INVOLUNTARY OUTPATIENT PLACEMENT.-An
2243	individual A person may be ordered to involuntary outpatient
2244	placement upon a finding of the court that by clear and
2245	convincing evidence that:
2246	(a) The individual is an adult person is 18 years of age
2247	or older;
2248	(b) The individual person has a mental illness;
2249	(c) The individual person is unlikely to survive safely in
2250	the community without supervision, based on a clinical
2251	determination;
2252	(d) The individual person has a history of lack of
2253	compliance with treatment for mental illness;
2254	(e) The individual person has:
2255	1. At least twice within the immediately preceding 36
2256	months been involuntarily admitted to a receiving or treatment
2257	facility as defined in s. 394.455, or has received mental health
2258	services in a forensic or correctional facility. The 36-month
2259	period does not include any period during which the individual
2260	person was admitted or incarcerated; or
2261	2. Engaged in one or more acts of serious violent behavior
2262	toward self or others, or attempts at serious bodily harm to
2263	self himself or herself or others, within the preceding 36
2264	months;
2265	(f) Due to The person is, as a result of his or her mental
2266	illness, the individual is unlikely to voluntarily participate
2267	in the recommended treatment plan and either he or she has
2268	refused voluntary placement for treatment after sufficient and
2269	conscientious explanation and disclosure of the purpose of
2270	placement for treatment or he or she is unable to determine for
2271	himself or herself whether placement is necessary;
2272	(g) In view of the individual's person's treatment history
2273	and current behavior, the individual person is in need of
2274	involuntary outpatient placement in order to prevent a relapse
2275	or deterioration that would be likely to result in serious
2276	bodily harm to self himself or herself or others, or a
2277	substantial harm to his or her well-being as set forth in s.
2278	394.463(1);
2279	(h) It is likely that the individual person will benefit
2280	from involuntary outpatient placement; and
2281	(i) All available, less restrictive alternatives that
2282	would offer an opportunity for improvement of his or her
2283	condition have been judged to be inappropriate or unavailable.
2284	(2) INVOLUNTARY OUTPATIENT PLACEMENT.-
2285	(a)1. An individual A patient who is being recommended for
2286	involuntary outpatient placement by the administrator of the
2287	receiving facility where the patient has been examined may be
2288	retained by the facility after adherence to the notice
2289	procedures provided in s. 394.4599.
2290	1. The recommendation must be supported by the opinion of
2291	a psychiatrist and the second opinion of a clinical psychologist
2292	or another psychiatrist, both of whom have personally examined
2293	the individual patient within the preceding 72 hours, that the
2294	criteria for involuntary outpatient placement are met. However,
2295	in a county having a population of fewer than 50,000, if the
2296	administrator certifies that a psychiatrist or clinical
2297	psychologist is not available to provide the second opinion, the
2298	second opinion may be provided by a licensed physician who has
2299	postgraduate training and experience in diagnosis and treatment
2300	of mental and nervous disorders or by a psychiatric nurse. Any
2301	second opinion authorized in this subparagraph may be conducted
2302	through a face-to-face examination, in person or by electronic
2303	means. Such recommendation must be entered on an involuntary
2304	outpatient placement certificate that authorizes the receiving
2305	facility to retain the patient pending completion of a hearing.
2306	The certificate shall be made a part of the patient's clinical
2307	record.
2308	2. If the individual patient has been stabilized and no
2309	longer meets the criteria for involuntary examination pursuant
2310	to s. 394.463(1), he or she the patient must be released from
2311	the receiving facility while awaiting the hearing for
2312	involuntary outpatient placement.
2313	3. Before filing a petition for involuntary outpatient
2314	treatment, the administrator of the a receiving facility or a
2315	designated department representative must identify the service
2316	provider that will have primary responsibility for service
2317	provision under an order for involuntary outpatient placement,
2318	unless the individual person is otherwise participating in
2319	outpatient psychiatric treatment and is not in need of public
2320	financing for that treatment, in which case the individual, if
2321	eligible, may be ordered to involuntary treatment pursuant to
2322	the existing psychiatric treatment relationship.
2323	4.3. The service provider shall prepare a written
2324	proposed treatment plan in consultation with the individual
2325	being held patient or his or her the patient's guardian
2326	advocate, if appointed, for the court's consideration for
2327	inclusion in the involuntary outpatient placement order. The
2328	service provider shall also provide a copy of the proposed
2329	treatment plan to the individual patient and the administrator
2330	of the receiving facility. The treatment plan must specify the
2331	nature and extent of the individual's patient's mental illness,
2332	address the reduction of symptoms that necessitate involuntary
2333	outpatient placement, and include measurable goals and
2334	objectives for the services and treatment that are provided to
2335	treat the individual's person's mental illness and assist the
2336	individual person in living and functioning in the community or
2337	to prevent a relapse or deterioration. Service providers may
2338	select and supervise other providers individuals to implement
2339	specific aspects of the treatment plan. The services in the
2340	treatment plan must be deemed clinically appropriate by a
2341	physician, clinical psychologist, psychiatric nurse, mental
2342	health counselor, marriage and family therapist, or clinical
2343	social worker who consults with, or is employed or contracted
2344	by, the service provider. The service provider must certify to
2345	the court in the proposed treatment plan whether sufficient
2346	services for improvement and stabilization are currently
2347	available and whether the service provider agrees to provide
2348	those services. If the service provider certifies that the
2349	services in the proposed treatment plan are not available, the
2350	petitioner may not file the petition.
2351	(b) If an individual a patient in involuntary inpatient
2352	placement meets the criteria for involuntary outpatient
2353	placement, the administrator of the treatment facility may,
2354	before the expiration of the period during which the treatment
2355	facility is authorized to retain the individual patient,
2356	recommend involuntary outpatient placement.
2357	1. The recommendation must be supported by the opinion of
2358	a psychiatrist and the second opinion of a clinical psychologist
2359	or another psychiatrist, both of whom have personally examined
2360	the individual patient within the preceding 72 hours, that the
2361	criteria for involuntary outpatient placement are met. However,
2362	in a county having a population of fewer than 50,000, if the
2363	administrator certifies that a psychiatrist or clinical
2364	psychologist is not available to provide the second opinion, the
2365	second opinion may be provided by a licensed physician who has
2366	postgraduate training and experience in diagnosis and treatment
2367	of mental and nervous disorders or by a psychiatric nurse. Any
2368	second opinion authorized in this subparagraph may be conducted
2369	through a face-to-face examination, in person or by electronic
2370	means. Such recommendation must be entered on an involuntary
2371	outpatient placement certificate, and the certificate must be
2372	made a part of the patient's clinical record.
2373	(c)1. The administrator of the treatment facility shall
2374	provide a copy of the involuntary outpatient placement
2375	certificate and a copy of the state mental health discharge form
2376	to a department representative in the county where the
2377	individual patient will be residing. For persons who are leaving
2378	a state mental health treatment facility, the petition for
2379	involuntary outpatient placement must be filed in the county
2380	where the patient will be residing.
2381	2. The service provider that will have primary
2382	responsibility for service provision shall be identified by the
2383	designated department representative prior to the order for
2384	involuntary outpatient placement and shall must, before prior to
2385	filing a petition for involuntary outpatient placement, certify
2386	to the court whether the services recommended in the
2387	individual's patient's discharge plan are available in the local
2388	community and whether the service provider agrees to provide
2389	those services. The service provider shall must develop with the
2390	individual patient, or the individual's patient's guardian
2391	advocate, if one is appointed, a treatment or service plan that
2392	addresses the needs identified in the discharge plan. The plan
2393	must be deemed to be clinically appropriate by a physician,
2394	clinical psychologist, psychiatric nurse, mental health
2395	counselor, marriage and family therapist, or clinical social
2396	worker, as defined in this chapter, who consults with, or is
2397	employed or contracted by, the service provider.
2398	3. If the service provider certifies that the services in
2399	the proposed treatment or service plan are not available, the
2400	petitioner may not file the petition.
2401	(3) PETITION FOR INVOLUNTARY OUTPATIENT PLACEMENT.-
2402	(a) A petition for involuntary outpatient placement may be
2403	filed by:
2404	1. The administrator of a receiving facility; or
2405	2. The administrator of a treatment facility.
2406	(b) Each required criterion for involuntary outpatient
2407	placement must be alleged and substantiated in the petition for
2408	involuntary outpatient placement. A copy of the certificate
2409	recommending involuntary outpatient placement completed by a
2410	qualified professional specified in subsection (2) must be
2411	attached to the petition. A copy of the proposed treatment plan
2412	must be attached to the petition. Before the petition is filed,
2413	the service provider shall certify that the services in the
2414	proposed treatment plan are available. If the necessary services
2415	are not available in the patient's local community where the
2416	individual will reside to respond to the person's individual
2417	needs, the petition may not be filed.
2418	(c) A The petition for involuntary outpatient placement
2419	must be filed in the county where the individual who is the
2420	subject of the petition patient is located, unless the
2421	individual the patient is being placed from a state treatment
2422	facility, in which case the petition must be filed in the county
2423	where the individual patient will reside. When the petition is
2424	has been filed, the clerk of the court shall provide copies of
2425	the petition and the proposed treatment plan to the department,
2426	the individual patient, the individual's patient's guardian or
2427	representative, the state attorney, and the public defender or
2428	the patient's private counsel representing the individual. A fee
2429	may not be charged for filing a petition under this subsection.
2430	(4) APPOINTMENT OF COUNSEL.-Within 1 court working day
2431	after the filing of a petition for involuntary outpatient
2432	placement, the court shall appoint a the public defender to
2433	represent the individual person who is the subject of the
2434	petition, unless the individual person is otherwise represented
2435	by counsel. The clerk of the court shall immediately notify the
2436	public defender of the appointment. The public defender shall
2437	represent the individual person until the petition is dismissed,
2438	the court order expires, or the individual patient is discharged
2439	from involuntary outpatient placement. An attorney who
2440	represents the individual patient shall have access to the
2441	individual patient, witnesses, and records relevant to the
2442	presentation of the individual's patient's case and shall
2443	represent the interests of the individual patient, regardless of
2444	the source of payment to the attorney.
2445	(5) CONTINUANCE OF HEARING.-The patient is entitled, with
2446	the concurrence of the patient's counsel, to at least one
2447	continuance of the hearing. The continuance shall be for a
2448	period of up to 4 weeks.
2449	(5)(6) HEARING ON INVOLUNTARY OUTPATIENT PLACEMENT.-
2450	(a)1. The court shall hold the hearing on involuntary
2451	outpatient placement within 5 working days after the filing of
2452	the petition, unless a continuance is granted. The hearing shall
2453	be held in the county where the petition is filed, shall be as
2454	convenient to the individual who is the subject of the petition
2455	patient as is consistent with orderly procedure, and shall be
2456	conducted in physical settings not likely to be injurious to the
2457	individual's patient's condition. If the court finds that the
2458	individual's patient's attendance at the hearing is not
2459	consistent with the individual's best interests, of the patient
2460	and if the individual's patient's counsel does not object, the
2461	court may waive the presence of the individual patient from all
2462	or any portion of the hearing. The state attorney for the
2463	circuit in which the individual patient is located shall
2464	represent the state, rather than the petitioner, as the real
2465	party in interest in the proceeding.
2466	(b)2. The court may appoint a magistrate master to preside
2467	at the hearing. One of the professionals who executed the
2468	involuntary outpatient placement certificate shall be a witness.
2469	The individual who is the subject of the petition patient and
2470	his or her the patient's guardian or representative shall be
2471	informed by the court of the right to an independent expert
2472	examination. If the individual patient cannot afford such an
2473	examination, the court shall provide for one. The independent
2474	expert's report is shall be confidential and not discoverable,
2475	unless the expert is to be called as a witness for the
2476	individual patient at the hearing. The court shall allow
2477	testimony from persons individuals, including family members,
2478	deemed by the court to be relevant under state law, regarding
2479	the individual's person's prior history and how that prior
2480	history relates to the individual's person's current condition.
2481	The testimony in the hearing must be given under oath, and the
2482	proceedings must be recorded. The individual patient may refuse
2483	to testify at the hearing.
2484	(c) At the hearing on involuntary outpatient placement,
2485	the court shall consider testimony and evidence regarding the
2486	competence of the individual being held to consent to treatment.
2487	If the court finds that the individual is incompetent to
2488	consent, it shall appoint a guardian advocate as provided in s.
2489	394.4598.
2490	(d) The individual who is the subject of the petition is
2491	entitled to at least one continuance of the hearing for up to 4
2492	weeks, with the concurrence of the individual's counsel.
2493	However, the individual's counsel may not request a continuance
2494	unless the continuance is the individual's expressed desire.
2495	(6) COURT ORDER.-
2496	(a)(b)1. If the court concludes that the individual who is
2497	the subject of the petition patient meets the criteria for
2498	involuntary outpatient placement under pursuant to subsection
2499	(1), the court shall issue an order for involuntary outpatient
2500	placement. The court order may shall be for a period of up to 6
2501	months. The order must specify the nature and extent of the
2502	individual's patient's mental illness. The court order of the
2503	court and the treatment plan must shall be made part of the
2504	patient's clinical record. The service provider shall discharge
2505	an individual a patient from involuntary outpatient placement
2506	when the order expires or any time the individual patient no
2507	longer meets the criteria for involuntary placement. Upon
2508	discharge, the service provider shall send a certificate of
2509	discharge to the court.
2510	(b)2. The court may not order the department or the
2511	service provider to provide services if the program or service
2512	is not available in the patient's local community of the
2513	individual being served, if there is no space available in the
2514	program or service for the individual patient, or if funding is
2515	not available for the program or service. A copy of the order
2516	must be sent to the Agency for Health Care Administration by the
2517	service provider within 1 working day after it is received from
2518	the court. After the placement order is issued, the service
2519	provider and the individual patient may modify provisions of the
2520	treatment plan. For any material modification of the treatment
2521	plan to which the individual patient or the individual's
2522	patient's guardian advocate, if appointed, agrees does agree,
2523	the service provider shall send notice of the modification to
2524	the court. Any material modifications of the treatment plan
2525	which are contested by the individual patient or the
2526	individual's patient's guardian advocate, if appointed, must be
2527	approved or disapproved by the court consistent with the
2528	requirements of subsection (2).
2529	(c)3. If, in the clinical judgment of a physician, the
2530	individual being served patient has failed or has refused to
2531	comply with the treatment ordered by the court, and, in the
2532	clinical judgment of the physician, efforts were made to solicit
2533	compliance and the individual patient may meet the criteria for
2534	involuntary examination, the individual a person may be brought
2535	to a receiving facility pursuant to s. 394.463 for involuntary
2536	examination. If, after examination, the individual patient does
2537	not meet the criteria for involuntary inpatient placement under
2538	pursuant to s. 394.467, the individual patient must be
2539	discharged from the receiving facility. The involuntary
2540	outpatient placement order remains shall remain in effect unless
2541	the service provider determines that the individual patient no
2542	longer meets the criteria for involuntary outpatient placement
2543	or until the order expires. The service provider shall must
2544	determine whether modifications should be made to the existing
2545	treatment plan and must continue to attempt to continue to
2546	engage the individual patient in treatment. For any material
2547	modification of the treatment plan to which the individual
2548	patient or the individual's patient's guardian advocate, if
2549	appointed, agrees does agree, the service provider shall send
2550	notice of the modification to the court. Any material
2551	modifications of the treatment plan which are contested by the
2552	individual patient or the individual's patient's guardian
2553	advocate, if appointed, must be approved or disapproved by the
2554	court consistent with the requirements of subsection (2).
2555	(d)(c) If, at any time before the conclusion of the
2556	initial hearing on involuntary outpatient placement, it appears
2557	to the court that the individual person does not meet the
2558	criteria for involuntary outpatient placement under this section
2559	but, instead, meets the criteria for involuntary inpatient
2560	placement, the court may order the individual person admitted
2561	for involuntary inpatient examination under s. 394.463. If the
2562	individual person instead meets the criteria for involuntary
2563	assessment, protective custody, or involuntary admission under
2564	pursuant to s. 397.675, the court may order the individual
2565	person to be admitted for involuntary assessment for a period of
2566	5 days pursuant to s. 397.6811. Thereafter, all proceedings are
2567	shall be governed by chapter 397.
2568	(d) At the hearing on involuntary outpatient placement,
2569	the court shall consider testimony and evidence regarding the
2570	patient's competence to consent to treatment. If the court finds
2571	that the patient is incompetent to consent to treatment, it
2572	shall appoint a guardian advocate as provided in s. 394.4598.
2573	The guardian advocate shall be appointed or discharged in
2574	accordance with s. 394.4598.
2575	(e) The administrator of the receiving facility or the
2576	designated department representative shall provide a copy of the
2577	court order and adequate documentation of an individual's a
2578	patient's mental illness to the service provider for involuntary
2579	outpatient placement. Such documentation must include any
2580	advance directives made by the individual patient, a psychiatric
2581	evaluation of the individual patient, and any evaluations of the
2582	individual patient performed by a clinical psychologist or a
2583	clinical social worker.
2584	(7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
2585	PLACEMENT.-
2586	(a)1. If an individual the person continues to meet the
2587	criteria for involuntary outpatient placement, the service
2588	provider shall, before the expiration of the period during which
2589	the placement treatment is ordered for the person, file in the
2590	circuit court a petition for continued involuntary outpatient
2591	placement.
2592	1.2. The existing involuntary outpatient placement order
2593	remains in effect until disposition of on the petition for
2594	continued involuntary outpatient placement.
2595	2.3. A certificate must shall be attached to the petition
2596	which includes a statement from the individual's person's
2597	physician or clinical psychologist justifying the request, a
2598	brief description of the individual's patient's treatment during
2599	the time he or she was involuntarily placed, and a personalized
2600	an individualized plan of continued treatment.
2601	3.4. The service provider shall develop the individualized
2602	plan of continued treatment in consultation with the individual
2603	patient or his or her the patient's guardian advocate, if
2604	appointed. When the petition has been filed, the clerk of the
2605	court shall provide copies of the certificate and the
2606	individualized plan of continued treatment to the department,
2607	the individual patient, the individual's patient's guardian
2608	advocate, the state attorney, and the individual's patient's
2609	private counsel or the public defender.
2610	(b) Within 1 court working day after the filing of a
2611	petition for continued involuntary outpatient placement, the
2612	court shall appoint the public defender to represent the
2613	individual person who is the subject of the petition, unless the
2614	individual person is otherwise represented by counsel. The clerk
2615	of the court shall immediately notify the public defender of
2616	such appointment. The public defender shall represent the
2617	individual person until the petition is dismissed, or the court
2618	order expires, or the individual patient is discharged from
2619	involuntary outpatient placement. An Any attorney representing
2620	the individual must patient shall have access to the individual
2621	patient, witnesses, and records relevant to the presentation of
2622	the individual's patient's case and shall represent the
2623	interests of the individual patient, regardless of the source of
2624	payment to the attorney.
2625	(c) The court shall inform the individual who is the
2626	subject of the petition and his or her guardian, guardian
2627	advocate, or representative of the individual's right to an
2628	independent expert examination. If the individual cannot afford
2629	such an examination, the court shall provide one.
2630	(d)(c) Hearings on petitions for continued involuntary
2631	outpatient placement are shall be before the circuit court. The
2632	court may appoint a magistrate master to preside at the hearing.
2633	The procedures for obtaining an order pursuant to this paragraph
2634	must shall be in accordance with subsection (5) (6), except that
2635	the time period included in paragraph (1)(e) is not applicable
2636	for in determining the appropriateness of additional periods of
2637	involuntary outpatient placement.
2638	(e)(d) Notice of the hearing shall be provided in
2639	accordance with as set forth in s. 394.4599. The individual
2640	being served patient and the individual's patient's attorney may
2641	agree to a period of continued outpatient placement without a
2642	court hearing.
2643	(f)(e) The same procedure must shall be repeated before
2644	the expiration of each additional period the individual being
2645	served patient is placed in treatment.
2646	(g)(f) If the individual in involuntary outpatient
2647	placement patient has previously been found incompetent to
2648	consent to treatment, the court shall consider testimony and
2649	evidence regarding the individual's patient's competence.
2650	Section 394.4598 governs the discharge of the guardian advocate
2651	if the individual's patient's competency to consent to treatment
2652	has been restored.
2653	Section 21. Section 394.467, Florida Statutes, is amended
2654	to read:
2655	394.467 Involuntary inpatient placement.-
2656	(1) CRITERIA.-An individual A person may be placed in
2657	involuntary inpatient placement for treatment upon a finding of
2658	the court by clear and convincing evidence that:
2659	(a) He or she has a mental illness is mentally ill and
2660	because of his or her mental illness:
2661	1.a. He or she has refused voluntary placement for
2662	treatment after sufficient and conscientious explanation and
2663	disclosure of the purpose of placement for treatment; or
2664	b. He or she is unable to determine for himself or herself
2665	whether placement is necessary; and
2666	2.a. He or she is manifestly incapable of surviving alone
2667	or with the help of willing and responsible family or friends,
2668	including available alternative services, and, without
2669	treatment, is likely to suffer from neglect or refuse to care
2670	for himself or herself, and such neglect or refusal poses a real
2671	and present threat of substantial harm to his or her well-being;
2672	or
2673	b. There is substantial likelihood that in the near future
2674	he or she will inflict serious bodily harm on self or others
2675	himself or herself or another person, as evidenced by recent
2676	behavior causing, attempting, or threatening such harm; and
2677	(b) All available less restrictive treatment alternatives
2678	that which would offer an opportunity for improvement of his or
2679	her condition have been judged to be inappropriate.
2680	(2) ADMISSION TO A TREATMENT FACILITY.-An individual A
2681	patient may be retained by a receiving facility or involuntarily
2682	placed in a treatment facility upon the recommendation of the
2683	administrator of the receiving facility where the individual
2684	patient has been examined and after adherence to the notice and
2685	hearing procedures provided in s. 394.4599. The recommendation
2686	must be supported by the opinion of a psychiatrist and the
2687	second opinion of a clinical psychologist or another
2688	psychiatrist, both of whom have personally examined the
2689	individual patient within the preceding 72 hours, that the
2690	criteria for involuntary inpatient placement are met. However,
2691	in a county that has a population of fewer than 50,000, if the
2692	administrator certifies that a psychiatrist or clinical
2693	psychologist is not available to provide the second opinion, the
2694	second opinion may be provided by a licensed physician who has
2695	postgraduate training and experience in diagnosis and treatment
2696	of mental and nervous disorders or by a psychiatric nurse. Any
2697	second opinion authorized in this subsection may be conducted
2698	through a face-to-face examination, in person or by electronic
2699	means. Such recommendation must shall be entered on an
2700	involuntary inpatient placement certificate that authorizes the
2701	receiving facility to retain the individual being held patient
2702	pending transfer to a treatment facility or completion of a
2703	hearing.
2704	(3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.-
2705	(a) The administrator of the facility shall file a
2706	petition for involuntary inpatient placement in the court in the
2707	county where the individual patient is located. Upon filing, the
2708	clerk of the court shall provide copies to the department, the
2709	individual patient, the individual's patient's guardian or
2710	representative, and the state attorney and public defender of
2711	the judicial circuit in which the individual patient is located.
2712	A No fee may not shall be charged for the filing of a petition
2713	under this subsection.
2714	(b) A receiving or treatment facility filing a petition
2715	for involuntary inpatient placement shall send a copy of the
2716	petition to the Agency for Health Care Administration by the
2717	next working day.
2718	(4) APPOINTMENT OF COUNSEL.-
2719	(a) Within 1 court working day after the filing of a
2720	petition for involuntary inpatient placement, the court shall
2721	appoint the public defender to represent the individual person
2722	who is the subject of the petition, unless the individual person
2723	is otherwise represented by counsel. The clerk of the court
2724	shall immediately notify the public defender of such
2725	appointment. Any attorney representing the individual patient
2726	shall have access to the individual patient, witnesses, and
2727	records relevant to the presentation of the individual's
2728	patient's case and shall represent the interests of the
2729	individual patient, regardless of the source of payment to the
2730	attorney. An attorney representing an individual in involuntary
2731	placement proceedings shall represent the individual's expressed
2732	desires and must be present and actively participate in all
2733	hearings on involuntary placement.
2734	(b) The state attorney for the circuit in which the
2735	individual is located shall represent the state rather than the
2736	petitioning facility administrator as the real party in interest
2737	in the proceeding. The state attorney shall have access to the
2738	individual's clinical record and witnesses and shall
2739	independently evaluate and confirm the allegations set forth in
2740	the petition for involuntary placement. If the allegations are
2741	substantiated, the state attorney shall vigorously prosecute the
2742	petition. If the allegations are not substantiated, the state
2743	attorney shall withdraw the petition. The state attorney shall
2744	be present and actively participate in all hearings on
2745	involuntary placement.
2746	(5) CONTINUANCE OF HEARING.-The individual patient is
2747	entitled, with the concurrence of the individual's patient's
2748	counsel, to at least one continuance of the hearing. Requests
2749	for a continuance from parties other than the individual or his
2750	or her counsel may not be granted. The continuance shall be for
2751	a period of up to 4 weeks. At the time the court is considering
2752	a motion for continuance, the court shall also conduct a hearing
2753	to consider the capacity of the individual to consent to
2754	treatment if there is a pending petition for adjudication of
2755	incompetence to consent to treatment. If the court finds that
2756	the individual is not competent to consent to treatment, a
2757	guardian advocate shall be appointed at the time the involuntary
2758	placement hearing is continued to make mental health decisions
2759	for the individual.
2760	(6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.-
2761	(a)1. The court shall hold the hearing on involuntary
2762	inpatient placement within 5 working days after the petition is
2763	filed, unless a continuance is granted.
2764	1. Except for good cause documented in the court file, the
2765	hearing shall be held in the receiving or treatment facility
2766	county where the individual patient is located. If the hearing
2767	cannot be held in the receiving or treatment facility, it must
2768	held in a location and shall be as convenient to the individual
2769	patient as is may be consistent with orderly procedure and which
2770	is shall be conducted in physical settings not likely to be
2771	injurious to the individual's patient's condition. If the
2772	individual wishes to waive his or her court finds that the
2773	patient's attendance at the hearing, the court must
2774	that the waiver is knowing, intelligent, and voluntary before
2775	waiving is not consistent with the best interests of the
2776	patient, and the patient's counsel does not object, the court
2777	may waive the presence of the individual patient from all or any
2778	portion of the hearing. The state attorney for the circuit in
2779	which the patient is located shall represent the state, rather
2780	than the petitioning facility administrator, as the real party
2781	in interest in the proceeding.
2782	2. The court may appoint a general or special magistrate
2783	to preside at the hearing. One of the two professionals who
2784	executed the involuntary inpatient placement certificate shall
2785	be a witness. The individual patient and the individual's
2786	patient's guardian or representative shall be informed by the
2787	court of the right to an independent expert examination. If the
2788	individual patient cannot afford such an examination, the court
2789	shall provide for one. The independent expert's report is shall
2790	be confidential and not discoverable, unless the expert is to be
2791	called as a witness for the individual patient at the hearing.
2792	The testimony in the hearing must be given under oath, and the
2793	proceedings must be recorded. The individual patient may refuse
2794	to testify at the hearing.
2795	3. The court shall allow testimony from persons, including
2796	family members, deemed by the court to be relevant regarding the
2797	individual's prior history and how that prior history relates to
2798	the individual's current condition.
2799	(b) If the court concludes that the individual patient
2800	meets the criteria for involuntary inpatient placement, it shall
2801	order that the individual patient be transferred to a treatment
2802	facility or, if the individual patient is at a treatment
2803	facility, that the individual patient be retained there or be
2804	treated at any other appropriate receiving or treatment
2805	facility, or that the individual patient receive services from a
2806	receiving or treatment facility, on an involuntary basis, for a
2807	period of up to 6 months. The order must shall specify the
2808	nature and extent of the individual's patient's mental illness.
2809	The facility shall discharge the individual a patient any time
2810	the individual patient no longer meets the criteria for
2811	involuntary inpatient placement, unless the individual patient
2812	has transferred to voluntary status.
2813	(c) If at any time before prior to the conclusion of the
2814	hearing on involuntary inpatient placement it appears to the
2815	court that the individual person does not meet the criteria for
2816	involuntary inpatient placement under this section, but instead
2817	meets the criteria for involuntary outpatient placement, the
2818	court may order the individual person evaluated for involuntary
2819	outpatient placement pursuant to s. 394.4655. The petition and
2820	hearing procedures set forth in s. 394.4655 shall apply. If the
2821	individual person instead meets the criteria for involuntary
2822	assessment, protective custody, or involuntary admission
2823	pursuant to s. 397.675, then the court may order the individual
2824	person to be admitted for involuntary assessment for up to a
2825	period of 5 days pursuant to s. 397.6811. Thereafter, all
2826	proceedings are shall be governed by chapter 397.
2827	(d) At the hearing on involuntary inpatient placement, the
2828	court shall consider testimony and evidence regarding the
2829	individual's patient's competence to consent to treatment. If
2830	the court finds that the individual patient is incompetent to
2831	consent to treatment, it shall appoint a guardian advocate as
2832	provided in s. 394.4598.
2833	(e) The administrator of the receiving facility shall
2834	provide a copy of the court order and adequate documentation of
2835	an individual's a patient's mental illness to the administrator
2836	of a treatment facility if the individual whenever a patient is
2837	ordered for involuntary inpatient placement, whether by civil or
2838	criminal court. The documentation must shall include any advance
2839	directives made by the individual patient, a psychiatric
2840	evaluation of the individual patient, and any evaluations of the
2841	individual patient performed by a clinical psychologist, a
2842	marriage and family therapist, a mental health counselor, or a
2843	clinical social worker. The administrator of a treatment
2844	facility may refuse admission to an individual any patient
2845	directed to its facilities on an involuntary basis, whether by
2846	civil or criminal court order, who is not accompanied at the
2847	same time by adequate orders and documentation.
2848	(7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT
2849	PLACEMENT.-
2850	(a) Hearings on petitions for continued involuntary
2851	inpatient placement shall be administrative hearings and shall
2852	be conducted in accordance with the provisions of s. 120.57(1),
2853	except that an any order entered by an the administrative law
2854	judge is shall be final and subject to judicial review in
2855	accordance with s. 120.68. Orders concerning an individual
2856	patients committed after successfully pleading not guilty by
2857	reason of insanity are shall be governed by the provisions of s.
2858	916.15.
2859	(b) If the individual patient continues to meet the
2860	criteria for involuntary inpatient placement, the administrator
2861	shall, before prior to the expiration of the period during which
2862	the treatment facility is authorized to retain the individual
2863	patient, file a petition requesting authorization for continued
2864	involuntary inpatient placement. The request must shall be
2865	accompanied by a statement from the individual's patient's
2866	physician or clinical psychologist justifying the request, a
2867	brief description of the individual's patient's treatment during
2868	the time he or she was involuntarily placed, and a personalized
2869	an individualized plan of continued treatment. Notice of the
2870	hearing must shall be provided in accordance with as set forth
2871	in s. 394.4599. If at the hearing the administrative law judge
2872	finds that attendance at the hearing is not consistent with the
2873	individual's best interests of the patient, the administrative
2874	law judge may waive the presence of the individual patient from
2875	all or any portion of the hearing, unless the individual
2876	patient, through counsel, objects to the waiver of presence. The
2877	testimony in the hearing must be under oath, and the proceedings
2878	must be recorded.
2879	(c) Unless the individual patient is otherwise represented
2880	or is ineligible, he or she shall be represented at the hearing
2881	on the petition for continued involuntary inpatient placement by
2882	the public defender of the circuit in which the facility is
2883	located.
2884	(d) The Division of Administrative Hearings shall inform
2885	the individual and his or her guardian, guardian advocate, or
2886	representative of the right to an independent expert
2887	examination. If the individual cannot afford such an
2888	examination, the administrative law judge shall appoint an
2889	independent expert and the county of the individual's residence
2890	shall be billed for the cost of the examination.
2891	(e)(d) If at a hearing it is shown that the individual
2892	patient continues to meet the criteria for involuntary inpatient
2893	placement, the administrative law judge shall sign the order for
2894	continued involuntary inpatient placement for a period of up to
2895	not to exceed 6 months. The same procedure must shall be
2896	repeated before prior to the expiration of each additional
2897	period the individual patient is retained.
2898	(f)(e) If continued involuntary inpatient placement is
2899	necessary for an individual a patient admitted while serving a
2900	criminal sentence, but whose sentence is about to expire, or for
2901	a minor patient involuntarily placed while a minor but who is
2902	about to reach the age of 18, the administrator shall petition
2903	the administrative law judge for an order authorizing continued
2904	involuntary inpatient placement.
2905	(g)(f) If the individual patient has been previously found
2906	incompetent to consent to treatment, the administrative law
2907	judge shall consider testimony and evidence regarding the
2908	individual's patient's competence. If the administrative law
2909	judge finds evidence that the individual patient is now
2910	competent to consent to treatment, the administrative law judge
2911	may issue a recommended order to the court that found the
2912	individual patient incompetent to consent to treatment that the
2913	individual's patient's competence be restored and that any
2914	guardian advocate previously appointed be discharged.
2915	(8) RETURN TO FACILITY OF PATIENTS.-If an individual held
2916	When a patient at a treatment facility leaves the facility
2917	without authorization, the administrator may authorize a search
2918	for, the patient and the return of, the individual patient to
2919	the facility. The administrator may request the assistance of a
2920	law enforcement agency in the search for and return of the
2921	patient.
2922	Section 22. Section 394.46715, Florida Statutes, is
2923	amended to read:
2924	394.46715 Rulemaking authority.-The department may adopt
2925	rules to administer of Children and Family Services shall have
2926	rulemaking authority to implement the provisions of ss. 394.455,
2927	394.4598, 394.4615, 394.463, 394.4655, and 394.467 as amended or
2928	created by this act. These rules are shall be for the purpose of
2929	protecting the health, safety, and well-being of individuals
2930	persons examined, treated, or placed under this part act.
2931	Section 23. Section 394.4672, Florida Statutes, is amended
2932	to read:
2933	394.4672 Procedure for placement of veteran with federal
2934	agency.-
2935	(1) If a Whenever it is determined by the court determines
2936	that an individual a person meets the criteria for involuntary
2937	placement and he or she it appears that such person is eligible
2938	for care or treatment by the United States Department of
2939	Veterans Affairs or other agency of the United States
2940	Government, the court, upon receipt of a certificate from the
2941	United States Department of Veterans Affairs or such other
2942	agency showing that facilities are available and that the
2943	individual person is eligible for care or treatment therein, may
2944	place that individual person with the United States Department
2945	of Veterans Affairs or other federal agency. The individual
2946	person whose placement is sought shall be personally served with
2947	notice of the pending placement proceeding in the manner as
2948	provided in this part., and nothing in This section does not
2949	shall affect the individual's his or her right to appear and be
2950	heard in the proceeding. Upon placement, the individual is
2951	person shall be subject to the rules and regulations of the
2952	United States Department of Veterans Affairs or other federal
2953	agency.
2954	(2) The judgment or order of placement issued by a court
2955	of competent jurisdiction of another state or of the District of
2956	Columbia which places an individual, placing a person with the
2957	United States Department of Veterans Affairs or other federal
2958	agency for care or treatment has, shall have the same force and
2959	effect in this state as in the jurisdiction of the court
2960	entering the judgment or making the order.; and The courts of
2961	the placing state or of the District of Columbia shall retain be
2962	deemed to have retained jurisdiction over of the individual
2963	person so placed. Consent is hereby given to the application of
2964	the law of the placing state or district with respect to the
2965	authority of the chief officer of any facility of the United
2966	States Department of Veterans Affairs or other federal agency
2967	operated in this state to retain custody or to transfer, parole,
2968	or discharge the individual person.
2969	(3) Upon receipt of a certificate of the United States
2970	Department of Veterans Affairs or another such other federal
2971	agency that facilities are available for the care or treatment
2972	individuals who have mental illness of mentally ill persons and
2973	that the individual person is eligible for that care or
2974	treatment, the administrator of the receiving or treatment
2975	facility may cause the transfer of that individual person to the
2976	United States Department of Veterans Affairs or other federal
2977	agency. Upon effecting such transfer, the committing court shall
2978	be notified by the transferring agency. An individual may not No
2979	person shall be transferred to the United States Department of
2980	Veterans Affairs or other federal agency if he or she is
2981	confined pursuant to the conviction of any felony or misdemeanor
2982	or if he or she has been acquitted of the charge solely on the
2983	ground of insanity, unless prior to transfer the court placing
2984	the individual such person enters an order for the transfer
2985	after appropriate motion and hearing and without objection by
2986	the United States Department of Veterans Affairs.
2987	(4) An individual Any person transferred as provided in
2988	this section shall be deemed to be placed with the United States
2989	Department of Veterans Affairs or other federal agency pursuant
2990	to the original placement.
2991	Section 24. Section 394.4674, Florida Statutes, is
2992	repealed.
2993	Section 25. Section 394.4685, Florida Statutes, is amended
2994	to read:
2995	394.4685 Transfer between of patients among facilities.-
2996	(1) TRANSFER BETWEEN PUBLIC FACILITIES.-
2997	(a) An individual A patient who has been admitted to a
2998	public receiving facility, or his or her the family member,
2999	guardian, or guardian advocate of such patient, may request the
3000	transfer of the individual patient to another public receiving
3001	facility. An individual A patient who has been admitted to a
3002	public treatment facility, or his or her the family member,
3003	guardian, or guardian advocate of such patient, may request the
3004	transfer of the individual patient to another public treatment
3005	facility. Depending on the medical treatment or mental health
3006	treatment needs of the individual patient and the availability
3007	of appropriate facility resources, the individual patient may be
3008	transferred at the discretion of the department. If the
3009	department approves the transfer of an individual on involuntary
3010	status patient, notice in accordance with according to the
3011	provisions of s. 394.4599 must shall be given before prior to
3012	the transfer by the transferring facility. The department shall
3013	respond to the request for transfer within 2 working days after
3014	receipt of the request by the facility administrator.
3015	(b) If When required by the medical treatment or mental
3016	health treatment needs of the individual patient or the
3017	efficient use utilization of a public receiving or public
3018	treatment facility, an individual a patient may be transferred
3019	from one receiving facility to another, or one treatment
3020	facility to another, at the department's discretion, or, with
3021	the express and informed consent of the individual patient or
3022	the individual's patient's guardian or guardian advocate, to a
3023	facility in another state. Notice in accordance with according
3024	to the provisions of s. 394.4599 must shall be given before
3025	prior to the transfer by the transferring facility. If prior
3026	notice is not possible, notice of the transfer must shall be
3027	provided as soon as practicable after the transfer.
3028	(2) TRANSFER FROM PUBLIC TO PRIVATE FACILITIES.-
3029	(a) An individual A patient who has been admitted to a
3030	public receiving or public treatment facility and has requested,
3031	either personally or through his or her guardian or guardian
3032	advocate, and is able to pay for treatment in a private facility
3033	shall be transferred at the individual's patient's expense to a
3034	private facility upon acceptance of the individual patient by
3035	the private facility.
3036	(b) A public facility may request the transfer of an
3037	individual from the facility to a private facility, and the
3038	individual may be transferred upon acceptance of the individual
3039	by the private facility.
3040	(3) TRANSFER FROM PRIVATE TO PUBLIC FACILITIES.-
3041	(a) An individual A patient or his or her the patient's
3042	guardian or guardian advocate may request the transfer of the
3043	individual patient from a private to a public facility, and the
3044	individual patient may be so transferred upon acceptance of the
3045	individual patient by the public facility.
3046	(b) A private facility may request the transfer of an
3047	individual a patient from the facility to a public facility, and
3048	the individual patient may be so transferred upon acceptance of
3049	the individual patient by the public facility. The cost of such
3050	transfer is shall be the responsibility of the transferring
3051	facility.
3052	(c) A public facility must respond to a request for the
3053	transfer of an individual a patient within 2 working days after
3054	receipt of the request.
3055	(4) TRANSFER BETWEEN PRIVATE FACILITIES.-An individual
3056	being held A patient in a private facility or his or her the
3057	patient's guardian or guardian advocate may request the transfer
3058	of the individual patient to another private facility at any
3059	time, and the individual patient shall be transferred upon
3060	acceptance of the individual patient by the facility to which
3061	transfer is sought.
3062	Section 26. Section 394.469, Florida Statutes, is amended
3063	to read:
3064	394.469 Discharge of involuntary placements patients.-
3065	(1) POWER TO DISCHARGE.-At any time an individual a
3066	patient is found to no longer meet the criteria for involuntary
3067	placement, the administrator shall:
3068	(a) Discharge the individual patient, unless the patient
3069	is under a criminal charge, in which case the patient shall be
3070	transferred to the custody of the appropriate law enforcement
3071	officer;
3072	(b) Transfer the individual patient to voluntary status on
3073	his or her own authority or at the individual's patient's
3074	request, unless the individual patient is under criminal charge
3075	or adjudicated incapacitated; or
3076	(c) Return an individual released from a receiving or
3077	treatment facility on voluntary or involuntary status who is
3078	charged with a crime to the custody of a law enforcement officer
3079	Place an improved patient, except a patient under a criminal
3080	charge, on convalescent status in the care of a community
3081	facility.
3082	(2) NOTICE.-Notice of discharge or transfer of an
3083	individual must be provided in accordance with a patient shall
3084	be given as provided in s. 394.4599.
3085	Section 27. Section 394.473, Florida Statutes, is amended
3086	to read:
3087	394.473 Attorney's fee; expert witness fee.-
3088	(1) In the case of an indigent person for whom An attorney
3089	is appointed to represent an indigent individual pursuant to the
3090	provisions of this part, the attorney shall be compensated by
3091	the state pursuant to s. 27.5304. In the case of an indigent
3092	person, the court may appoint a public defender. A The public
3093	defender appointed to represent an indigent person may shall
3094	receive no additional compensation other than that usually paid
3095	his or her office.
3096	(2) An In the case of an indigent person for whom expert
3097	whose testimony is required for an indigent individual in a
3098	court hearing pursuant to the provisions of this part act, the
3099	expert, except one who is classified as a full-time employee of
3100	the state or who is receiving remuneration from the state for
3101	his or her time in attendance at the hearing, shall be
3102	compensated by the state pursuant to s. 27.5304.
3103	Section 28. Section 394.475, Florida Statutes, is amended
3104	to read:
3105	394.475 Acceptance, examination, and involuntary placement
3106	of Florida residents from out-of-state mental health
3107	authorities.-
3108	(1) Upon the request of the state mental health authority
3109	of another state, the department may is authorized to accept an
3110	individual as a patient, for up to a period of not more than 15
3111	days, a person who is and has been a bona fide resident of this
3112	state for at least a period of not less than 1 year.
3113	(2) An individual Any person received pursuant to
3114	subsection (1) shall be examined by the staff of the state
3115	facility where the individual such patient has been admitted
3116	accepted, which examination shall be completed during the 15-day
3117	period.
3118	(3) If, upon examination, the individual such a person
3119	requires continued involuntary placement, a petition for a
3120	hearing regarding involuntary placement shall be filed with the
3121	court of the county where wherein the treatment facility
3122	receiving the individual patient is located or the county where
3123	the individual patient is a resident.
3124	(4) During the pendency of the examination period and the
3125	pendency of the involuntary placement proceedings, an individual
3126	such person may continue to be held in the treatment facility
3127	unless the court having jurisdiction enters an order to the
3128	contrary.
3129	Section 29. Section 394.4785, Florida Statutes, is amended
3130	to read:
3131	394.4785 Children and adolescents; admission and placement
3132	in mental health facilities.-
3133	(1) A child or adolescent as defined in s. 394.492 may not
3134	be admitted to a state-owned or state-operated mental health
3135	treatment facility. A child may be admitted pursuant to s.
3136	394.4625 or s. 394.467 to a crisis stabilization unit or a
3137	residential treatment center licensed under this chapter or a
3138	hospital licensed under chapter 395. The treatment center, unit,
3139	or hospital must provide the least restrictive available
3140	treatment that is appropriate to the individual needs of the
3141	child or adolescent and must adhere to the guiding principles,
3142	system of care, and service planning provisions of contained in
3143	part III of this chapter.
3144	(2) A child or adolescent, as defined in s. 394.492, who
3145	is younger than person under the age of 14 years of age and who
3146	is admitted to a any hospital licensed pursuant to chapter 395
3147	may not be admitted to a bed in a room or ward with an adult
3148	patient in a mental health unit or share common areas with an
3149	adult patient in a mental health unit. However, an adolescent a
3150	person 14 years of age or older may be admitted to a bed in a
3151	room or ward in the mental health unit with an adult if the
3152	admitting physician documents in the case record that such
3153	placement is medically indicated or for reasons of safety. Such
3154	placement shall be reviewed by the attending physician or a
3155	designee or on-call physician each day and documented in the
3156	clinical case record.
3157	Section 30. Subsection (2) of section 394.4786, Florida
3158	Statutes, is amended to read:
3159	394.4786 Intent.-
3160	(2) Further, the Legislature intends that a specialty
3161	psychiatric hospital that provides health care to specified
3162	indigent individuals patients be eligible for reimbursement up
3163	to the amount that hospital contributed to the Public Medical
3164	Assistance Trust Fund in the previous fiscal year.
3165	Section 31. Subsection (2) of section 394.47865, Florida
3166	Statutes, is amended to read:
3167	394.47865 South Florida State Hospital; privatization.-
3168	(2) The contractor shall operate South Florida State
3169	Hospital as a mental health treatment facility that serves
3170	voluntarily and involuntarily committed indigent adult
3171	individuals adults who meet the criteria of this part I of this
3172	chapter and who reside in the South Florida State Hospital
3173	service area.
3174	(a) South Florida State Hospital shall remain a
3175	participant in the mental health disproportionate share program
3176	so long as such individuals the residents receive eligible
3177	services.
3178	(b) The department and the contractor shall ensure that
3179	the treatment facility is operated as a part of a total
3180	continuum of care for individuals persons who are mentally ill.
3181	The contractor shall have as its primary goal for the treatment
3182	facility to effectively treat and assist individuals held at the
3183	facility residents to return to the community as quickly as
3184	possible.
3185	Section 32. Section 394.4787, Florida Statutes, is amended
3186	to read:
3187	394.4787 Definitions; ss. 394.4786, 394.4787, 394.4788,
3188	and 394.4789.-As used in ss. 394.4786-394.4789, the term this
3189	section and ss. 394.4786, 394.4788, and 394.4789:
3190	(1) "Acute mental health services" means mental health
3191	services provided through inpatient hospitalization.
3192	(2) "Agency" means the Agency for Health Care
3193	Administration.
3194	(3) "Charity care" means that portion of hospital charges
3195	for care provided to an individual a patient whose family income
3196	for the 12 months preceding the determination is equal to or
3197	below 150 percent of the current federal nonfarm poverty
3198	guideline or the amount of hospital charges due from the
3199	individual patient which exceeds 25 percent of the annual family
3200	income and for which there is no compensation. Charity care does
3201	shall not include administrative or courtesy discounts,
3202	contractual allowances to third party payors, or failure of a
3203	hospital to collect full charges due to partial payment by
3204	governmental programs.
3205	(4) "Indigent" means an individual whose financial status
3206	would qualify him or her for charity care.
3207	(5) "Operating expense" means all common and accepted
3208	costs appropriate in developing and maintaining the operating of
3209	the patient care facility and its activities.
3210	(6) "PMATF" means the Public Medical Assistance Trust
3211	Fund.
3212	(7) "Specialty psychiatric hospital" has the same meaning
3213	as in means a hospital licensed by the agency pursuant to s.
3214	395.002(28), and includes facilities licensed under and part II
3215	of chapter 408 as a specialty psychiatric hospital.
3216	Section 33. Subsections (1), (2), and (6) of section
3217	394.4788, Florida Statutes, are amended to read:
3218	394.4788 Use of certain PMATF funds for the purchase of
3219	acute care mental health services.-
3220	(1) A hospital may be eligible to be reimbursed an amount
3221	no greater than the hospital's previous year contribution to the
3222	PMATF for acute mental health services provided to indigent
3223	individuals who are mentally ill persons who have been
3224	determined by the agency or its agent to require such treatment
3225	and who:
3226	(a) Do not meet Medicaid eligibility criteria, unless the
3227	agency makes a referral for a Medicaid eligible individual
3228	patient pursuant to s. 394.4789;
3229	(b) Meet the criteria for mental illness under this part;
3230	and
3231	(c) Meet the definition of charity care.
3232	(2) The agency shall annually calculate a per diem
3233	reimbursement rate for each specialty psychiatric hospital to be
3234	paid to the specialty psychiatric hospitals for the provision of
3235	acute mental health services provided to indigent individuals
3236	who are mentally ill individuals patients who meet the criteria
3237	in subsection (1). After the first rate period, providers shall
3238	be notified of new reimbursement rates for each new state fiscal
3239	year by June 1. The new reimbursement rates shall commence on
3240	July 1.
3241	(6) Hospitals that agree to participate in the program set
3242	forth in this section and ss. 394.4786, 394.4787, and 394.4789
3243	shall agree that payment from the PMATF is payment in full for
3244	all individuals patients for which reimbursement is received
3245	under this section and ss. 394.4786, 394.4787, and 394.4789,
3246	until the funds for this program are no longer available.
3247	Section 34. Section 394.4789, Florida Statutes, is amended
3248	to read:
3249	394.4789 Establishment of referral process and eligibility
3250	determination.-
3251	(1) The department shall adopt by rule a referral process
3252	that provides which shall provide each participating specialty
3253	psychiatric hospital with a system for accepting into the
3254	hospital's care indigent individuals who are mentally ill
3255	persons referred by the department. It is the intent of the
3256	Legislature that a hospital that which seeks payment under s.
3257	394.4788 shall accept referrals from the department. However, a
3258	hospital may shall have the right to refuse the admission of an
3259	individual a patient due to lack of functional bed space or lack
3260	of services appropriate to a patient's specific treatment and is
3261	not no hospital shall be required to accept referrals if the
3262	costs for treating the referred patient are no longer
3263	reimbursable because the hospital has reached the level of
3264	contribution made to the PMATF in the previous fiscal year.
3265	Furthermore, a hospital that does not seek compensation for
3266	indigent individuals who are mentally ill patients under the
3267	provisions of this part is act shall not be obliged to accept
3268	department referrals, notwithstanding any agreements it may have
3269	entered into with the department. The right of refusal in this
3270	subsection does shall not affect a hospital's requirement to
3271	provide emergency care pursuant to s. 395.1041 or other state or
3272	federal law statutory requirements related to the provision of
3273	emergency care.
3274	(2) The department shall adopt by rule a patient
3275	eligibility form and is shall be responsible for eligibility
3276	determination. However, the department may contract with
3277	participating psychiatric hospitals for eligibility
3278	determination. The eligibility form must shall provide the
3279	mechanism for determining a patient's eligibility according to
3280	the requirements of s. 394.4788(1).
3281	(a) A specialty psychiatric hospital is shall be eligible
3282	for reimbursement only if when an eligibility form has been
3283	completed for each indigent individual who is mentally ill
3284	person for whom reimbursement is sought.
3285	(b) As part of eligibility determination, every effort
3286	shall be made by the hospital to determine if any third party
3287	insurance coverage is available.
3288	Section 35. Paragraph (a) of subsection (3) of section
3289	39.407, Florida Statutes, is amended to read:
3290	39.407 Medical, psychiatric, and psychological examination
3291	and treatment of child; physical, mental, or substance abuse
3292	examination of person with or requesting child custody.-
3293	(3)(a)1. Except as otherwise provided in subparagraph
3294	(b)1. or paragraph (e), before the department provides
3295	psychotropic medications to a child in its custody, the
3296	prescribing physician shall attempt to obtain express and
3297	informed consent, as defined in s. 394.455 394.455(9) and as
3298	described in s. 394.459(3) 394.459(3)(a), from the child's
3299	parent or legal guardian. The department shall must take steps
3300	necessary to facilitate the inclusion of the parent in the
3301	child's consultation with the physician. However, if the
3302	parental rights of the parent have been terminated, the parent's
3303	location or identity is unknown or cannot reasonably be
3304	ascertained, or the parent declines to give express and informed
3305	consent, the department may, after consultation with the
3306	prescribing physician, seek court authorization to provide the
3307	psychotropic medications to the child. Unless parental rights
3308	have been terminated and if it is possible to do so, the
3309	department shall continue to involve the parent in the
3310	decisionmaking process regarding the provision of psychotropic
3311	medications. If, at any time, a parent whose parental rights
3312	have not been terminated provides express and informed consent
3313	to the provision of a psychotropic medication, the requirements
3314	of this section that the department seek court authorization do
3315	not apply to that medication until such time as the parent no
3316	longer consents.
3317	2. If Any time the department seeks a medical evaluation
3318	to determine the need to initiate or continue a psychotropic
3319	medication for a child, the department must provide to the
3320	evaluating physician all pertinent medical information known to
3321	the department concerning that child.
3322	Section 36. Subsection (3) of section 394.495, Florida
3323	Statutes, is amended to read:
3324	394.495 Child and adolescent mental health system of care;
3325	programs and services.-
3326	(3) Assessments shall must be performed by:
3327	(a) A clinical psychologist, clinical social worker,
3328	physician, psychiatric nurse, or psychiatrist professional as
3329	defined in s. 394.455 394.455(2), (4), (21), (23), or (24);
3330	(b) A professional licensed under chapter 491; or
3331	(c) A person who is under the direct supervision of a
3332	professional listed in paragraph (a) or paragraph (b) as defined
3333	in s. 394.455(2), (4), (21), (23), or (24) or a
3334	licensed under chapter 491.
3335
3336	The department shall adopt by rule statewide standards for
3337	mental health assessments, which are must be based on current
3338	relevant professional and accreditation standards.
3339	Section 37. Subsection (6) of section 394.496, Florida
3340	Statutes, is amended to read:
3341	394.496 Service planning.-
3342	(6) A clinical psychologist, clinical social worker,
3343	physician, psychiatric nurse, or psychiatrist professional as
3344	defined in s. 394.455, 394.455(2), (4), (21), (23), or (24) or a
3345	professional licensed under chapter 491, must be included among
3346	those persons developing the services plan.
3347	Section 38. Subsection (6) of section 394.9085, Florida
3348	Statutes, is amended to read:
3349	394.9085 Behavioral provider liability.-
3350	(6) For purposes of this section, the terms
3351	"detoxification services," "addictions receiving facility," and
3352	"receiving facility" have the same meanings as those provided in
3353	ss. 397.311(18)(a)4., 397.311(18)(a)1., and 394.455 394.455(26),
3354	respectively.
3355	Section 39. Paragraph (d) of subsection (1) of section
3356	419.001, Florida Statutes, is amended to read:
3357	419.001 Site selection of community residential homes.-
3358	(1) For the purposes of this section, the following
3359	definitions shall apply:
3360	(d) "Resident" means any of the following: a frail elder
3361	as defined in s. 429.65; a physically disabled or handicapped
3362	person as defined in s. 760.22(7)(a); a developmentally disabled
3363	person as defined in s. 393.063; a nondangerous individual who
3364	has a mental illness as defined in s. 394.455 mentally ill
3365	person as defined in s. 394.455(18); or a child who is found to
3366	be dependent as defined in s. 39.01 or s. 984.03, or a child in
3367	need of services as defined in s. 984.03 or s. 985.03.
3368	Section 40. Subsection (7) of section 744.704, Florida
3369	Statutes, is amended to read:
3370	744.704 Powers and duties.-
3371	(7) A public guardian may shall not commit a ward to a
3372	mental health treatment facility, as defined in s. 394.455
3373	394.455(32), without an involuntary placement proceeding as
3374	provided by law.
3375	Section 41. This act shall take effect July 1, 2010.

CODING: Words stricken are deletions; words underlined are additions.