Bill Text: FL H1213 | 2010 | Regular Session | Introduced
Bill Title: Mental Health
Spectrum: Partisan Bill (Democrat 1-0)
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
HB 1213 |
1 | |
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 |
115 | include |
116 | educational, and rehabilitative services for individuals |
117 | |
118 | in order to encourage them to assume responsibility for their |
119 | treatment and recovery. It is intended that such individuals |
120 | |
121 | detention for evaluation if |
122 | to treatment facilities if |
123 | continuing care is needed and unavailable in the community; that |
124 | involuntary placement be provided only if |
125 | determines that it is necessary; that any involuntary treatment |
126 | or examination be accomplished in a setting that |
127 | clinically appropriate and most likely to facilitate the |
128 | individual's |
129 | possible; and that |
130 | guaranteed to all individuals |
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 | |
135 | services. It is the policy of this state that the use of |
136 | restraint and seclusion |
137 | emergency safety measure to be used in response to imminent |
138 | danger to the individual |
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 |
142 | Section 2. Section 394.455, Florida Statutes, is amended |
143 | to read: |
144 | 394.455 Definitions.-As used in this part, |
145 | |
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) |
154 | defined in s. 490.003 |
155 | |
156 | |
157 | employed by a facility operated by the United States Department |
158 | of Veterans Affairs or the United States Department of Defense |
159 | |
160 | |
161 | (5) |
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 |
165 | pertains to an individual's |
166 | treatment. |
167 | (6) |
168 | s. 491.003 |
169 | |
170 | (7) |
171 | provider contracting with the department to furnish substance |
172 | abuse or mental health services under part IV of this chapter. |
173 | (8) |
174 | publicly funded, not-for-profit center that |
175 | the department for the provision of inpatient, outpatient, day |
176 | treatment, or emergency services. |
177 | (9) |
178 | circuit court. |
179 | (10) |
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) |
185 | voluntarily given in writing, by a competent individual |
186 | after sufficient explanation and disclosure of the subject |
187 | matter involved to enable the individual |
188 | knowing and willful decision without any element of force, |
189 | fraud, deceit, duress, or other form of constraint or coercion. |
190 | (13) |
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 |
194 | who appear to have |
195 | as having a mental illness. The term |
196 | a |
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) |
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) |
206 | court to make decisions regarding mental health treatment on |
207 | behalf of an individual |
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) |
212 | |
213 | chapter 408. |
214 | (18) |
215 | has been adjudicated incapacitated pursuant to part V of chapter |
216 | 744 and a guardian of the person has been appointed. |
217 | (19) |
218 | an individual's |
219 | mental illness that he or she |
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) |
230 | |
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) |
236 | service that |
237 | voluntary admission |
238 | onsite services to an individual who has |
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 |
243 | a mental health overlay program must |
244 | contract with the department |
245 | a public receiving facility that is also a community mental |
246 | health center. |
247 | (26) |
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 |
251 | |
252 | |
253 | does not include a |
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) |
261 | nonresidential crisis service attached to a public receiving |
262 | facility and available 24 hours a day, 7 days a week, |
263 | which provides immediate intensive assessments and |
264 | interventions, including screening for admission into a |
265 | receiving facility, |
266 | appropriate treatment services. |
267 | |
268 | |
269 | (29) |
270 | under chapter 458 or chapter 459 |
271 | |
272 | physician employed by a facility operated by the United States |
273 | Department of Veterans Affairs or the United States Department |
274 | of Defense |
275 | |
276 | (30) "Physician assistant" means a person licensed as a |
277 | physician assistant under chapter 458 or chapter 459. |
278 | (31) |
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) |
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 | |
288 | |
289 | |
290 | (33) |
291 | licensed under chapter 458 or chapter 459 who has primarily |
292 | diagnosed and treated mental and nervous disorders for at least |
293 | |
294 | residency. |
295 | (34) |
296 | contracted with the department to provide mental health services |
297 | to all individuals |
298 | and is receiving state funds for such purpose. |
299 | (35) |
300 | facility expressly designated by the department to receive and |
301 | hold individuals involuntarily |
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) |
306 | to s. 394.4597(2) |
307 | |
308 | |
309 | (37) |
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 |
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 |
318 | or her freedom of movement and is not part of the standard |
319 | treatment regimen for an individual having |
320 | diagnosed mental illness |
321 | Physically holding an individual |
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 |
327 | necessary for routine physical examinations and tests; |
328 | purposes of orthopedic, surgical, or other similar medical |
329 | treatment; |
330 | functional body position or proper balance; or |
331 | protect an individual |
332 | (38) |
333 | |
334 | |
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 |
338 | from leaving the room or area. For purposes of this chapter, the |
339 | term does not mean isolation due to an individual's |
340 | medical condition or symptoms. |
341 | (39) |
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) |
350 | approved by the appropriate |
351 | during which an individual |
352 | |
353 | evaluated for appropriateness of admission to a state treatment |
354 | |
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) |
359 | state-operated, or state-supported hospital, or a community |
360 | mental health center |
361 | for extended treatment and hospitalization of individuals who |
362 | have a mental illness |
363 | facility or a |
364 | |
365 | facility designated by the department when rendering such |
366 | services |
367 | |
368 | |
369 | |
370 | |
371 | |
372 | |
373 | |
374 | |
375 | |
376 | |
377 | |
378 | |
379 | |
380 | |
381 | |
382 | |
383 | |
384 | |
385 | |
386 | |
387 | |
388 | |
389 | |
390 | |
391 | |
392 | |
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 |
414 | |
415 | individuals |
416 | serving individuals |
417 | any agency or facility providing services under |
418 | |
419 | (b) The publication and distribution of an information |
420 | handbook to facilitate the understanding of |
421 | policies and procedures involved in the implementation of this |
422 | part, and the responsibilities of the various service providers |
423 | |
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 |
431 | receiving and treatment facilities; clinics; laboratories; |
432 | departments, divisions, and other units of state government; |
433 | state colleges and universities; |
434 | colleges and universities; counties, municipalities, and |
435 | other political subdivisions |
436 | facilities of the United States Government; and any other public |
437 | or private entity that |
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 |
443 | for community-based Baker Act services for inpatient, crisis |
444 | stabilization, short-term residential treatment, and screening |
445 | |
446 | government, |
447 | using competitive solicitation if |
448 | commission of the county receiving the services makes a request |
449 | to the department's circuit |
450 | contracting year. The office may |
451 | competitively bid contract |
452 | will result in increases of state or local expenditures for |
453 | Baker Act services within the circuit |
454 | |
455 | |
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 |
465 | programs. All such moneys must |
466 | Treasury and |
467 | (5) RULES.-The department shall adopt rules: |
468 | (a) |
469 | and procedures relating to the rights and privileges of |
470 | individuals receiving |
471 | or treatment from facilities under this part. |
472 | (b) |
473 | implementation and administration of the provisions of this |
474 | part. |
475 | |
476 | ensure the protection of the health, safety, and welfare of the |
477 | individuals examined and |
478 | program have been adopted. Such rules |
479 | |
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 |
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 |
492 | |
493 | of restraint or seclusion be documented in the clinical record |
494 | of the individual who has been restrained or secluded |
495 | (c) |
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 |
507 | who are believed to have a mental illness. |
508 | (7) PAYMENT FOR CARE |
509 | for individuals receiving treatment or services |
510 | state-owned, state-operated, or state-supported treatment |
511 | facilities must |
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) |
517 | Administration shall require employment screening for mental |
518 | health personnel using |
519 | standards provided in s. 435.04 |
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 |
525 | |
526 | |
527 | |
528 | |
529 | (a) |
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 |
534 | supervision in the actual physical presence of a licensed health |
535 | care professional. |
536 | |
537 | |
538 | |
539 | |
540 | |
541 | |
542 | |
543 | |
544 | (b) |
545 | for less than 40 hours per month is exempt from the |
546 | fingerprinting and screening requirements if |
547 | volunteer is under direct and constant supervision by persons |
548 | who meet the screening requirements of this section |
549 | |
550 | (2) The department or the Agency for Health Care |
551 | Administration may grant exemptions from disqualification as |
552 | provided in s. 435.07 |
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 |
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 |
562 | required to be refingerprinted or rescreened in order to comply |
563 | with the |
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 |
570 | assessing the |
571 | service 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 |
576 | with individuals who are eligible for publicly funded mental |
577 | health services |
578 | others |
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 |
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 |
587 | have access to the full array of services within the mental |
588 | health services delivery system. |
589 | (2) The department shall |
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 |
593 | treatment facilities to community mental health facilities. Such |
594 | system must |
595 | and case managers |
596 | (a) Reduce the possibility of an individual'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 |
601 | shall provide information and referral services necessary to |
602 | ensure that such individuals |
603 | appropriate and least restrictive form of care, based on the |
604 | individual's |
605 | Such agency shall have a single telephone number, operating 24 |
606 | hours per day, 7 days per week, if |
607 | central location, where each individual receiving mental health |
608 | services has |
609 | (c) Advocate on behalf of the individual receiving mental |
610 | health services |
611 | are provided |
612 | manner. |
613 | (d) Require a |
614 | initiating an individual's |
615 | hospital for acute care mental health services not accessible |
616 | through the public receiving facility to |
617 | hospital of the |
618 | the emergency psychiatric or medical condition. |
619 | (3) The department shall |
620 | include performance measures in contracts with service providers |
621 | relating to |
622 | objectives |
623 | |
624 | data collection methods and reports and may |
625 | |
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 | |
631 | |
632 | |
633 | |
634 | |
635 | |
636 | |
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 |
652 | of this subsection related to appropriateness for placement as a |
653 | mental health resident if it was completed within 90 days before |
654 | |
655 | (3) The secretary |
656 | consultation with the Agency for Health Care Administration, |
657 | shall annually require each circuit |
658 | develop, with community input, detailed plans that demonstrate |
659 | how the circuit |
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 |
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) |
674 | authorized by the person in charge of a receiving or treatment |
675 | facility |
676 | this part, it is unlawful to: |
677 | (a) Introduce into or upon the grounds of such facility |
678 | |
679 | facility |
680 | |
681 | section: |
682 | 1. An |
683 | causes or may cause an intoxicating effect; |
684 | 2. A |
685 | or |
686 | 3. A firearm |
687 | (b) |
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 |
691 | |
692 | thing declared by this section to be contraband, at any place |
693 | |
694 | |
695 | |
696 | Section 8. Section 394.459, Florida Statutes, is amended |
697 | to read: |
698 | 394.459 Rights of individuals receiving treatment and |
699 | services |
700 | (1) RIGHT TO |
701 | state that the |
702 | examination or admitted for mental health treatment |
703 | |
704 | including |
705 | custody, held, or transported. Procedures, facilities, vehicles, |
706 | and restraining devices used |
707 | accused of a crime may |
708 | individuals |
709 | protection of that individual |
710 | |
711 | criminal offense may |
712 | the jails of this state. An individual |
713 | treatment for mental illness may |
714 | constitutional rights. However, if such individual |
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 |
721 | illness, and services may |
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 |
725 | |
726 | party payers |
727 | services under |
728 | (b) Shall be provided |
729 | |
730 | treatment, |
731 | needs and best interests, |
732 | optimum improvement of the individual's |
733 | (c) |
734 | |
735 | examination and psychiatric evaluation by |
736 | |
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) |
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) |
746 | |
747 | plan in writing, which the individual |
748 | opportunity to assist in preparing and to review prior to |
749 | implementation, within 5 days after admission to a facility. The |
750 | plan must |
751 | comments and signature. |
752 | (3) RIGHT TO EXPRESS AND INFORMED |
753 | (a) |
754 | asked to give express and informed consent for admission or |
755 | treatment. |
756 | 1. If the individual |
757 | incapacitated or found to be incompetent to consent to |
758 | treatment, express and informed consent must |
759 | be sought instead from his or her |
760 | guardian advocate. If the individual |
761 | and informed consent for admission or treatment must be obtained |
762 | |
763 | |
764 | |
765 | guardian, unless the minor is seeking outpatient crisis |
766 | intervention services under s. 394.4784. |
767 | |
768 | |
769 | |
770 | |
771 | 2. Before giving express and informed consent, the |
772 | following information shall be provided and explained in plain |
773 | language to the individual |
774 | |
775 | |
776 | to his or her |
777 | |
778 | treatment, or to both the individual |
779 | the individual |
780 | treatment; the proposed treatment; the purpose of the treatment |
781 | to be provided; the common risks, benefits, and side effects |
782 | |
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 | |
789 | care decisions on the individual's behalf |
790 | (b) Before performing a medical procedure |
791 | |
792 | electroconvulsive treatment, |
793 | |
794 | from the individual subject to the procedure |
795 | individual |
796 | minor |
797 | has been adjudicated incapacitated, or from the individual's |
798 | guardian advocate |
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 |
803 | |
804 | physician is unwilling to perform a medical procedure, including |
805 | an electroconvulsive treatment, based solely on the individual's |
806 | |
807 | unknown or unlocatable, the court shall hold a hearing to |
808 | determine the medical necessity of the |
809 | individual subject to the procedure must |
810 | physically present |
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 |
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 |
819 | attending physician, authorize emergency medical treatment, |
820 | including a surgical procedure, if such treatment is deemed |
821 | lifesaving |
822 | the individual |
823 | |
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 |
829 | |
830 | that are |
831 | |
832 | and humanely with full respect for the individual's |
833 | dignity and personal integrity. Each individual must |
834 | |
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 |
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, |
843 | and consistent with rules adopted by the department |
844 | |
845 | 1. Criteria, procedures, and required staff training for |
846 | the |
847 | restraint, seclusion, or isolation; |
848 | orders; |
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 | |
855 | 3. A system for investigating, tracking, managing, and |
856 | responding to complaints by individuals |
857 | services or persons |
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 |
881 | |
882 | demonstrate that this information has been conveyed to each |
883 | |
884 | (5) COMMUNICATION, ABUSE REPORTING, AND VISITS.- |
885 | (a) Each individual held for examination or admitted for |
886 | mental health treatment |
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 |
891 | facility shall make |
892 | |
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 |
896 | distance calls. The telephone must |
897 | |
898 | |
899 | The facility may establish reasonable rules for the use of this |
900 | telephone which |
901 | an individual's |
902 | abuse pursuant to paragraph (e). |
903 | (b) Each individual |
904 | |
905 | and mail sealed, unopened correspondence; and the individual's |
906 | |
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 |
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 |
914 | to an individual held for examination or admitted for mental |
915 | health treatment |
916 | deny or withdraw consent at any time |
917 | the individual's |
918 | advocate, representative, Florida statewide or local advocacy |
919 | council, or attorney, unless such access would be detrimental to |
920 | the individual |
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 |
924 | |
925 | advocate, or representative, |
926 | reasons for the restriction, must |
927 | |
928 | restriction must |
929 | |
930 | right to communicate or receive visitors may |
931 | restricted as a means of punishment. |
932 | does not |
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 |
938 | individual has |
939 | receive communication from his or her attorney |
940 | at any reasonable time. |
941 | (e) Each individual held for examination or admitted for |
942 | |
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 |
946 | shall make every reasonable effort to present the information in |
947 | a language the individual |
948 | that procedure, including the telephone number of the central |
949 | abuse hotline and reporting forms, must |
950 | view. |
951 | (f) The department shall adopt rules providing a procedure |
952 | for reporting abuse. Facility staff |
953 | condition of employment, must |
954 | requirements and procedures for |
955 | (6) CARE AND CUSTODY OF PERSONAL EFFECTS |
956 | rights of an individual held for examination or admitted for |
957 | mental health treatment |
958 | his or her clothing and personal effects shall be respected. The |
959 | facility may take temporary custody of such effects if |
960 | required for medical and safety reasons. The |
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 |
964 | |
965 | shall be recorded in the |
966 | inventory may be amended upon the request of the individual |
967 | |
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 |
971 | clothing and personal effects held by the facility must |
972 | returned to the individual |
973 | |
974 | unless such return would be detrimental to the individual |
975 | |
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 |
979 | guardian advocate, or representative. As soon as practicable |
980 | after an emergency transfer |
981 | |
982 | the individual's |
983 | the inventory and any amendments, unless an alternate plan is |
984 | approved by the individual |
985 | his or her |
986 | representative. |
987 | (7) VOTING IN PUBLIC ELECTIONS.-An individual held for |
988 | examination or admitted for mental health treatment |
989 | who is eligible to vote |
990 | the right to vote in the primary and general elections. The |
991 | department shall establish rules to enable such individuals |
992 | |
993 | absentee ballots, and absentee ballots. |
994 | (8) HABEAS CORPUS.- |
995 | (a) At any time, and without notice, an individual |
996 | |
997 | facility, or a relative, friend, guardian, guardian advocate, |
998 | representative, or attorney, or the department, on behalf of |
999 | such individual |
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 |
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 |
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 |
1010 | petition in the circuit court in the county where the individual |
1011 | |
1012 | being unjustly denied a right or privilege granted under this |
1013 | section |
1014 | |
1015 | court may |
1016 | and |
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 |
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 |
1027 | provided under this part, by any facility or professional |
1028 | licensed or regulated by the agency. The agency may |
1029 | |
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 |
1034 | examination or admitted for mental health treatment |
1035 | provided under |
1036 | by law. Any person who acts reasonably, in good faith, and |
1037 | without negligence in compliance with |
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 |
1044 | or from a facility. |
1045 | |
1046 | (11) RIGHT TO PARTICIPATE IN TREATMENT AND DISCHARGE |
1047 | PLANNING.-An individual held for examination or admitted for |
1048 | mental health treatment |
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 |
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) |
1062 | facility shall post a notice, which lists and describes in |
1063 | |
1064 | individual |
1065 | understand, of the rights provided under |
1066 | notice must |
1067 | federal Americans with Disabilities Act apply and the name and |
1068 | telephone number of a person to contact for further information. |
1069 | The |
1070 | accessible to |
1071 | individuals served |
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 |
1083 | providers. |
1084 | (b) "Sexual activity" means: |
1085 | 1. Fondling the genital area, groin, inner thighs, |
1086 | buttocks, or breasts of an individual |
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 |
1093 | enticing an individual |
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 |
1098 | 6. Intentionally committing any other sexual act that does |
1099 | not involve actual physical or sexual contact with another |
1100 | individual |
1101 | sadomasochistic abuse, sexual bestiality, or the simulation of |
1102 | any act involving sexual activity in the presence of the |
1103 | individual |
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 |
1107 | of that individual |
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 |
1112 | (a) Is in the custody of the department; or |
1113 | (b) Resides in a receiving facility or a treatment |
1114 | facility |
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 |
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 |
1125 | (b) Has no reason to believe that the person with whom the |
1126 | employee engaged in sexual misconduct is an individual |
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 |
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 |
1135 | legal records |
1136 | |
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 | |
1142 | (1) VOLUNTARY ADMISSION |
1143 | individual |
1144 | treatment facility, the identity and contact information of the |
1145 | |
1146 | in the |
1147 | (2) INVOLUNTARY ADMISSION |
1148 | |
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 |
1152 | guardian or guardian advocate, or representative if he or she |
1153 | |
1154 | surrogate, and |
1155 | |
1156 | (a) |
1157 | guardian advocate, he or she |
1158 | designate a representative. If the individual |
1159 | or unwilling to designate a representative, the facility shall |
1160 | select a representative. |
1161 | (b) |
1162 | regard to the selection of a representative by the receiving or |
1163 | treatment facility and may |
1164 | the |
1165 | (c) |
1166 | a representative, first preference shall be given to a health |
1167 | care surrogate, if one has been previously selected |
1168 | |
1169 | health care surrogate, the selection, except for good cause |
1170 | documented in the |
1171 | the following list in the order of listing: |
1172 | 1. The individual's |
1173 | 2. An adult child of the individual |
1174 | 3. A parent of the individual |
1175 | 4. The adult next of kin of the individual |
1176 | 5. An adult friend of the individual |
1177 | 6. The appropriate Florida local advocacy council as |
1178 | provided in s. 402.166. |
1179 | (d) |
1180 | individual |
1181 | providing direct services to the individual |
1182 | part, a department employee, a person providing other |
1183 | substantial services to the individual |
1184 | or business capacity, or a creditor of the individual may |
1185 | |
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 |
1227 | consent to treatment. If the court finds that the individual |
1228 | |
1229 | adjudicated incapacitated and a guardian having |
1230 | authority to consent to mental health treatment has not been |
1231 | appointed, it shall appoint a guardian advocate. The individual |
1232 | |
1233 | at the hearing. If the individual |
1234 | shall appoint the office of the public defender to represent him |
1235 | or her at the hearing. The individual |
1236 | testify, cross-examine witnesses, and present witnesses. The |
1237 | proceeding must |
1238 | stenographically, and testimony shall be |
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 |
1242 | must meet the qualifications of a guardian pursuant to |
1243 | |
1244 | services to the individual under |
1245 | employee of the facility providing direct services to the |
1246 | individual |
1247 | facility administrator, or a member of the Florida local |
1248 | advocacy council may |
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 |
1253 | and responsibilities of guardian advocates, including |
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 |
1258 | |
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 |
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 |
1266 | face-to-face |
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 |
1273 | |
1274 | (3) Before |
1275 | |
1276 | complete |
1277 | The |
1278 | include, at minimum, information concerning individual |
1279 | |
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 |
1283 | chapter 744. |
1284 | (4) The information provided |
1285 | guardian advocates before |
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 |
1289 | |
1290 | |
1291 | |
1292 | |
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 |
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 |
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 |
1307 | (b) An adult child of the individual |
1308 | (c) A parent of the individual |
1309 | (d) The adult next of kin of the individual |
1310 | (e) An adult friend of the individual |
1311 | (f) An adult trained and willing to serve as guardian |
1312 | advocate for the individual |
1313 | (6) If a guardian having |
1314 | medical treatment has not already been appointed, or if the |
1315 | individual held for examination or admitted for mental health |
1316 | treatment |
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 |
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 |
1325 | |
1326 | |
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 |
1337 | treatment or procedure is essential to the care of the |
1338 | individual |
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 |
1344 | an order for involuntary outpatient |
1345 | inpatient placement or when the individual |
1346 | transferred from involuntary to voluntary status. The court |
1347 | |
1348 | |
1349 | involuntarily placed individual's |
1350 | consent to treatment at any hearing. Upon sufficient evidence, |
1351 | the court may restore, or the magistrate |
1352 | recommend that the court restore, the individual'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 |
1356 | guardian advocate. |
1357 | Section 13. Section 394.4599, Florida Statutes, is amended |
1358 | to read: |
1359 | 394.4599 Notice.- |
1360 | (1) VOLUNTARY ADMISSION |
1361 | individual's |
1362 | only at the individual's request |
1363 | an emergency, notice shall be given as determined by the |
1364 | facility. |
1365 | (2) INVOLUNTARY ADMISSION |
1366 | (a) If notice of involuntary admission |
1367 | required to be given |
1368 | to the individual admitted |
1369 | guardian, guardian advocate, attorney, and representative. |
1370 | 1. If |
1371 | |
1372 | language and terminology that the individual |
1373 | understand, and, if needed, the facility shall provide an |
1374 | interpreter for the individual |
1375 | 2. Notice to an individual's |
1376 | guardian advocate, health care surrogate or proxy, attorney, and |
1377 | representative shall be given by |
1378 | registered |
1379 | |
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 |
1383 | |
1384 | (b) A receiving facility shall give prompt notice of the |
1385 | whereabouts of an individual |
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 |
1389 | |
1390 | attempts must |
1391 | clinical record and shall begin as soon as reasonably possible |
1392 | after the individual's |
1393 | individual is being involuntarily held must |
1394 | |
1395 | local advocacy council by |
1396 | after the individual |
1397 | (c) The written notice of the filing of the petition for |
1398 | the involuntary placement of an individual being held must |
1399 | include |
1400 | 1. Notice that the petition has been filed with the |
1401 | circuit court in the county in which the individual |
1402 | hospitalized and the court's address |
1403 | 2. Notice that the office of the public defender has been |
1404 | appointed to represent the individual |
1405 | if the individual |
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 |
1411 | |
1412 | apply for a change of venue for the convenience of the parties |
1413 | or witnesses or because of the individual's condition |
1414 | |
1415 | 5. Notice that the individual |
1416 | independent expert examination and, if the individual |
1417 | cannot afford such |
1418 | for one. |
1419 | (d) A treatment facility shall provide notice of an |
1420 | individual's |
1421 | regular working day after the individual's |
1422 | the facility. |
1423 | (e) If an individual |
1424 | from one facility to another, notice shall be given by the |
1425 | facility where the individual |
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 |
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 |
1437 | department, may |
1438 | individuals on an involuntary basis |
1439 | (1) RECEIVING FACILITY.-The department may designate any |
1440 | |
1441 | within the state, including a private facility, as a receiving |
1442 | facility if |
1443 | |
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 |
1448 | |
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 | |
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) |
1462 | as receiving and treatment facilities by the department may |
1463 | provide examination and treatment of individuals on an |
1464 | involuntary or |
1465 | |
1466 | (5) |
1467 | (a) A facility designated as a |
1468 | treatment facility under this section shall annually report |
1469 | |
1470 | department, unless such |
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 |
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 |
1485 | (c) The data required under this subsection shall be |
1486 | submitted to the department within |
1487 | |
1488 | |
1489 | |
1490 | |
1491 | (d) The department shall issue an annual report based on |
1492 | the data collected |
1493 | must |
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) |
1498 | to: |
1499 | (a) Procedures and criteria for receiving and evaluating |
1500 | |
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 |
1506 | a facility must meet and maintain in order to be designated as a |
1507 | receiving or treatment facility, and procedures for monitoring |
1508 | |
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 |
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 |
1524 | express and informed consent of the individual, |
1525 | or by his or her |
1526 | health care surrogate or proxy, or, if |
1527 | by his or her |
1528 | family member who stands next in line of intestate succession, |
1529 | the confidential status of the clinical record is |
1530 | lost by |
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 |
1535 | (a) The individual |
1536 | guardian, guardian advocate, or health care surrogate or proxy |
1537 | authorizes the release. The guardian, |
1538 | surrogate shall be provided access to the appropriate clinical |
1539 | records |
1540 | individual's |
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 |
1544 | (b) The individual |
1545 | the records are needed by such |
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) |
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 |
1555 | such information pertains. |
1556 | (e) |
1557 | returned to |
1558 | |
1559 | Corrections requests such records. The |
1560 | furnished without charge to the Department of Corrections. |
1561 | (3) Information from the clinical record may be released |
1562 | if |
1563 | (a) The individual |
1564 | intention to harm other persons. If |
1565 | been made, the administrator may authorize the release of |
1566 | sufficient information to provide adequate warning to the person |
1567 | threatened with harm |
1568 | (b) |
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 |
1573 | records, compilation of treatment data, aftercare planning, or |
1574 | evaluation of programs. |
1575 | (c) The information is necessary for |
1576 | determining whether an individual |
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 |
1581 | the court, and to the appropriate mental health professionals, |
1582 | including the service provider identified in s. 394.4655(6)(b) |
1583 | |
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 |
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) |
1603 | prohibit the parent or next of kin of an individual |
1604 | is held for examination |
1605 | mental health treatment |
1606 | receiving information limited to a summary of that individual's |
1607 | |
1608 | condition. Release of such information must |
1609 | accordance with the code of ethics of the profession involved. |
1610 | (10) An adult individual |
1611 | access to his or her |
1612 | is determined by the individual's |
1613 | harmful to the individual |
1614 | right to inspect his or her clinical record is restricted by the |
1615 | facility, written notice of the |
1616 | given to the individual |
1617 | guardian, guardian advocate, attorney, and representative. In |
1618 | addition, the restriction must |
1619 | record, together with the reasons for it. The restriction |
1620 | expires |
1621 | |
1622 | review, for subsequent 7-day periods. |
1623 | (11) Any person who fraudulently alters, defaces, or |
1624 | falsifies the clinical record of an individual |
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 |
1636 | order or the execution of a certificate for involuntary |
1637 | examination by an authorized professional and to transport that |
1638 | individual |
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 |
1644 | 1. The county or jurisdiction designated by the county has |
1645 | contracted |
1646 | transport service or private transport company for |
1647 | transportation of individuals |
1648 | |
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 |
1653 | others. |
1654 | (b) |
1655 | provided by an emergency medical transport service or private |
1656 | transport company, the county or law enforcement agency |
1657 | |
1658 | transportation expenses. The individual being transported is |
1659 | |
1660 | |
1661 | reimbursement from the following sources in the following order: |
1662 | 1. |
1663 | or other source, if the individual being transported |
1664 | |
1665 | or subscribes to a health care corporation or other source for |
1666 | payment of such expenses. |
1667 | 2. |
1668 | |
1669 | 3. |
1670 | treatment, hospitalization, or transportation payable or |
1671 | accruing to the injured party. |
1672 | (c) |
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 |
1676 | insured and maintain at least |
1677 | liability insurance with respect to such |
1678 | |
1679 | (d) |
1680 | of a county to transport individuals for examination or |
1681 | treatment must |
1682 | of the department to ensure their |
1683 | |
1684 | (e) |
1685 | an individual |
1686 | request assistance from emergency medical personnel if such |
1687 | assistance is needed for the safety of the officer or the |
1688 | individual |
1689 | (f) |
1690 | or a mobile crisis response service who is a professional |
1691 | authorized to initiate an involuntary examination pursuant to s. |
1692 | 394.463 |
1693 | and determines that transportation to a receiving facility is |
1694 | needed, the service |
1695 | individual |
1696 | enforcement agency or other transportation arrangement best |
1697 | suited to the needs of the individual being transported |
1698 | (g) |
1699 | of an individual |
1700 | criminal behavior that meets the statutory guidelines for |
1701 | involuntary examination under this part, the law enforcement |
1702 | officer shall transport the individual |
1703 | receiving facility for examination. |
1704 | (h) |
1705 | an adult individual |
1706 | the individual |
1707 | involuntary examination or placement under this part, the |
1708 | individual |
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 |
1713 | receiving facility is not required to admit an individual |
1714 | |
1715 | documents that it is unable to provide adequate security, but |
1716 | shall provide mental health examination and treatment to the |
1717 | individual |
1718 | (i) |
1719 | that an individual |
1720 | as defined in s. 395.002, the individual |
1721 | transported to a hospital for emergency medical treatment, |
1722 | regardless of whether the hospital is a designated receiving |
1723 | facility. |
1724 | (j) |
1725 | hospitalization, and treatment incurred under this subsection by |
1726 | individuals |
1727 | state law or county or municipal ordinance may be recovered as |
1728 | provided in s. 901.35. |
1729 | (k) |
1730 | individuals |
1731 | involuntary examination. |
1732 | (l) |
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) |
1739 | with an emergency medical transport service or a private |
1740 | transport company for transportation of individuals |
1741 | receiving facilities, such service or company shall be given |
1742 | preference for transportation of individuals |
1743 | nursing homes, assisted living facilities, adult day care |
1744 | centers, or adult family-care homes, unless the behavior of the |
1745 | individual |
1746 | by a law enforcement officer is necessary. |
1747 | (n) |
1748 | |
1749 | individuals |
1750 | |
1751 | (2) TRANSPORTATION TO A TREATMENT FACILITY.- |
1752 | (a) If |
1753 | admitted for mental health treatment or |
1754 | legally obligated or responsible for the individual |
1755 | not able to pay for the expense of transporting an individual |
1756 | |
1757 | governing board of the county in which the individual |
1758 | hospitalized shall arrange for the |
1759 | and shall ensure the safe and dignified transportation of the |
1760 | individual |
1761 | |
1762 | |
1763 | |
1764 | (b) Any company that transports an individual |
1765 | pursuant to this subsection is considered an |
1766 | contractor and is solely liable for the safe and |
1767 | transportation of the individual |
1768 | insured and provide at least |
1769 | insurance for such |
1770 | |
1771 | (c) Any company that contracts with the governing board of |
1772 | a county to transport individuals must |
1773 | with the applicable rules of the department to ensure the safety |
1774 | and dignity of the individuals transported |
1775 | (d) County or municipal law enforcement and correctional |
1776 | personnel and equipment may |
1777 | individuals |
1778 | court to meet the criteria for involuntary placement under |
1779 | |
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 |
1788 | of improving service coordination or better meeting the special |
1789 | needs of individuals. A proposal for an exception shall |
1790 | submitted to the secretary by the circuit |
1791 | after being approved by the governing board of each affected |
1792 | county |
1793 | |
1794 | 1. |
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, |
1798 | provide a plan for the coordination of services such as case |
1799 | management. |
1800 | 2. |
1801 | a. |
1802 | provision of services within a circuit |
1803 | include an exception to the requirement for transportation to |
1804 | the nearest receiving facility; |
1805 | b. |
1806 | provide, in addition to required psychiatric services, an |
1807 | environment and services that |
1808 | needs of an identified group of individuals who have |
1809 | |
1810 | impairments or visual impairments, or elderly persons who have |
1811 | |
1812 | c. |
1813 | efficient and humane method of transporting individuals |
1814 | to receiving facilities, among receiving facilities, and to |
1815 | treatment facilities. |
1816 | 2. |
1817 | must |
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 |
1831 | |
1832 | (a) A facility may receive for observation, diagnosis, or |
1833 | treatment an adult who makes |
1834 | |
1835 | or any minor |
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 |
1840 | |
1841 | 2. A minor |
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 |
1861 | |
1862 | (b) A mental health overlay program, |
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 |
1867 | respective circuit |
1868 | assessment of the ability of the following individuals |
1869 | to give express and informed consent to treatment before such |
1870 | individuals |
1871 | 1. An individual |
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 |
1875 | dementia. |
1876 | 2. An individual |
1877 | whom transfer is being sought from a nursing home pursuant to s. |
1878 | 400.0255(11) |
1879 | 3. An individual |
1880 | concerning medical treatment are currently being lawfully made |
1881 | by a |
1882 | 765. |
1883 | (c) If |
1884 | individual |
1885 | treatment is required under this section, and a mobile crisis |
1886 | response service does not respond to a |
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 |
1891 | professional authorized to initiate an involuntary examination |
1892 | under |
1893 | |
1894 | financial interest in, |
1895 | transfer or the |
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 |
1899 | voluntary status |
1900 | incapacitated, unless the condition of incapacity has been |
1901 | judicially removed. If a facility admits an individual on |
1902 | voluntary status |
1903 | determined to have been adjudicated incapacitated |
1904 | condition of incapacity had not been removed by the time of the |
1905 | admission, the facility must |
1906 | transfer the individual |
1907 | (e) The health care surrogate or proxy of an individual on |
1908 | |
1909 | mental health treatment for that individual |
1910 | individual on voluntary status |
1911 | unwilling or unable to provide express and informed consent to |
1912 | mental health treatment must |
1913 | to involuntary status. |
1914 | (f) Within 24 hours after an individual's voluntary |
1915 | admission |
1916 | document in the |
1917 | |
1918 | admission. If the individual |
1919 | and informed consent for admission, the facility must |
1920 | |
1921 | to involuntary status pursuant to subsection (5). |
1922 | (2) RELEASE OR DISCHARGE |
1923 | (a) A facility shall discharge an individual admitted on |
1924 | voluntary status who |
1925 | 1. |
1926 | facility is no longer desirable. The individual |
1927 | also be discharged to the care of a community facility. |
1928 | 2. |
1929 | requests discharge. The individual |
1930 | her |
1931 | discharge |
1932 | admission to the facility. The individual |
1933 | discharged within 24 hours after |
1934 | request is rescinded or the individual |
1935 | involuntary status pursuant to this section. The 24-hour time |
1936 | period may be extended by a treatment facility if |
1937 | for adequate discharge planning, but may |
1938 | exclusive of weekends and holidays. If the individual |
1939 | or another on his or her |
1940 | request for discharge to a staff member, such request must |
1941 | be immediately entered in the |
1942 | request for discharge is made by a person other than the |
1943 | individual |
1944 | individual's express and informed consent |
1945 | (b) An individual on |
1946 | been admitted to a facility and who refuses to consent to or |
1947 | revokes consent to treatment must |
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 |
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 |
1957 | voluntary status |
1958 | her right to apply for a discharge. |
1959 | (4) TRANSFER TO VOLUNTARY STATUS.-An individual on |
1960 | involuntary status |
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 |
1964 | individual |
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 | |
1971 | individual's |
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 |
1976 | the individual |
1977 | placement, the administrator of the facility must file with the |
1978 | court a petition for involuntary placement |
1979 | working days after the request |
1980 | petition is not filed within 2 court working days, the |
1981 | individual must |
1982 | of the petition, the individual |
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 | |
1987 | Section 19. Section 394.463, Florida Statutes, is amended |
1988 | to read: |
1989 | 394.463 Involuntary examination.- |
1990 | (1) CRITERIA.-An individual |
1991 | receiving facility for involuntary examination if there is |
1992 | reason to believe that he or she |
1993 | and because of this |
1994 | (a)1. The individual |
1995 | examination after conscientious explanation and disclosure of |
1996 | the purpose of the examination; or |
1997 | 2. The individual |
1998 | himself or herself whether examination is necessary; and |
1999 | (b) |
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 |
2007 | |
2008 | to self |
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 |
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. |
2021 | |
2022 | |
2023 | enforcement officer, or other designated agent of the court, |
2024 | shall take the individual |
2025 | her to the nearest receiving facility for involuntary |
2026 | examination. The |
2027 | part of the |
2028 | charged for the filing of an order under this subsection. Any |
2029 | receiving facility accepting the individual |
2030 | |
2031 | Health Care Administration on the next working day. The order is |
2032 | |
2033 | receiving facility |
2034 | period specified in the order itself, whichever occurs first. If |
2035 | a |
2036 | |
2037 | signed. |
2038 | 2. A law enforcement officer shall take an individual |
2039 | |
2040 | examination into custody and deliver or arrange for the delivery |
2041 | of the individual |
2042 | nearest receiving facility for examination. The officer shall |
2043 | complete |
2044 | under which the individual |
2045 | The report must |
2046 | record. Any receiving facility accepting the individual |
2047 | based on 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, |
2051 | clinical social worker, or physician assistant may execute a |
2052 | certificate stating that he or she has examined the individual |
2053 | |
2054 | individual |
2055 | examination and stating the observations upon which that |
2056 | conclusion is based. |
2057 | |
2058 | |
2059 | |
2060 | her to the nearest receiving facility for involuntary |
2061 | examination. The law enforcement officer shall complete |
2062 | a written report detailing the circumstances under which the |
2063 | individual |
2064 | certificate shall be made a part of the |
2065 | record. Any receiving facility accepting the individual |
2066 | based on 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) |
2078 | from a |
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 |
2083 | such that preparation of a law enforcement officer's report is |
2084 | not practicable before removal, the report must |
2085 | completed as soon as possible after removal, but |
2086 | before the individual |
2087 | facility. A receiving facility admitting an individual |
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 |
2091 | Health Care Administration of such admission by certified mail |
2092 | by |
2093 | |
2094 | |
2095 | (d) |
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) |
2100 | an ex parte order issued pursuant to this subsection may use |
2101 | |
2102 | to the premises |
2103 | structures located on the premises, and to take custody of the |
2104 | individual |
2105 | (f) |
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 |
2112 | The agency shall prepare annual reports analyzing the data |
2113 | obtained from these documents |
2114 | individuals held for examination or admitted for mental health |
2115 | treatment |
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) |
2120 | physician or clinical psychologist |
2121 | without unnecessary delay to determine if the criteria for |
2122 | involuntary inpatient placement is met. Emergency treatment may |
2123 | be provided |
2124 | |
2125 | necessary for the safety of the patient or others. |
2126 | |
2127 | |
2128 | |
2129 | |
2130 | |
2131 | |
2132 | |
2133 | |
2134 | |
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) |
2161 | examination has been initiated |
2162 | treated at a hospital for an emergency medical condition |
2163 | specified in s. 395.002, |
2164 | |
2165 | individual |
2166 | attending physician documents that the individual |
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. |
2170 | |
2171 | |
2172 | |
2173 | |
2174 | |
2175 | |
2176 | |
2177 | |
2178 | |
2179 | |
2180 | |
2181 | |
2182 | medical services may transfer an individual |
2183 | |
2184 | stabilization if |
2185 | are |
2186 | |
2187 | the |
2188 | individual's |
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 | |
2204 | |
2205 | |
2206 | |
2207 | |
2208 | |
2209 | |
2210 | |
2211 | |
2212 | |
2213 | |
2214 | |
2215 | |
2216 | |
2217 | |
2218 | |
2219 | |
2220 | |
2221 | |
2222 | |
2223 | |
2224 | |
2225 | |
2226 | |
2227 | |
2228 | |
2229 | |
2230 | |
2231 | |
2232 | |
2233 | |
2234 | (3) NOTICE OF RELEASE.-Notice of the release shall be |
2235 | given to the individual's |
2236 | to any person who executed a certificate admitting the |
2237 | individual |
2238 | that |
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 |
2244 | placement upon a finding of the court |
2245 | convincing evidence that: |
2246 | (a) The individual is an adult |
2247 | |
2248 | (b) The individual |
2249 | (c) The individual |
2250 | the community without supervision, based on a clinical |
2251 | determination; |
2252 | (d) The individual |
2253 | compliance with treatment for mental illness; |
2254 | (e) The individual |
2255 | 1. At least twice within the immediately preceding 36 |
2256 | months been involuntarily admitted to a receiving or treatment |
2257 | facility |
2258 | services in a forensic or correctional facility. The 36-month |
2259 | period does not include any period during which the individual |
2260 | |
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 |
2264 | months; |
2265 | (f) Due to |
2266 | illness, the individual is unlikely to voluntarily participate |
2267 | in the recommended treatment plan and |
2268 | refused voluntary placement for treatment after sufficient and |
2269 | conscientious explanation and disclosure of the purpose of |
2270 | placement for treatment or |
2271 | himself or herself whether placement is necessary; |
2272 | (g) In view of the individual's |
2273 | and current behavior, the individual |
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 |
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 |
2280 | from involuntary outpatient placement; and |
2281 | (i) All available, less restrictive alternatives that |
2282 | |
2283 | condition have been judged to be inappropriate or unavailable. |
2284 | (2) INVOLUNTARY OUTPATIENT PLACEMENT.- |
2285 | (a) |
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 |
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 |
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 |
2307 | record. |
2308 | 2. If the individual |
2309 | longer meets the criteria for involuntary examination pursuant |
2310 | to s. 394.463(1), he or she |
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 |
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 |
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. |
2324 | proposed treatment plan in consultation with the individual |
2325 | being held |
2326 | advocate, if appointed, for the court's consideration for |
2327 | inclusion in the involuntary outpatient placement order. The |
2328 | service provider shall |
2329 | treatment plan to the individual |
2330 | of the receiving facility. The treatment plan must specify the |
2331 | nature and extent of the individual's |
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 |
2336 | individual |
2337 | to prevent a relapse or deterioration. Service providers may |
2338 | select and supervise other providers |
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 |
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 |
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 |
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 |
2373 | |
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 |
2378 | |
2379 | |
2380 | |
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 |
2385 | filing a petition for involuntary outpatient placement, certify |
2386 | to the court whether the services recommended in the |
2387 | individual's |
2388 | community and whether the service provider agrees to provide |
2389 | those services. The service provider shall |
2390 | individual |
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 |
2397 | employed or contracted by, the service provider. |
2398 | |
2399 | |
2400 | |
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 |
2416 | individual will reside |
2417 | |
2418 | (c) A |
2419 | must be filed in the county where the individual who is the |
2420 | subject of the petition |
2421 | individual |
2422 | facility, in which case the petition must be filed in the county |
2423 | where the individual |
2424 | |
2425 | the petition and the proposed treatment plan to the department, |
2426 | the individual |
2427 | representative, the state attorney, and the public defender or |
2428 | |
2429 | may not be charged for filing a petition under this subsection. |
2430 | (4) APPOINTMENT OF COUNSEL.-Within 1 court working day |
2431 | after |
2432 | placement, the court shall appoint a |
2433 | represent the individual |
2434 | petition, unless the individual |
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 |
2438 | the court order expires, or the individual |
2439 | from involuntary outpatient placement. An attorney who |
2440 | represents the individual |
2441 | individual |
2442 | presentation of the individual's |
2443 | represent the interests of the individual |
2444 | the source of payment to the attorney. |
2445 | |
2446 | |
2447 | |
2448 | |
2449 | (5) |
2450 | (a) |
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, |
2454 | convenient to the individual who is the subject of the petition |
2455 | |
2456 | conducted in physical settings not likely to be injurious to the |
2457 | individual's |
2458 | individual's |
2459 | consistent with the individual's best interests, |
2460 | and if the individual's |
2461 | court may waive the presence of the individual |
2462 | or any portion of the hearing. The state attorney for the |
2463 | circuit in which the individual |
2464 | represent the state, rather than the petitioner, as the real |
2465 | party in interest in the proceeding. |
2466 | (b) |
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 |
2470 | his or her |
2471 | informed by the court of the right to an independent expert |
2472 | examination. If the individual |
2473 | examination, the court shall provide |
2474 | expert's report is |
2475 | unless the expert is |
2476 | individual |
2477 | testimony from persons |
2478 | deemed by the court to be relevant |
2479 | the individual's |
2480 | history relates to the individual's |
2481 | The testimony in the hearing must be |
2482 | proceedings must be recorded. The individual |
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) |
2497 | the subject of the petition |
2498 | involuntary outpatient placement under |
2499 | (1), the court shall issue an order for involuntary outpatient |
2500 | placement. The court order may |
2501 | months. The order must specify the nature and extent of the |
2502 | individual's |
2503 | |
2504 | |
2505 | an individual |
2506 | when the order expires or any time the individual |
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) |
2511 | service provider to provide services if the program or service |
2512 | is not available in the |
2513 | individual being served, if there is no space available in the |
2514 | program or service for the individual |
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 |
2520 | treatment plan. For any material modification of the treatment |
2521 | plan to which the individual |
2522 | |
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 |
2526 | individual's |
2527 | approved or disapproved by the court consistent with the |
2528 | requirements of subsection (2). |
2529 | (c) |
2530 | individual being served |
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 |
2534 | involuntary examination, the individual |
2535 | to a receiving facility pursuant to s. 394.463 for involuntary |
2536 | examination. If, after examination, the individual |
2537 | not meet the criteria for involuntary inpatient placement under |
2538 | |
2539 | discharged from the receiving facility. The involuntary |
2540 | outpatient placement order remains |
2541 | the service provider determines that the individual |
2542 | longer meets the criteria for involuntary outpatient placement |
2543 | or until the order expires. The service provider shall |
2544 | determine whether modifications should be made to the existing |
2545 | treatment plan and must continue to attempt |
2546 | engage the individual |
2547 | modification of the treatment plan to which the individual |
2548 | |
2549 | appointed, agrees |
2550 | notice of the modification to the court. Any material |
2551 | modifications of the treatment plan which are contested by the |
2552 | individual |
2553 | advocate, if appointed, must be approved or disapproved by the |
2554 | court consistent with the requirements of subsection (2). |
2555 | (d) |
2556 | initial hearing on involuntary outpatient placement, it appears |
2557 | to the court that the individual |
2558 | criteria for involuntary outpatient placement under this section |
2559 | but |
2560 | placement, the court may order the individual |
2561 | for involuntary inpatient examination under s. 394.463. If the |
2562 | individual |
2563 | assessment, protective custody, or involuntary admission under |
2564 | |
2565 | |
2566 | |
2567 | |
2568 | |
2569 | |
2570 | |
2571 | |
2572 | |
2573 | |
2574 | |
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 |
2578 | |
2579 | outpatient placement. Such documentation must include any |
2580 | advance directives made by the individual |
2581 | evaluation of the individual |
2582 | individual |
2583 | clinical social worker. |
2584 | (7) |
2585 | PLACEMENT.- |
2586 | (a) |
2587 | criteria for involuntary outpatient placement, the service |
2588 | provider shall, before the expiration of the period during which |
2589 | the placement |
2590 | circuit court a petition for continued involuntary outpatient |
2591 | placement. |
2592 | 1. |
2593 | remains in effect until disposition of |
2594 | continued involuntary outpatient placement. |
2595 | 2. |
2596 | which includes a statement from the individual's |
2597 | physician or clinical psychologist justifying the request, a |
2598 | brief description of the individual's |
2599 | the time he or she was involuntarily placed, and a personalized |
2600 | |
2601 | 3. |
2602 | plan of continued treatment in consultation with the individual |
2603 | |
2604 | appointed. When the petition has been filed, the clerk of the |
2605 | court shall provide copies of the certificate and the |
2606 | |
2607 | the individual |
2608 | advocate, the state attorney, and the individual'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 |
2614 | individual |
2615 | of the court shall immediately notify the public defender of |
2616 | such appointment. The public defender shall represent the |
2617 | individual |
2618 | order expires, or the individual |
2619 | involuntary outpatient placement. An |
2620 | the individual must |
2621 | |
2622 | the individual's |
2623 | interests of the individual |
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) |
2631 | outpatient placement are |
2632 | court may appoint a magistrate |
2633 | The procedures for obtaining an order pursuant to this paragraph |
2634 | must |
2635 | the time period included in paragraph (1)(e) is not applicable |
2636 | for |
2637 | involuntary outpatient placement. |
2638 | (e) |
2639 | accordance with |
2640 | being served |
2641 | agree to a period of continued outpatient placement without a |
2642 | court hearing. |
2643 | (f) |
2644 | the expiration of each additional period the individual being |
2645 | served |
2646 | (g) |
2647 | placement |
2648 | consent to treatment, the court shall consider testimony and |
2649 | evidence regarding the individual's |
2650 | Section 394.4598 governs the discharge of the guardian advocate |
2651 | if the individual's |
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 |
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 |
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 | |
2676 | behavior causing, attempting, or threatening such harm; and |
2677 | (b) All available less restrictive treatment alternatives |
2678 | that |
2679 | her condition have been judged to be inappropriate. |
2680 | (2) ADMISSION TO A TREATMENT FACILITY.-An individual |
2681 | |
2682 | placed in a treatment facility upon the recommendation of the |
2683 | administrator of the receiving facility where the individual |
2684 | |
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 |
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 |
2695 | |
2696 | |
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 |
2700 | involuntary inpatient placement certificate that authorizes the |
2701 | receiving facility to retain the individual being held |
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 |
2708 | clerk of the court shall provide copies to the department, the |
2709 | individual |
2710 | representative, and the state attorney and public defender of |
2711 | the judicial circuit in which the individual |
2712 | A |
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 |
2722 | who is the subject of the petition, unless the individual |
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 |
2726 | shall have access to the individual |
2727 | records relevant to the presentation of the individual's |
2728 | |
2729 | individual |
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 |
2747 | entitled, with the concurrence of the individual'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 | |
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) |
2762 | inpatient placement within 5 working days after the petition is |
2763 | filed |
2764 | 1. Except for good cause documented in the court file, the |
2765 | hearing shall be held in the receiving or treatment facility |
2766 | |
2767 | cannot be held in the receiving or treatment facility, it must |
2768 | held in a location |
2769 | |
2770 | is |
2771 | injurious to the individual's |
2772 | individual wishes to waive his or her |
2773 | |
2774 | that the waiver is knowing, intelligent, and voluntary before |
2775 | waiving |
2776 | |
2777 | |
2778 | portion of the hearing. |
2779 | |
2780 | |
2781 | |
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 |
2786 | |
2787 | court of the right to an independent expert examination. If the |
2788 | individual |
2789 | shall provide for one. The independent expert's report is |
2790 | |
2791 | called as a witness for the individual |
2792 | The testimony in the hearing must be |
2793 | proceedings must be recorded. The individual |
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 |
2800 | meets the criteria for involuntary inpatient placement, it shall |
2801 | order that the individual |
2802 | facility or, if the individual |
2803 | facility, that the individual |
2804 | treated at any other appropriate receiving or treatment |
2805 | facility, or that the individual |
2806 | receiving or treatment facility, on an involuntary basis, for |
2807 | |
2808 | nature and extent of the individual's |
2809 | The facility shall discharge the individual |
2810 | the individual |
2811 | involuntary inpatient placement, unless the individual |
2812 | has transferred to voluntary status. |
2813 | (c) If at any time before |
2814 | hearing on involuntary inpatient placement it appears to the |
2815 | court that the individual |
2816 | involuntary inpatient placement under this section, but instead |
2817 | meets the criteria for involuntary outpatient placement, the |
2818 | court may order the individual |
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 |
2822 | assessment, protective custody, or involuntary admission |
2823 | pursuant to s. 397.675, |
2824 | |
2825 | |
2826 | proceedings are |
2827 | (d) At the hearing on involuntary inpatient placement, the |
2828 | court shall consider testimony and evidence regarding the |
2829 | individual's |
2830 | the court finds that the individual |
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 |
2836 | of a treatment facility if the individual |
2837 | ordered for involuntary inpatient placement, whether by civil or |
2838 | criminal court. The documentation must |
2839 | directives made by the individual |
2840 | evaluation of the individual |
2841 | individual |
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 |
2845 | directed to its facilities on an involuntary basis, whether by |
2846 | civil or criminal court order, who is not accompanied |
2847 | |
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 |
2853 | except that an |
2854 | judge is |
2855 | accordance with s. 120.68. Orders concerning an individual |
2856 | |
2857 | reason of insanity are |
2858 | 916.15. |
2859 | (b) If the individual |
2860 | criteria for involuntary inpatient placement, the administrator |
2861 | shall, before |
2862 | the treatment facility is authorized to retain the individual |
2863 | |
2864 | involuntary inpatient placement. The request must |
2865 | accompanied by a statement from the individual's |
2866 | physician or clinical psychologist justifying the request, a |
2867 | brief description of the individual's |
2868 | the time he or she was involuntarily placed, and a personalized |
2869 | |
2870 | hearing must |
2871 | |
2872 | finds that attendance at the hearing is not consistent with the |
2873 | individual's best interests |
2874 | law judge may waive the presence of the individual |
2875 | all or any portion of the hearing, unless the individual |
2876 | |
2877 | testimony in the hearing must be under oath, and the proceedings |
2878 | must be recorded. |
2879 | (c) Unless the individual |
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) |
2892 | |
2893 | placement, the administrative law judge shall sign the order for |
2894 | continued involuntary inpatient placement for a period of up to |
2895 | |
2896 | repeated before |
2897 | period the individual |
2898 | (f) |
2899 | necessary for an individual |
2900 | criminal sentence |
2901 | a minor |
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) |
2906 | incompetent to consent to treatment, the administrative law |
2907 | judge shall consider testimony and evidence regarding the |
2908 | individual's |
2909 | judge finds evidence that the individual |
2910 | competent to consent to treatment, the |
2911 | may issue a recommended order to the court that found the |
2912 | individual |
2913 | individual's |
2914 | guardian advocate previously appointed be discharged. |
2915 | (8) RETURN TO FACILITY |
2916 | |
2917 | without authorization, the administrator may authorize a search |
2918 | for, |
2919 | the facility. The administrator may request the assistance of a |
2920 | law enforcement agency |
2921 | |
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 |
2926 | |
2927 | 394.4598, 394.4615, 394.463, 394.4655, and 394.467 |
2928 | |
2929 | protecting the health, safety, and well-being of individuals |
2930 | |
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 |
2936 | that an individual |
2937 | placement and he or she |
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 |
2944 | place that individual |
2945 | of Veterans Affairs or other federal agency. The individual |
2946 | |
2947 | notice of the pending placement proceeding in the manner as |
2948 | provided in this part. |
2949 | |
2950 | heard in the proceeding. Upon placement, the individual is |
2951 | |
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 |
2957 | United States Department of Veterans Affairs or other federal |
2958 | agency for care or treatment has |
2959 | effect in this state as in the jurisdiction of the court |
2960 | entering the judgment or making the order. |
2961 | the placing state or of the District of Columbia shall retain |
2962 | |
2963 | |
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 |
2969 | (3) Upon receipt of a certificate of the United States |
2970 | Department of Veterans Affairs or another |
2971 | agency that facilities are available for the care or treatment |
2972 | individuals who have mental illness |
2973 | that the individual |
2974 | treatment, the administrator of the receiving or treatment |
2975 | facility may |
2976 | United States Department of Veterans Affairs or other federal |
2977 | agency. Upon |
2978 | be notified by the transferring agency. An individual may not |
2979 | |
2980 | |
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 |
2984 | the individual |
2985 | after appropriate motion and hearing and without objection by |
2986 | the United States Department of Veterans Affairs. |
2987 | (4) An individual |
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 |
2996 | (1) TRANSFER BETWEEN PUBLIC FACILITIES.- |
2997 | (a) An individual |
2998 | public receiving facility, or his or her |
2999 | guardian, or guardian advocate |
3000 | transfer of the individual |
3001 | facility. An individual |
3002 | public treatment facility, or his or her |
3003 | guardian, or guardian advocate |
3004 | transfer of the individual |
3005 | facility. Depending on the medical treatment or mental health |
3006 | treatment needs of the individual |
3007 | of appropriate facility resources, the individual |
3008 | transferred at the discretion of the department. If the |
3009 | department approves the transfer of an individual on involuntary |
3010 | status |
3011 | |
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 |
3016 | health treatment needs of the individual |
3017 | efficient use |
3018 | treatment facility, an individual |
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 |
3022 | the individual's |
3023 | facility in another state. Notice in accordance with |
3024 | |
3025 | |
3026 | notice is not possible, notice of the transfer must |
3027 | provided as soon as practicable after the transfer. |
3028 | (2) TRANSFER FROM PUBLIC TO PRIVATE FACILITIES.- |
3029 | (a) An individual |
3030 | public receiving or public treatment facility and has requested, |
3031 | |
3032 | advocate, and is able to pay for treatment in a private facility |
3033 | shall be transferred at the individual's |
3034 | private facility upon acceptance of the individual |
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 |
3042 | guardian or guardian advocate may request the transfer of the |
3043 | individual |
3044 | individual |
3045 | individual |
3046 | (b) A private facility may request the transfer of an |
3047 | individual |
3048 | the individual |
3049 | the individual |
3050 | transfer is |
3051 | facility. |
3052 | (c) A public facility must respond to a request for the |
3053 | transfer of an individual |
3054 | receipt of the request. |
3055 | (4) TRANSFER BETWEEN PRIVATE FACILITIES.-An individual |
3056 | being held |
3057 | |
3058 | of the individual |
3059 | time, and the individual |
3060 | acceptance of the individual |
3061 | transfer is sought. |
3062 | Section 26. Section 394.469, Florida Statutes, is amended |
3063 | to read: |
3064 | 394.469 Discharge of involuntary placements |
3065 | (1) POWER TO DISCHARGE.-At any time an individual |
3066 | |
3067 | placement, the administrator shall: |
3068 | (a) Discharge the individual |
3069 | |
3070 | |
3071 | |
3072 | (b) Transfer the individual |
3073 | his or her own authority or at the individual's |
3074 | request, unless the individual |
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 | |
3080 | |
3081 | |
3082 | (2) NOTICE.-Notice of discharge or transfer of an |
3083 | individual must be provided in accordance with |
3084 | |
3085 | Section 27. Section 394.473, Florida Statutes, is amended |
3086 | to read: |
3087 | 394.473 Attorney's fee; expert witness fee.- |
3088 | (1) |
3089 | |
3090 | provisions of this part |
3091 | the state pursuant to s. 27.5304. |
3092 | |
3093 | defender appointed to represent an indigent person may |
3094 | receive no additional compensation other than that usually paid |
3095 | his or her office. |
3096 | (2) An |
3097 | whose testimony is required for an indigent individual in a |
3098 | court hearing pursuant to the provisions of this part |
3099 | |
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 | |
3107 | authorities.- |
3108 | (1) Upon the request of the state mental health authority |
3109 | of another state, the department may |
3110 | individual as a patient, for up to |
3111 | days, |
3112 | state for at least |
3113 | (2) An individual |
3114 | subsection (1) shall be examined by the staff of the state |
3115 | facility where the individual |
3116 | |
3117 | period. |
3118 | (3) If, upon examination, the individual |
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 |
3122 | receiving the individual |
3123 | the individual |
3124 | (4) During the pendency of the examination period and the |
3125 | pendency of the involuntary placement proceedings, an individual |
3126 | |
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 |
3141 | child or adolescent and must adhere to the guiding principles, |
3142 | system of care, and service planning provisions of |
3143 | part III of this chapter. |
3144 | (2) A child or adolescent, as defined in s. 394.492, who |
3145 | is younger than |
3146 | is admitted to a |
3147 | may not be admitted to a bed in a room or ward with an adult |
3148 | |
3149 | adult |
3150 | |
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 |
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 |
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 |
3172 | |
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 |
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 |
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 |
3184 | possible. |
3185 | Section 32. Section 394.4787, Florida Statutes, is amended |
3186 | to read: |
3187 | 394.4787 Definitions |
3188 | |
3189 | |
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 |
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 |
3200 | income and for which there is no compensation. Charity care does |
3201 | |
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 |
3214 | 395.002(28), and includes facilities licensed under |
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 |
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 | |
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 |
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 |
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 |
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 |
3253 | psychiatric hospital with a system for accepting |
3254 | |
3255 | |
3256 | Legislature that a hospital that |
3257 | 394.4788 shall accept referrals from the department. However, a |
3258 | hospital may |
3259 | individual |
3260 | of services appropriate to a patient's specific treatment and is |
3261 | not |
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 |
3267 | provisions of this part is |
3268 | department referrals, notwithstanding any agreements it may have |
3269 | entered into with the department. The right of refusal in this |
3270 | subsection does |
3271 | provide emergency care pursuant to s. 395.1041 or other state or |
3272 | federal law |
3273 | |
3274 | (2) The department shall adopt by rule a patient |
3275 | eligibility form and is |
3276 | determination. However, the department may contract with |
3277 | participating psychiatric hospitals for eligibility |
3278 | determination. The eligibility form must |
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 |
3282 | for reimbursement only if |
3283 | completed for each indigent individual who is mentally ill |
3284 | |
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 |
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 |
3298 | described in s. 394.459(3) |
3299 | parent or legal guardian. The department shall |
3300 | |
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 |
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 |
3327 | (a) A clinical psychologist, clinical social worker, |
3328 | physician, psychiatric nurse, or psychiatrist |
3329 | defined in s. 394.455 |
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) |
3333 | |
3334 | |
3335 | |
3336 | The department shall adopt by rule statewide standards for |
3337 | mental health assessments, which are |
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 |
3344 | defined in s. 394.455, |
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 |
3353 | ss. 397.311(18)(a)4., 397.311(18)(a)1., and 394.455 |
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 |
3365 | |
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 |
3372 | mental health treatment facility, as defined in s. 394.455 |
3373 | |
3374 | provided by law. |
3375 | Section 41. This act shall take effect July 1, 2010. |
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