Bill Text: FL S0012 | 2016 | Regular Session | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Mental Health and Substance Abuse
Spectrum: Bipartisan Bill
Status: (Passed) 2016-04-15 - Chapter No. 2016-241, companion bill(s) passed, see CS/HB 373 (Ch. 2016-80), CS/CS/CS/HB 439 (Ch. 2016-127), HB 5101 (Ch. 2016-65) [S0012 Detail]
Download: Florida-2016-S0012-Introduced.html
Bill Title: Mental Health and Substance Abuse
Spectrum: Bipartisan Bill
Status: (Passed) 2016-04-15 - Chapter No. 2016-241, companion bill(s) passed, see CS/HB 373 (Ch. 2016-80), CS/CS/CS/HB 439 (Ch. 2016-127), HB 5101 (Ch. 2016-65) [S0012 Detail]
Download: Florida-2016-S0012-Introduced.html
Florida Senate - 2016 SB 12 By Senator Garcia 38-01698B-16 201612__ 1 A bill to be entitled 2 An act relating to mental health and substance abuse; 3 amending s. 29.004, F.S.; including services provided 4 to treatment-based mental health programs within case 5 management funded from state revenues as an element of 6 the state courts system; amending s. 39.001, F.S.; 7 providing legislative intent regarding mental illness 8 for purposes of the child welfare system; amending s. 9 39.507, F.S.; providing for consideration of mental 10 health issues and involvement in treatment-based 11 mental health programs in adjudicatory hearings and 12 orders; amending s. 39.521, F.S.; providing for 13 consideration of mental health issues and involvement 14 in treatment-based mental health programs in 15 disposition hearings; amending s. 394.455, F.S.; 16 defining terms; revising definitions; amending s. 17 394.4573, F.S.; requiring the Department of Children 18 and Families to submit a certain assessment to the 19 Governor and the Legislature by a specified date; 20 redefining terms; providing essential elements of a 21 coordinated system of care; providing requirements for 22 the department’s annual assessment; authorizing the 23 department to award certain grants; deleting duties 24 and measures of the department regarding continuity of 25 care management systems; amending s. 394.4597, F.S.; 26 revising the prioritization of health care surrogates 27 to be selected for involuntary patients; specifying 28 certain persons who are prohibited from being selected 29 as an individual’s representative; amending s. 30 394.4598, F.S.; specifying certain persons who are 31 prohibited from being appointed as a person’s guardian 32 advocate; amending s. 394.462, F.S.; requiring that 33 counties develop and implement transportation plans; 34 providing requirements for the plans; revising 35 requirements for transportation to a receiving 36 facility and treatment facility; deleting exceptions 37 to such requirements; amending s. 394.463, F.S.; 38 authorizing county or circuit courts to enter ex parte 39 orders for involuntary examinations; requiring a 40 facility to provide copies of ex parte orders, 41 reports, and certifications to managing entities and 42 the department, rather than the Agency for Health Care 43 Administration; requiring the managing entity and 44 department to receive certain orders, certificates, 45 and reports; requiring the department to provide such 46 documents to the Agency for Health Care 47 Administration; requiring certain individuals to be 48 released to law enforcement custody; providing 49 exceptions; amending s. 394.4655, F.S.; providing for 50 involuntary outpatient services; requiring a service 51 provider to document certain inquiries; requiring the 52 managing entity to document certain efforts; making 53 technical changes; amending s. 394.467, F.S.; revising 54 criteria for involuntary inpatient placement; 55 requiring a facility filing a petition for involuntary 56 inpatient placement to send a copy to the department 57 and managing entity; revising criteria for a hearing 58 on involuntary inpatient placement; revising criteria 59 for a procedure for continued involuntary inpatient 60 services; specifying requirements for a certain waiver 61 of the patient’s attendance at a hearing; requiring 62 the court to consider certain testimony and evidence 63 regarding a patient’s incompetence; amending s. 64 394.46715, F.S.; revising rulemaking authority of the 65 department; creating s. 394.761, F.S.; authorizing the 66 agency and the department to develop a plan for 67 revenue maximization; requiring the plan to be 68 submitted to the Legislature by a certain date; 69 amending s. 394.875, F.S.; requiring the department to 70 modify licensure rules and procedures to create an 71 option for a single, consolidated license for certain 72 providers by a specified date; amending s. 394.9082, 73 F.S.; providing a purpose for behavioral health 74 managing entities; revising definitions; providing 75 duties of the department; requiring the department to 76 revise its contracts with managing entities; providing 77 duties for managing entities; deleting provisions 78 relating to legislative findings and intent, service 79 delivery strategies, essential elements, reporting 80 requirements, and rulemaking authority; amending s. 81 397.311, F.S.; defining the term “involuntary 82 services”; revising the definition of the term 83 “qualified professional”; conforming a cross 84 reference; amending s. 397.675, F.S.; revising the 85 criteria for involuntary admissions due to substance 86 abuse or co-occurring mental health disorders; 87 amending s. 397.679, F.S.; specifying the licensed 88 professionals who may complete a certificate for the 89 involuntary admission of an individual; amending s. 90 397.6791, F.S.; providing a list of professionals 91 authorized to initiate a certificate for an emergency 92 assessment or admission of a person with a substance 93 abuse disorder; amending s. 397.6793, F.S.; revising 94 the criteria for initiation of a certificate for an 95 emergency admission for a person who is substance 96 abuse impaired; amending s. 397.6795, F.S.; revising 97 the list of persons who may deliver a person for an 98 emergency assessment; amending s. 397.681, F.S.; 99 prohibiting the court from charging a fee for 100 involuntary petitions; amending s. 397.6811, F.S.; 101 revising the list of persons who may file a petition 102 for an involuntary assessment and stabilization; 103 amending s. 397.6814, F.S.; prohibiting a fee from 104 being charged for the filing of a petition for 105 involuntary assessment and stabilization; amending s. 106 397.6819, F.S.; revising the responsibilities of 107 service providers who admit an individual for an 108 involuntary assessment and stabilization; amending s. 109 397.695, F.S.; authorizing certain persons to file a 110 petition for involuntary outpatient services of an 111 individual; providing procedures and requirements for 112 such petitions; amending s. 397.6951, F.S.; requiring 113 that certain additional information be included in a 114 petition for involuntary outpatient services; amending 115 s. 397.6955, F.S.; requiring a court to fulfill 116 certain additional duties upon the filing of petition 117 for involuntary outpatient services; amending s. 118 397.6957, F.S.; providing additional requirements for 119 a hearing on a petition for involuntary outpatient 120 services; amending s. 397.697, F.S.; authorizing a 121 court to make a determination of involuntary 122 outpatient services; prohibiting a court from ordering 123 involuntary outpatient services under certain 124 circumstances; requiring the service provider to 125 document certain inquiries; requiring the managing 126 entity to document certain efforts; requiring a copy 127 of the court’s order to be sent to the department and 128 managing entity; providing procedures for 129 modifications to such orders; amending s. 397.6971, 130 F.S.; establishing the requirements for an early 131 release from involuntary outpatient services; amending 132 s. 397.6975, F.S.; requiring the court to appoint 133 certain counsel; providing requirements for hearings 134 on petitions for continued involuntary outpatient 135 services; requiring notice of such hearings; amending 136 s. 397.6977, F.S.; conforming provisions to changes 137 made by the act; creating s. 397.6978, F.S.; providing 138 for the appointment of guardian advocates if an 139 individual is found incompetent to consent to 140 treatment; providing a list of persons prohibited from 141 being appointed as an individual’s guardian advocate; 142 providing requirements for a facility requesting the 143 appointment of a guardian advocate; requiring a 144 training course for guardian advocates; providing 145 requirements for the training course; providing 146 requirements for the prioritization of individuals to 147 be selected as guardian advocates; authorizing certain 148 guardian advocates to consent to medical treatment; 149 providing exceptions; providing procedures for the 150 discharge of a guardian advocate; amending ss. 39.407, 151 212.055, 394.4599, 394.495, 394.496, 394.9085, 152 397.405, 397.407, 397.416, 409.972, 440.102, 744.704, 153 and 790.065, F.S.; conforming cross-references; 154 providing an effective date. 155 156 Be It Enacted by the Legislature of the State of Florida: 157 158 Section 1. Paragraph (e) is added to subsection (10) of 159 section 29.004, Florida Statutes, to read: 160 29.004 State courts system.—For purposes of implementing s. 161 14, Art. V of the State Constitution, the elements of the state 162 courts system to be provided from state revenues appropriated by 163 general law are as follows: 164 (10) Case management. Case management includes: 165 (e) Service referral, coordination, monitoring, and 166 tracking for mental health programs under chapter 394. 167 168 Case management may not include costs associated with the 169 application of therapeutic jurisprudence principles by the 170 courts. Case management also may not include case intake and 171 records management conducted by the clerk of court. 172 Section 2. Subsection (6) of section 39.001, Florida 173 Statutes, is amended to read: 174 39.001 Purposes and intent; personnel standards and 175 screening.— 176 (6) MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES.— 177 (a) The Legislature recognizes that early referral and 178 comprehensive treatment can help combat mental illness and 179 substance abuse disorders in families and that treatment is 180 cost-effective. 181 (b) The Legislature establishes the following goals for the 182 state related to mental illness and substance abuse treatment 183 services in the dependency process: 184 1. To ensure the safety of children. 185 2. To prevent and remediate the consequences of mental 186 illness and substance abuse disorders on families involved in 187 protective supervision or foster care and reduce the occurrences 188 of mental illness and substance abuse disorders, including 189 alcohol abuse or other related disorders, for families who are 190 at risk of being involved in protective supervision or foster 191 care. 192 3. To expedite permanency for children and reunify healthy, 193 intact families, when appropriate. 194 4. To support families in recovery. 195 (c) The Legislature finds that children in the care of the 196 state’s dependency system need appropriate health care services, 197 that the impact of mental illnesses and substance abuse on 198 health indicates the need for health care services to include 199 treatment for mental health and substance abuse disorders for 200services tochildren and parents where appropriate, and that it 201 is in the state’s best interest that such children be provided 202 the services they need to enable them to become and remain 203 independent of state care. In order to provide these services, 204 the state’s dependency system must have the ability to identify 205 and provide appropriate intervention and treatment for children 206 with personal or family-related mental illness and substance 207 abuse problems. 208 (d) It is the intent of the Legislature to encourage the 209 use of the mental health programs established under chapter 394 210 and the drug court program model established underbys. 397.334 211 and authorize courts to assess children and persons who have 212 custody or are requesting custody of children where good cause 213 is shown to identify and address mental illnesses and substance 214 abuse disordersproblemsas the court deems appropriate at every 215 stage of the dependency process. Participation in treatment, 216 including a treatment-based mental health court program or a 217 treatment-based drug court program, may be required by the court 218 following adjudication. Participation in assessment and 219 treatment beforeprior toadjudication isshall bevoluntary, 220 except as provided in s. 39.407(16). 221 (e) It is therefore the purpose of the Legislature to 222 provide authority for the state to contract with mental health 223 service providers and community substance abuse treatment 224 providers for the development and operation of specialized 225 support and overlay services for the dependency system, which 226 will be fully implemented and used as resources permit. 227 (f) Participation in a treatment-based mental health court 228 program or athetreatment-based drug court program does not 229 divest any public or private agency of its responsibility for a 230 child or adult, but is intended to enable these agencies to 231 better meet their needs through shared responsibility and 232 resources. 233 Section 3. Subsection (10) of section 39.507, Florida 234 Statutes, is amended to read: 235 39.507 Adjudicatory hearings; orders of adjudication.— 236 (10) After an adjudication of dependency, or a finding of 237 dependency where adjudication is withheld, the court may order a 238 person who has custody or is requesting custody of the child to 239 submit to a mental health or substance abuse disorder assessment 240 or evaluation. The assessment or evaluation must be administered 241 by a qualified professional, as defined in s. 397.311. The court 242 may also require such person to participate in and comply with 243 treatment and services identified as necessary, including, when 244 appropriate and available, participation in and compliance with 245 a mental health program established under chapter 394 or a 246 treatment-based drug court program established under s. 397.334. 247 In addition to supervision by the department, the court, 248 including a treatment-based mental health court program or athe249 treatment-based drug court program, may oversee the progress and 250 compliance with treatment by a person who has custody or is 251 requesting custody of the child. The court may impose 252 appropriate available sanctions for noncompliance upon a person 253 who has custody or is requesting custody of the child or make a 254 finding of noncompliance for consideration in determining 255 whether an alternative placement of the child is in the child’s 256 best interests. Any order entered under this subsection may be 257 made only upon good cause shown. This subsection does not 258 authorize placement of a child with a person seeking custody, 259 other than the parent or legal custodian, who requires mental 260 health or substance abuse disorder treatment. 261 Section 4. Paragraph (b) of subsection (1) of section 262 39.521, Florida Statutes, is amended to read: 263 39.521 Disposition hearings; powers of disposition.— 264 (1) A disposition hearing shall be conducted by the court, 265 if the court finds that the facts alleged in the petition for 266 dependency were proven in the adjudicatory hearing, or if the 267 parents or legal custodians have consented to the finding of 268 dependency or admitted the allegations in the petition, have 269 failed to appear for the arraignment hearing after proper 270 notice, or have not been located despite a diligent search 271 having been conducted. 272 (b) When any child is adjudicated by a court to be 273 dependent, the court having jurisdiction of the child has the 274 power by order to: 275 1. Require the parent and, when appropriate, the legal 276 custodian and the child to participate in treatment and services 277 identified as necessary. The court may require the person who 278 has custody or who is requesting custody of the child to submit 279 to a mental illness or substance abuse disorder assessment or 280 evaluation. The assessment or evaluation must be administered by 281 a qualified professional, as defined in s. 397.311. The court 282 may also require such person to participate in and comply with 283 treatment and services identified as necessary, including, when 284 appropriate and available, participation in and compliance with 285 a mental health program established under chapter 394 or a 286 treatment-based drug court program established under s. 397.334. 287 In addition to supervision by the department, the court, 288 including a treatment-based mental health court program or athe289 treatment-based drug court program, may oversee the progress and 290 compliance with treatment by a person who has custody or is 291 requesting custody of the child. The court may impose 292 appropriate available sanctions for noncompliance upon a person 293 who has custody or is requesting custody of the child or make a 294 finding of noncompliance for consideration in determining 295 whether an alternative placement of the child is in the child’s 296 best interests. Any order entered under this subparagraph may be 297 made only upon good cause shown. This subparagraph does not 298 authorize placement of a child with a person seeking custody of 299 the child, other than the child’s parent or legal custodian, who 300 requires mental health or substance abuse treatment. 301 2. Require, if the court deems necessary, the parties to 302 participate in dependency mediation. 303 3. Require placement of the child either under the 304 protective supervision of an authorized agent of the department 305 in the home of one or both of the child’s parents or in the home 306 of a relative of the child or another adult approved by the 307 court, or in the custody of the department. Protective 308 supervision continues until the court terminates it or until the 309 child reaches the age of 18, whichever date is first. Protective 310 supervision shall be terminated by the court whenever the court 311 determines that permanency has been achieved for the child, 312 whether with a parent, another relative, or a legal custodian, 313 and that protective supervision is no longer needed. The 314 termination of supervision may be with or without retaining 315 jurisdiction, at the court’s discretion, and shall in either 316 case be considered a permanency option for the child. The order 317 terminating supervision by the department mustshallset forth 318 the powers of the custodian of the child andshallinclude the 319 powers ordinarily granted to a guardian of the person of a minor 320 unless otherwise specified. Upon the court’s termination of 321 supervision by the department,nofurther judicial reviews are 322 not required if, so long aspermanency has been established for 323 the child. 324 Section 5. Section 394.455, Florida Statutes, is amended to 325 read: 326 394.455 Definitions.—As used in this part,unless the327context clearly requires otherwise,the term: 328 (1) “Access center” or “drop-off center” means a facility 329 staffed by medical, behavioral, and substance abuse 330 professionals which provides emergency screening and evaluation 331 for mental health or substance abuse disorders and may provide 332 transportation to an appropriate facility if an individual is in 333 need of more intensive services. 334 (2) “Addictions receiving facility” means a secure, acute 335 care facility that, at a minimum, provides emergency screening, 336 evaluation, and short-term stabilization services; is operated 337 24 hours per day, 7 days per week; and is designated by the 338 department to serve individuals found to have substance abuse 339 impairment who qualify for services under this part. 340 (3)(1)“Administrator” means the chief administrative 341 officer of a receiving or treatment facility or his or her 342 designee. 343 (4) “Adult” means an individual who is 18 years of age or 344 older or who has had the disability of nonage removed under 345 chapter 743. 346 (5) “Advanced registered nurse practitioner” means any 347 person licensed in this state to practice professional nursing 348 who is certified in advanced or specialized nursing practice 349 under s. 464.012. 350(2) “Clinicalpsychologist” means a psychologist as defined351in s. 490.003(7) with 3 years of postdoctoral experience in the352practice of clinical psychology, inclusive of the experience353required for licensure, or a psychologist employed by a facility354operated by the United States Department of Veterans Affairs355that qualifies as a receiving or treatment facility under this356part.357 (6)(3)“Clinical record” means all parts of the record 358 required to be maintained and includes all medical records, 359 progress notes, charts, and admission and discharge data, and 360 all other information recorded byafacility staff which 361 pertains to the patient’s hospitalization or treatment. 362 (7)(4)“Clinical social worker” means a person licensed as 363 a clinical social worker under s. 491.005 or s. 491.006chapter364491. 365 (8)(5)“Community facility” means aanycommunity service 366 provider that contractscontractingwith the department to 367 furnish substance abuse or mental health services under part IV 368 of this chapter. 369 (9)(6)“Community mental health center or clinic” means a 370 publicly funded, not-for-profit center thatwhichcontracts with 371 the department for the provision of inpatient, outpatient, day 372 treatment, or emergency services. 373 (10)(7)“Court,” unless otherwise specified, means the 374 circuit court. 375 (11)(8)“Department” means the Department of Children and 376 Families. 377 (12) “Designated receiving facility” means a facility 378 approved by the department which provides, at a minimum, 379 emergency screening, evaluation, and short-term stabilization 380 for mental health or substance abuse disorders, and which may 381 have an agreement with a corresponding facility for 382 transportation and services. 383 (13) “Detoxification facility” means a facility licensed to 384 provide detoxification services under chapter 397. 385 (14) “Electronic means” is a form of telecommunication 386 which requires all parties to maintain visual as well as audio 387 communication. 388 (15)(9)“Express and informed consent” means consent 389 voluntarily givenin writing, by a competent person, after 390 sufficient explanation and disclosure of the subject matter 391 involved to enable the person to make a knowing and willful 392 decision without any element of force, fraud, deceit, duress, or 393 other form of constraint or coercion. 394 (16)(10)“Facility” means any hospital, community facility, 395 public or private facility, or receiving or treatment facility 396 providing for the evaluation, diagnosis, care, treatment, 397 training, or hospitalization of persons who appear to havea398mental illnessor who have been diagnosed as having a mental 399 illness or substance abuse impairment. The term“Facility”does 400 not include aanyprogram or an entity licensed underpursuant401tochapter 400 or chapter 429. 402 (17) “Governmental facility” means a facility owned, 403 operated, or administered by the Department of Corrections or 404 the United States Department of Veterans Affairs. 405 (18)(11)“Guardian” means the natural guardian of a minor, 406 or a person appointed by a court to act on behalf of a ward’s 407 person if the ward is a minor or has been adjudicated 408 incapacitated. 409 (19)(12)“Guardian advocate” means a person appointed by a 410 court to make decisions regarding mental health or substance 411 abuse treatment on behalf of a patient who has been found 412 incompetent to consent to treatment pursuant to this part.The413guardian advocate may be granted specific additional powers by414written order of the court, as provided in this part.415 (20)(13)“Hospital” means a hospitalfacility as defined in416s. 395.002 andlicensed under chapter 395 and part II of chapter 417 408. 418 (21)(14)“Incapacitated” means that a person has been 419 adjudicated incapacitated pursuant to part V of chapter 744 and 420 a guardian of the person has been appointed. 421 (22)(15)“Incompetent to consent to treatment” means a 422 state in whichthata person’s judgment is so affected by ahis423or hermental illness, a substance abuse impairment, or any 424 medical or organic cause that he or shethe personlacks the 425 capacity to make a well-reasoned, willful, and knowing decision 426 concerning his or her medical,ormental health, or substance 427 abuse treatment. 428 (23) “Involuntary examination” means an examination 429 performed under s. 394.463 or s. 397.675 to determine whether a 430 person qualifies for involuntary outpatient services or 431 involuntary inpatient placement. 432 (24) “Involuntary services” means court-ordered outpatient 433 services or inpatient placement for mental health treatment 434 pursuant to s. 394.4655 or s. 394.467. 435 (25)(16)“Law enforcement officer” has the same meaning as 436 providedmeans a law enforcement officer as definedin s. 437 943.10. 438 (26) “Marriage and family therapist” means a person 439 licensed to practice marriage and family therapy under s. 440 491.005 or s. 491.006. 441 (27) “Mental health counselor” means a person licensed to 442 practice mental health counseling under s. 491.005 or s. 443 491.006. 444 (28)(17)“Mental health overlay program” means a mobile 445 service thatwhichprovides an independent examination for 446 voluntary admissionadmissionsand a range of supplemental 447 onsite services to persons with a mental illness in a 448 residential setting such as a nursing home, an assisted living 449 facility, or an adult family-care home,or a nonresidential 450 setting such as an adult day care center. Independent 451 examinations providedpursuant to this partthrough a mental 452 health overlay program must only be provided under contract with 453 the departmentfor this serviceor be attached to a public 454 receiving facility that is also a community mental health 455 center. 456 (29)(18)“Mental illness” means an impairment of the mental 457 or emotional processes that exercise conscious control of one’s 458 actions or of the ability to perceive or understand reality, 459 which impairment substantially interferes with the person’s 460 ability to meet the ordinary demands of living. For the purposes 461 of this part, the term does not include a developmental 462 disability as defined in chapter 393, intoxication, or 463 conditions manifested only by antisocial behavior or substance 464 abuse impairment. 465 (30) “Minor” means an individual who is 17 years of age or 466 younger and who has not had the disability of nonage removed 467 pursuant to s. 743.01 or s. 743.015. 468 (31)(19)“Mobile crisis response service” means a 469 nonresidential crisis serviceattached to a public receiving470facility andavailable 24 hours a day, 7 days a week,through471 which provides immediate intensive assessments and 472 interventions, including screening for admission into a mental 473 health receiving facility, an addictions receiving facility, or 474 a detoxification facility,take placefor the purpose of 475 identifying appropriate treatment services. 476 (32)(20)“Patient” means any person who is held or accepted 477 for mental health or substance abuse treatment. 478 (33)(21)“Physician” means a medical practitioner licensed 479 under chapter 458 or chapter 459who has experience in the480diagnosis and treatment of mental and nervous disordersor a 481 physician employed by a facility operated by the United States 482 Department of Veterans Affairs or the United States Department 483 of Defensewhich qualifies as a receiving or treatment facility484under this part. 485 (34) “Physician assistant” means a person licensed under 486 chapter 458 or chapter 459 who has experience in the diagnosis 487 and treatment of mental disorders. 488 (35)(22)“Private facility” means any hospital or facility 489 operated by a for-profit or not-for-profit corporation or 490 association whichthatprovides mental health or substance abuse 491 services and is not a public facility. 492 (36)(23)“Psychiatric nurse” means an advanced registered 493 nurse practitioner certified under s. 464.012 who has a master’s 494 or doctoral degree in psychiatric nursing, holds a national 495 advanced practice certification as a psychiatric mental health 496 advanced practice nurse, and has 2 years of post-master’s 497 clinical experience under the supervision of a physician. 498 (37)(24)“Psychiatrist” means a medical practitioner 499 licensed under chapter 458 or chapter 459who has primarily500diagnosed and treated mental and nervous disordersfor at least 501a period of not less than3 years, inclusive of psychiatric 502 residency. 503 (38) “Psychologist” has the same meaning as provided in s. 504 490.003 or means a psychologist employed by a facility operated 505 by the United States Department of Veterans Affairs which 506 qualifies as a receiving or treatment facility under this part. 507 (39)(25)“Public facility” means aanyfacility that has 508 contracted with the department to provide mental health or 509 substance abuse services to all persons, regardless oftheir510 ability to pay, and is receiving state funds for such purpose. 511 (40) “Qualified professional” means a physician or a 512 physician assistant licensed under chapter 458 or chapter 459; a 513 professional licensed under chapter 490 or chapter 491; a 514 psychiatrist licensed under chapter 458 or chapter 459; or a 515 psychiatric nurse as defined in subsection (36). 516 (41)(26)“Receiving facility” means any public or private 517 facility designated by the department to receive and hold or 518 refer, as appropriate, involuntary patients under emergency 519 conditionsorfor mental health or substance abusepsychiatric520 evaluation and to provideshort-termtreatment or transportation 521 to the appropriate service provider. The term does not include a 522 county jail. 523 (42)(27)“Representative” means a person selected to 524 receive notice of proceedings during the time a patient is held 525 in or admitted to a receiving or treatment facility. 526 (43)(28)(a)“Restraint” means:a physical device, method,527or drug used to control behavior.528 (a) A physical restraint, includingisany manual method or 529 physical or mechanical device, material, or equipment attached 530 or adjacent to antheindividual’s body so that he or she cannot 531 easily remove the restraint and which restricts freedom of 532 movement or normal access to one’s body. Physical restraint 533 includes the physical holding of a person during a procedure to 534 forcibly administer psychotropic medication. Physical restraint 535 does not include physical devices such as orthopedically 536 prescribed appliances, surgical dressings and bandages, 537 supportive body bands, or other physical holding when necessary 538 for routine physical examinations and tests or for purposes of 539 orthopedic, surgical, or other similar medical treatment, when 540 used to provide support for the achievement of functional body 541 position or proper balance, or when used to protect a person 542 from falling out of bed. 543 (b) A drug orused as a restraint is amedication used to 544 control atheperson’s behavior or to restrict his or her 545 freedom of movement whichandis not part of the standard 546 treatment regimen of a person with a diagnosed mental illness 547who is a client of the department. Physically holding a person548during a procedure to forcibly administer psychotropic549medication is a physical restraint. 550(c) Restraint does not include physical devices, such as551orthopedically prescribed appliances, surgical dressings and552bandages, supportive body bands, or other physical holding when553necessary for routine physical examinations and tests; or for554purposes of orthopedic, surgical, or other similar medical555treatment; when used to provide support for the achievement of556functional body position or proper balance; or when used to557protect a person from falling out of bed.558 (44) “School psychologist” has the same meaning as in s. 559 490.003. 560 (45)(29)“Seclusion” means the physical segregationof a561person in any fashionor involuntary isolation of a person in a 562 room or area from which the person is prevented from leaving. 563 The prevention may be by physical barrier or by a staff member 564 who is acting in a manner, or who is physically situated, so as 565 to prevent the person from leaving the room or area. For 566 purposes of this partchapter, the term does not mean isolation 567 due to a person’s medical condition or symptoms. 568 (46)(30)“Secretary” means the Secretary of Children and 569 Families. 570 (47) “Service provider” means a receiving facility, any 571 facility licensed under chapter 397, a treatment facility, an 572 entity under contract with the department to provide mental 573 health or substance abuse services, a community mental health 574 center or clinic, a psychologist, a clinical social worker, a 575 marriage and family therapist, a mental health counselor, a 576 physician, a psychiatrist, an advanced registered nurse 577 practitioner, a psychiatric nurse, or a qualified professional 578 as defined in this section. 579 (48) “Substance abuse impairment” means a condition 580 involving the use of alcoholic beverages or any psychoactive or 581 mood-altering substance in such a manner as to induce mental, 582 emotional, or physical problems and cause socially dysfunctional 583 behavior. 584 (49)(31)“Transfer evaluation” means the process by which,585as approved by the appropriate district office of the586department,wherebya person who is being considered for 587 placement in a state treatment facility isfirstevaluated for 588 appropriateness of admission to a state treatmentthefacility 589by a community-based public receiving facility or by a community590mental health center or clinic if the public receiving facility591is not a community mental health center or clinic. 592 (50)(32)“Treatment facility” means aanystate-owned, 593 state-operated, or state-supported hospital, center, or clinic 594 designated by the department for extended treatment and 595 hospitalization, beyond that provided for by a receiving 596 facility, of persons who have a mental illness or substance 597 abuse disorders, including facilities of the United States 598 Government, and any private facility designated by the 599 department when rendering such services to a person pursuant to 600 the provisions of this part. Patients treated in facilities of 601 the United States Government shall be solely those whose care is 602 the responsibility of the United States Department of Veterans 603 Affairs. 604 (51) “Triage center” means a facility that is staffed by 605 medical, behavioral, and substance abuse professionals who 606 provide emergency screening and evaluation of individuals 607 transported to the center by a law enforcement officer. 608(33) “Service provider” means any public or private609receiving facility, an entity under contract with the Department610of Children and Families to provide mental health services, a611clinical psychologist, a clinical social worker, a marriage and612family therapist, a mental health counselor, a physician, a613psychiatric nurse as defined in subsection (23), or a community614mental health center or clinic as defined in this part.615(34) “Involuntary examination” means an examination616performed under s. 394.463 to determine if an individual617qualifies for involuntary inpatient treatment under s.618394.467(1) or involuntary outpatient treatment under s.619394.4655(1).620(35) “Involuntary placement” means either involuntary621outpatient treatment pursuant to s. 394.4655 or involuntary622inpatient treatment pursuant to s. 394.467.623(36) “Marriage and family therapist” means a person624licensed as a marriage and family therapist under chapter 491.625(37) “Mental health counselor” means a person licensed as a626mental health counselor under chapter 491.627(38) “Electronic means” means a form of telecommunication628that requires all parties to maintain visual as well as audio629communication.630 Section 6. Section 394.4573, Florida Statutes, is amended 631 to read: 632 394.4573 Coordinated system of care; annual assessment; 633 essential elementsContinuity of care management system; 634 measures of performance; system improvement grants; reports.—On 635 or before October 1 of each year, the department shall submit to 636 the Governor, the President of the Senate, and the Speaker of 637 the House of Representatives an assessment of the behavioral 638 health services in this state in the context of the No-Wrong 639 Door model and standards set forth in this section. The 640 department’s assessment shall be based on both quantitative and 641 qualitative data and must identify any significant regional 642 variations. The assessment must include information gathered 643 from managing entities, service providers, law enforcement, 644 judicial officials, local governments, behavioral health 645 consumers and their family members, and the public. 646 (1) As used inFor the purposes ofthis section: 647 (a) “Case management” means those direct services provided 648 to a client in order to assess his or heractivities aimed at649assessingclientneeds, plan or arrangeplanningservices, 650 coordinate service providers, monitorlinking the service system651to a client, coordinating the various systemcomponents,652monitoringservice delivery, and evaluate patient outcomes 653evaluating the effectof service delivery. 654 (b) “Case manager” means an individual who works with 655 clients,and their families and significant others,to provide 656 case management. 657 (c) “Client manager” means an employee of the managing 658 entity or entity under contract with the managing entity 659departmentwho is assigned to specific provider agencies and 660 geographic areas to ensure that the full range of needed 661 services is available to clients. 662 (d) “Coordinated systemContinuityof caremanagement663system” meansa system thatassures, within available resources,664that clients have access tothe full array of behavioral and 665 related services in a region or community offered by all service 666 providers, whether participating under contract with the 667 managing entity or another method of community partnership or 668 mutual agreementwithin the mental health services delivery669system. 670 (e) “No-Wrong-Door model” means a model for the delivery of 671 health care services to persons who have mental health or 672 substance abuse disorders, or both, which optimizes access to 673 care, regardless of the entry point to the behavioral health 674 care system. 675 (2) The essential elements of a coordinated system of care 676 include: 677 (a) Community interventions, such as prevention, primary 678 care for behavioral health needs, therapeutic and supportive 679 services, crisis response services, and diversion programs. 680 (b) A designated receiving system consisting of one or more 681 facilities serving a defined geographic area and responsible for 682 assessment and evaluation, both voluntary and involuntary, and 683 treatment or triage for patients who present with mental 684 illness, substance abuse disorder, or co-occurring disorders. 685 The system must be authorized by each county or by several 686 counties, planned through an inclusive process, approved by the 687 managing entity, and documented through written memoranda of 688 agreement or other binding arrangements. The designated 689 receiving system may be organized in any of the following ways 690 so long as it functions as a No-Wrong-Door model that responds 691 to individual needs and integrates services among various 692 providers: 693 1. A central receiving system, which consists of a 694 designated central receiving facility that serves as a single 695 entry point for persons with mental health or substance abuse 696 disorders, or both. The designated receiving facility must be 697 capable of assessment, evaluation, and triage or treatment for 698 various conditions and circumstances. 699 2. A coordinated receiving system, which consists of 700 multiple entry points that are linked by shared data systems, 701 formal referral agreements, and cooperative arrangements for 702 care coordination and case management. Each entry point must be 703 a designated receiving facility and must provide or arrange for 704 necessary services following an initial assessment and 705 evaluation. 706 3. A tiered receiving system, which consists of multiple 707 entry points, some of which offer only specialized or limited 708 services. Each service provider participating in the tiered 709 receiving system must be classified as a designated receiving 710 facility, a triage center, or an access center. All 711 participating service providers must be linked by shared data 712 systems, formal referral agreements, and cooperative 713 arrangements for care coordination and case management. An 714 accurate inventory of the participating service providers which 715 specifies the capabilities and limitations of each provider must 716 be maintained and made available at all times to all first 717 responders in the service area. 718 (c) Transportation in accordance with a plan developed 719 under s. 394.462. 720 (d) Crisis services, including mobile response teams, 721 crisis stabilization units, addiction receiving facilities, and 722 detoxification facilities. 723 (e) Case management, including intensive case management 724 for individuals determined to be high-need or high-utilization 725 individuals under s. 394.9082(2)(e). 726 (f) Outpatient services. 727 (g) Residential services. 728 (h) Hospital inpatient care. 729 (i) Aftercare and other post-discharge services. 730 (j) Medication assistance and management. 731 (k) Recovery support, including housing assistance and 732 support for competitive employment, educational attainment, 733 independent living skills development, family support and 734 education, and wellness management and self-care. 735 (3) The department’s annual assessment must compare the 736 status and performance of the extant behavioral health system 737 with the following standards and any other standards or measures 738 that the department determines to be applicable. 739 (a) The capacity of the contracted service providers to 740 meet estimated need when such estimates are based on credible 741 evidence and sound methodologies. 742 (b) The extent to which the behavioral health system uses 743 evidence-based practices and broadly disseminates the results of 744 quality improvement activities to all service providers. 745 (c) The degree to which services are offered in the least 746 restrictive and most appropriate therapeutic environment. 747 (d) The scope of systemwide accountability activities used 748 to monitor patient outcomes and measure continuous improvement 749 in the behavioral health system. 750 (4) Subject to a specific appropriation by the Legislature, 751 the department may award system improvement grants to managing 752 entities based on the submission of a detailed plan to enhance 753 services, coordination, or performance measurement in accordance 754 with the model and standards specified in this section. Such a 755 grant must be awarded through a performance-based contract that 756 links payments to the documented and measurable achievement of 757 system improvementsThe department isdirected to implementa758continuity of care management system for the provision of mental759health care, through the provision of client and case760management, including clients referred from state treatment761facilities to community mental health facilities.Such system762shall include a network of client managers and case managers763throughout the state designed to:764(a) Reduce the possibility of a client’s admission or765readmission to a state treatment facility.766(b) Provide for the creation or designation of an agency in767each county to provide single intake services for each person768seeking mental health services. Such agency shall provide769information and referral services necessary to ensure that770clients receive the most appropriate and least restrictive form771of care, based on the individual needs of the person seeking772treatment. Such agency shall have a single telephone number,773operating 24 hours per day, 7 days per week, where practicable,774at a central location, where each client will have a central775record.776(c) Advocate on behalf of the client to ensure that all777appropriate services are afforded to the client in a timely and778dignified manner.779(d) Require that any public receiving facility initiating a780patient transfer to a licensed hospital for acute care mental781health services not accessible through the public receiving782facility shall notify the hospital of such transfer and send all783records relating to the emergency psychiatric or medical784condition.785(3) The department is directed to develop and include in786contracts with service providers measures of performance with787regard to goals and objectives as specified in the state plan.788Such measures shall use, to the extent practical, existing data789collection methods and reports and shall not require, as a790result of this subsection, additional reports on the part of791service providers. The department shall plan monitoring visits792of community mental health facilities with other state, federal,793and local governmental and private agencies charged with794monitoring such facilities.795 Section 7. Paragraphs (d) and (e) of subsection (2) of 796 section 394.4597, Florida Statutes, are amended to read: 797 394.4597 Persons to be notified; patient’s representative.— 798 (2) INVOLUNTARY PATIENTS.— 799 (d) When the receiving or treatment facility selects a 800 representative, first preference shall be given to a health care 801 surrogate, if one has been previously selected by the patient. 802 If the patient has not previously selected a health care 803 surrogate, the selection, except for good cause documented in 804 the patient’s clinical record, shall be made from the following 805 list in the order of listing: 806 1. The patient’s spouse. 807 2. An adult child of the patient. 808 3. A parent of the patient. 809 4. The adult next of kin of the patient. 810 5. An adult friend of the patient. 8116. The appropriate Florida local advocacy council as812provided in s. 402.166.813 (e) The following persons are prohibited from selection as 814 a patient’s representative: 815 1. A professional providing clinical services to the 816 patient under this part. 817 2. The licensed professional who initiated the involuntary 818 examination of the patient, if the examination was initiated by 819 professional certificate. 820 3. An employee, an administrator, or a board member of the 821 facility providing the examination of the patient. 822 4. An employee, an administrator, or a board member of a 823 treatment facility providing treatment for the patient. 824 5. A person providing any substantial professional services 825 to the patient, including clinical and nonclinical services. 826 6. A creditor of the patient. 827 7. A person subject to an injunction for protection against 828 domestic violence under s. 741.30, whether the order of 829 injunction is temporary or final, and for which the patient was 830 the petitioner. 831 8. A person subject to an injunction for protection against 832 repeat violence, sexual violence, or dating violence under s. 833 784.046, whether the order of injunction is temporary or final, 834 and for which the patient was the petitionerA licensed835professional providing services to the patient under this part,836an employee of a facility providing direct services to the837patient under this part, a department employee, a person838providing other substantial services to the patient in a839professional or business capacity, or a creditor of the patient840shall not be appointed as the patient’s representative. 841 Section 8. Present subsections (2) through (7) of section 842 394.4598, Florida Statutes, are redesignated as subsections (3) 843 through (8), respectively, a new subsection (2) is added to that 844 section, and present subsections (3) and (4) of that section are 845 amended, to read: 846 394.4598 Guardian advocate.— 847 (2) The following persons are prohibited from appointment 848 as a patient’s guardian advocate: 849 (a) A professional providing clinical services to the 850 patient under this part. 851 (b) The licensed professional who initiated the involuntary 852 examination of the patient, if the examination was initiated by 853 professional certificate. 854 (c) An employee, an administrator, or a board member of the 855 facility providing the examination of the patient. 856 (d) An employee, an administrator, or a board member of a 857 treatment facility providing treatment of the patient. 858 (e) A person providing any substantial professional 859 services to the patient, including clinical and nonclinical 860 services. 861 (f) A creditor of the patient. 862 (g) A person subject to an injunction for protection 863 against domestic violence under s. 741.30, whether the order of 864 injunction is temporary or final, and for which the patient was 865 the petitioner. 866 (h) A person subject to an injunction for protection 867 against repeat violence, sexual violence, or dating violence 868 under s. 784.046, whether the order of injunction is temporary 869 or final, and for which the patient was the petitioner. 870 (4)(3)In lieu of the training required of guardians 871 appointed pursuant to chapter 744,Prior toa guardian advocate 872 must attend at least a 4-hour training course approved by the 873 court before exercising his or her authority, the guardian874advocate shall attend a training course approved by the court. 875 At a minimum, this training course, of not less than 4 hours,876 must include, at minimum,information aboutthepatient rights, 877 psychotropic medications, the diagnosis of mental illness, the 878 ethics of medical decisionmaking, and duties of guardian 879 advocates.This training course shall take the place of the880training required for guardians appointed pursuant to chapter881744.882 (5)(4)The required training course and the information to 883 be supplied to prospective guardian advocates beforeprior to884 their appointmentand the training course for guardian advocates885 must be developedand completed through a course developedby 886 the department,andapproved by the chief judge of the circuit 887 court, and taught by a court-approved organization, which.888Court-approved organizationsmay include, but isarenot limited 889 to, a community collegecommunityor juniorcolleges, a 890 guardianship organizationguardianship organizations, aand the891 local bar association, or The Florida Bar. The court may, in its892discretion,waive some or all of the training requirements for 893 guardian advocates or impose additional requirements. The court 894 shall make its decision on a case-by-case basis and, in making 895 its decision, shall consider the experience and education of the 896 guardian advocate, the duties assigned to the guardian advocate, 897 and the needs of the patient. 898 Section 9. Section 394.462, Florida Statutes, is amended to 899 read: 900 394.462 Transportation.—A transportation plan must be 901 developed and implemented in each county in accordance with this 902 section. A county may enter into a memorandum of understanding 903 with the governing boards of nearby counties to establish a 904 shared transportation plan. When multiple counties enter into a 905 memorandum of understanding for this purpose, the managing 906 entity must be notified and provided a copy of the agreement. 907 The transportation plan must specify methods of transport to a 908 facility within the designated receiving system and may delegate 909 responsibility for other transportation to a participating 910 facility when necessary and agreed to by the facility. The plan 911 must ensure that individuals who meet the criteria for 912 involuntary assessment and evaluation pursuant to ss. 394.463 913 and 397.675 will be transported. The plan may rely on emergency 914 medical transport services or private transport companies as 915 appropriate. 916 (1) TRANSPORTATION TO A RECEIVING FACILITY.— 917 (a) Each county shall designate a single law enforcement 918 agency within the county, or portions thereof, to take a person 919 into custody upon the entry of an ex parte order or the 920 execution of a certificate for involuntary examination by an 921 authorized professional and to transport that person to an 922 appropriate facility within the designated receiving systemthe923nearest receiving facilityfor examination. 924 (b)1. The designated law enforcement agency may decline to 925 transport the person to a receiving facility only if: 926 a.1.The jurisdiction designated by the county has 927 contracted on an annual basis with an emergency medical 928 transport service or private transport company for 929 transportation of persons to receiving facilities pursuant to 930 this section at the sole cost of the county; and 931 b.2.The law enforcement agency and the emergency medical 932 transport service or private transport company agree that the 933 continued presence of law enforcement personnel is not necessary 934 for the safety of the person or others. 935 2.3.The entity providing transportationjurisdiction936designated by the countymay seek reimbursement for 937 transportation expenses. The party responsible for payment for 938 such transportation is the person receiving the transportation. 939 The county shall seek reimbursement from the following sources 940 in the following order: 941 a. From a private or public third-party payoran insurance942company, health care corporation, or other source, if the person 943 receiving the transportation has applicable coverageis covered944by an insurance policy or subscribes to a health care945corporation or other source for payment of such expenses. 946 b. From the person receiving the transportation. 947 c. From a financial settlement for medical care, treatment, 948 hospitalization, or transportation payable or accruing to the 949 injured party. 950 (c)(b)AAnycompany that transports a patient pursuant to 951 this subsection is considered an independent contractor and is 952 solely liable for the safe and dignified transport 953transportationof the patient. Such company must be insured and 954 provide no less than $100,000 in liability insurance with 955 respect to the transporttransportationof patients. 956 (d)(c)Any company that contracts with a governing board of 957 a county to transport patients shall comply with the applicable 958 rules of the department to ensure the safety and dignity ofthe959 patients. 960 (e)(d)When a law enforcement officer takes custody of a 961 person pursuant to this part, the officer may request assistance 962 from emergency medical personnel if such assistance is needed 963 for the safety of the officer or the person in custody. 964 (f)(e)When a member of a mental health overlay program or 965 a mobile crisis response service is a professional authorized to 966 initiate an involuntary examination pursuant to s. 394.463 or s. 967 397.675 and that professional evaluates a person and determines 968 that transportation to a receiving facility is needed, the 969 service, at its discretion, may transport the person to the 970 facility or may call on the law enforcement agency or other 971 transportation arrangement best suited to the needs of the 972 patient. 973 (g)(f)When any law enforcement officer has custody of a 974 person based on either noncriminal or minor criminal behavior 975 that meets the statutory guidelines for involuntary examination 976 under this part, the law enforcement officer shall transport the 977 person to an appropriatethenearest receivingfacility within 978 the designated receiving system for examination. 979 (h)(g)When any law enforcement officer has arrested a 980 person for a felony and it appears that the person meets the 981 statutory guidelines for involuntary examination or placement 982 under this part, such person mustshallfirst be processed in 983 the same manner as any other criminal suspect. The law 984 enforcement agency shall thereafter immediately notify the 985 appropriatenearest publicreceivingfacility within the 986 designated receiving system, which shall be responsible for 987 promptly arranging for the examination and treatment of the 988 person. A receiving facility is not required to admit a person 989 charged with a crime for whom the facility determines and 990 documents that it is unable to provide adequate security, but 991 shall providemental healthexamination and treatment to the 992 person where he or she is held. 993 (i)(h)If the appropriate law enforcement officer believes 994 that a person has an emergency medical condition as defined in 995 s. 395.002, the person may be first transported to a hospital 996 for emergency medical treatment, regardless of whether the 997 hospital is a designated receiving facility. 998 (j)(i)The costs of transportation, evaluation, 999 hospitalization, and treatment incurred under this subsection by 1000 persons who have been arrested for violations of any state law 1001 or county or municipal ordinance may be recovered as provided in 1002 s. 901.35. 1003 (k)(j)Thenearestreceivingfacility within the designated 1004 receiving system must accept persons brought by law enforcement 1005 officers, an emergency medical transport service, or a private 1006 transport company for involuntary examination. 1007 (l)(k)Each law enforcement agency designated pursuant to 1008 paragraph (a) shall establish a policy thatdevelop a memorandum1009of understanding with each receiving facility within the law1010enforcement agency’s jurisdictionwhichreflects a single set of 1011 protocols approved by the managing entity for the safe and 1012 secure transportationof the personand transfer of custody of 1013 the person.These protocols must also address crisis1014intervention measures.1015 (m)(l)When a jurisdiction has entered into a contract with 1016 an emergency medical transport service or a private transport 1017 company for transportation of persons toreceivingfacilities 1018 within the designated receiving system, such service or company 1019 shall be given preference for transportation of persons from 1020 nursing homes, assisted living facilities, adult day care 1021 centers, or adult family-care homes, unless the behavior of the 1022 person being transported is such that transportation by a law 1023 enforcement officer is necessary. 1024 (n)(m)Nothing inThis section may notshallbe construed 1025 to limit emergency examination and treatment of incapacitated 1026 persons provided in accordance withthe provisions ofs. 1027 401.445. 1028 (2) TRANSPORTATION TO A TREATMENT FACILITY.— 1029 (a) If neither the patient nor any person legally obligated 1030 or responsible for the patient is able to pay for the expense of 1031 transporting a voluntary or involuntary patient to a treatment 1032 facility, the transportation plan established by the governing 1033 board of the county or counties must specify howin whichthe 1034 hospitalized patient will be transported to, from, and between 1035 facilities in ais hospitalizedshallarrange for such required1036transportation and shall ensure thesafe and dignified manner 1037transportation of the patient.The governing board of each1038county is authorized to contract with private transport1039companies for the transportation of such patients to and from a1040treatment facility.1041 (b) AAnycompany that transports a patient pursuant to 1042 this subsection is considered an independent contractor and is 1043 solely liable for the safe and dignified transportation of the 1044 patient. Such company must be insured and provide no less than 1045 $100,000 in liability insurance with respect to the transport 1046transportationof patients. 1047 (c) AAnycompany that contracts with one or more counties 1048the governing board of a countyto transport patients in 1049 accordance with this section shall comply with the applicable 1050 rules of the department to ensure the safety and dignity ofthe1051 patients. 1052 (d) County or municipal law enforcement and correctional 1053 personnel and equipment mayshallnot be used to transport 1054 patients adjudicated incapacitated or found by the court to meet 1055 the criteria for involuntary placement pursuant to s. 394.467, 1056 except in small rural counties where there are no cost-efficient 1057 alternatives. 1058 (3) TRANSFER OF CUSTODY.—Custody of a person who is 1059 transported pursuant to this part, along with related 1060 documentation, shall be relinquished to a responsible individual 1061 at the appropriate receiving or treatment facility. 1062(4) EXCEPTIONS.—An exception to the requirements of this1063section may be granted by the secretary of the department for1064the purposes of improving service coordination or better meeting1065the special needs of individuals. A proposal for an exception1066must be submitted by the district administrator after being1067approved by the governing boards of any affected counties, prior1068to submission to the secretary.1069(a) A proposal for an exception must identify the specific1070provision from which an exception is requested;describehow the1071proposal will be implemented by participating law enforcement1072agencies and transportation authorities;and provide a plan for1073the coordination of services such as case management.1074(b) The exception may be granted only for:10751. An arrangement centralizing and improving the provision1076of services within a district, which may include an exception to1077the requirement for transportation to the nearest receiving1078facility;10792. An arrangement by which a facility may provide, in1080addition to required psychiatric services, an environment and1081services which are uniquely tailored to the needs of an1082identified group of persons with special needs, such as persons1083with hearing impairments or visual impairments, or elderly1084persons with physical frailties; or10853. A specialized transportation system that provides an1086efficient and humane method of transporting patients to1087receiving facilities, among receiving facilities, and to1088treatment facilities.1089(c) Any exception approved pursuant to this subsection1090shall be reviewed and approved every 5 years by the secretary.1091 Section 10. Subsection (2) of section 394.463, Florida 1092 Statutes, is amended to read: 1093 394.463 Involuntary examination.— 1094 (2) INVOLUNTARY EXAMINATION.— 1095 (a) An involuntary examination may be initiated by any one 1096 of the following means: 1097 1. A circuit or county court may enter an ex parte order 1098 stating that a person appears to meet the criteria for 1099 involuntary examination and specifying, givingthe findings on 1100 which that conclusion is based. The ex parte order for 1101 involuntary examination must be based on written or oral sworn 1102 testimony that includes specific facts that support the 1103 findings, written or oral. If other, less restrictive, means are 1104 not available, such as voluntary appearance for outpatient 1105 evaluation, a law enforcement officer, or other designated agent 1106 of the court, shall take the person into custody and deliver him 1107 or her to an appropriatethenearest receivingfacility within 1108 the designated receiving system for involuntary examination. The 1109 order of the court shall be made a part of the patient’s 1110 clinical record. ANofee may notshallbe charged for the 1111 filing of an order under this subsection. Anyreceivingfacility 1112 accepting the patient based on this order must send a copy of 1113 the order to the managing entity in the region and to the 1114 departmentAgency for Health Care Administrationon the next 1115 working day. The order shall be valid only until the person is 1116 delivered to the appropriate facilityexecutedor,if not1117executed,for the period specified in the order itself, 1118 whichever comes first. If no time limit is specified in the 1119 order, the order shall be valid for 7 days after the date that 1120 the order was signed. 1121 2. A law enforcement officer shall take a person who 1122 appears to meet the criteria for involuntary examination into 1123 custody and deliver the person or have him or her delivered to 1124 the appropriatenearestreceivingfacility within the designated 1125 receiving system for examination. The officer shall execute a 1126 written report detailing the circumstances under which the 1127 person was taken into custody, which mustand the report shall1128 be made a part of the patient’s clinical record. Anyreceiving1129 facility accepting the patient based on this report must send a 1130 copy of the report to the department and the managing entity 1131Agency for Health Care Administrationon the next working day. 1132 3. A physician,clinicalpsychologist, psychiatric nurse, 1133 mental health counselor, marriage and family therapist, or 1134 clinical social worker may execute a certificate stating that he 1135 or she has examined a person within the preceding 48 hours and 1136 finds that the person appears to meet the criteria for 1137 involuntary examination and stating the observations upon which 1138 that conclusion is based. If other, less restrictive means, such 1139 as voluntary appearance for outpatient evaluation, are not 1140 available,such as voluntary appearance for outpatient1141evaluation,a law enforcement officer shall take into custody 1142 the person named in the certificateinto custodyand deliver him 1143 or her to the appropriatenearest receivingfacility within the 1144 designated receiving system for involuntary examination. The law 1145 enforcement officer shall execute a written report detailing the 1146 circumstances under which the person was taken into custody. The 1147 report and certificate shall be made a part of the patient’s 1148 clinical record. Anyreceivingfacility accepting the patient 1149 based on this certificate must send a copy of the certificate to 1150 the managing entity and the departmentAgency for Health Care1151Administrationonthe next working day. 1152 (b) A person mayshallnot be removed from any program or 1153 residential placement licensed under chapter 400 or chapter 429 1154 and transported to a receiving facility for involuntary 1155 examination unless an ex parte order, a professional 1156 certificate, or a law enforcement officer’s report is first 1157 prepared. If the condition of the person is such that 1158 preparation of a law enforcement officer’s report is not 1159 practicable before removal, the report shall be completed as 1160 soon as possible after removal, but in any case before the 1161 person is transported to a receiving facility. Areceiving1162 facility admitting a person for involuntary examination who is 1163 not accompanied by the required ex parte order, professional 1164 certificate, or law enforcement officer’s report shall notify 1165 the managing entity and the departmentAgency for Health Care1166Administrationof such admission by certified mail or by 1167 electronic means if available, byno later thanthe next working 1168 day. The provisions of this paragraph do not apply when 1169 transportation is provided by the patient’s family or guardian. 1170 (c) A law enforcement officer acting in accordance with an 1171 ex parte order issued pursuant to this subsection may serve and 1172 execute such order on any day of the week, at any time of the 1173 day or night. 1174 (d) A law enforcement officer acting in accordance with an 1175 ex parte order issued pursuant to this subsection may use such 1176 reasonable physical force as is necessary to gain entry to the 1177 premises, and any dwellings, buildings, or other structures 1178 located on the premises, and to take custody of the person who 1179 is the subject of the ex parte order. 1180 (e) The managing entity and the departmentAgency for1181Health Care Administrationshall receive and maintain the copies 1182 of ex parte petitions and orders, involuntary outpatient 1183 servicesplacementorders issued pursuant to s. 394.4655, 1184 involuntary inpatient placement orders issued pursuant to s. 1185 394.467, professional certificates, and law enforcement 1186 officers’ reports. These documents shall be considered part of 1187 the clinical record, governed by the provisions of s. 394.4615. 1188 These documents shall be provided by the department to the 1189 Agency for Health Care Administration and used by the agency to 1190The agency shallprepare annual reports analyzing the data 1191 obtained from these documents, without information identifying 1192 patients, and shall provide copies of reports to the department, 1193 the President of the Senate, the Speaker of the House of 1194 Representatives, and the minority leaders of the Senate and the 1195 House of Representatives. 1196 (f) A patient shall be examined by a physician or,a 1197 psychologistclinical psychologist,or by a psychiatric nurse 1198 performing within the framework of an established protocol with 1199 a psychiatrist at areceivingfacility without unnecessary delay 1200 to determine if the criteria for involuntary services are met. 1201 Emergency treatment may be providedand may,upon the order of a 1202 physician, if the physician determinesbe given emergency1203treatment if it is determinedthat such treatment is necessary 1204 for the safety of the patient or others. The patient may not be 1205 released by the receiving facility or its contractor without the 1206 documented approval of a psychiatrist or a psychologistclinical1207psychologistor,if the receiving facility is owned or operated1208by a hospital or health system, the release may also be approved1209bya psychiatric nurse performing within the framework of an 1210 established protocol with a psychiatrist, or an attending 1211 emergency department physician with experience in the diagnosis 1212 and treatment of mental illnessand nervous disorders andafter 1213 completion of an involuntary examination pursuant to this 1214 subsection. A psychiatric nurse may not approve the release of a 1215 patient if the involuntary examination was initiated by a 1216 psychiatrist unless the release is approved by the initiating 1217 psychiatrist.However, a patient may not be held in a receiving1218facility for involuntary examination longer than 72 hours.1219 (g) A person may not be held for involuntary examination 1220 for more than 72 hours from the time of his or her arrival at 1221 the facility. Based on the person’s needs, one of the following 1222 actions must be taken within the involuntary examination period: 1223 1. The person must be released with the approval of a 1224 physician, psychiatrist, psychiatric nurse, or psychologist. 1225 However, if the examination is conducted in a hospital, an 1226 attending emergency department physician with experience in the 1227 diagnosis and treatment of mental illness may approve the 1228 release. The professional approving the release must have 1229 personally conducted the involuntary examination. 1230 2. The person must be asked to give express and informed 1231 consent for voluntary admission if a physician, psychiatrist, 1232 psychiatric nurse, or psychologist has determined that the 1233 individual is competent to consent to treatment. 1234 3. A petition for involuntary services must be completed 1235 and filed in the circuit court by the facility administrator. If 1236 electronic filing of the petition is not available in the county 1237 and the 72-hour period ends on a weekend or legal holiday, the 1238 petition must be filed by the next working day. If involuntary 1239 services are deemed necessary, the least restrictive treatment 1240 consistent with the optimum improvement of the person’s 1241 condition must be made available. 1242 (h) An individual discharged from a facility on a voluntary 1243 or an involuntary basis who is currently charged with a crime 1244 shall be released to the custody of a law enforcement officer, 1245 unless the individual has been released from law enforcement 1246 custody by posting of a bond, by a pretrial conditional release, 1247 or by other judicial release. 1248 (i)(g)A person for whom an involuntary examination has 1249 been initiated who is being evaluated or treated at a hospital 1250 for an emergency medical condition specified in s. 395.002 must 1251 be examined by an appropriatea receivingfacility within 72 1252 hours. The 72-hour period begins when the patient arrives at the 1253 hospital and ceases when the attending physician documents that 1254 the patient has an emergency medical condition. If the patient 1255 is examined at a hospital providing emergency medical services 1256 by a professional qualified to perform an involuntary 1257 examination and is found as a result of that examination not to 1258 meet the criteria for involuntary outpatient servicesplacement1259 pursuant to s. 394.4655(1) or involuntary inpatient placement 1260 pursuant to s. 394.467(1), the patient may be offered voluntary 1261 placement, if appropriate, or released directly from the 1262 hospital providing emergency medical services. The finding by 1263 the professional that the patient has been examined and does not 1264 meet the criteria for involuntary inpatient placement or 1265 involuntary outpatient servicesplacementmust be entered into 1266 the patient’s clinical record.Nothing inThis paragraph is not 1267 intended to prevent a hospital providing emergency medical 1268 services from appropriately transferring a patient to another 1269 hospital beforeprior tostabilization if, providedthe 1270 requirements of s. 395.1041(3)(c) have been met. 1271 (j)(h)One of the following must occur within 12 hours 1272 after the patient’s attending physician documents that the 1273 patient’s medical condition has stabilized or that an emergency 1274 medical condition does not exist: 1275 1. The patient must be examined by an appropriatea1276designated receivingfacility and released; or 1277 2. The patient must be transferred to a designated 1278receivingfacility in which appropriate medical treatment is 1279 available. However, thereceivingfacility must be notified of 1280 the transfer within 2 hours after the patient’s condition has 1281 been stabilized or after determination that an emergency medical 1282 condition does not exist. 1283(i) Within the 72-hour examination period or, if the 721284hours ends on a weekend or holiday, no later than the next1285working day thereafter, one of the following actions must be1286taken, based on the individual needs of the patient:12871. The patient shall be released, unless he or she is1288charged with a crime, in which case the patient shall be1289returned to the custody of a law enforcement officer;12902. The patient shall be released, subject to the provisions1291of subparagraph 1., for voluntary outpatient treatment;12923. The patient, unless he or she is charged with a crime,1293shall be asked to give express and informed consent to placement1294as a voluntary patient, and, if such consent is given, the1295patient shall be admitted as a voluntary patient; or12964. A petition for involuntary placement shall be filed in1297the circuit court when outpatient or inpatient treatment is1298deemed necessary. When inpatient treatment is deemed necessary,1299the least restrictive treatment consistent with the optimum1300improvement of the patient’s condition shall be made available.1301When a petition is to be filed for involuntary outpatient1302placement, it shall be filed by one of the petitioners specified1303in s. 394.4655(3)(a). A petition for involuntary inpatient1304placement shall be filed by the facility administrator.1305 Section 11. Section 394.4655, Florida Statutes, is amended 1306 to read: 1307 394.4655 Involuntary outpatient servicesplacement.— 1308 (1) CRITERIA FOR INVOLUNTARY OUTPATIENT SERVICES 1309PLACEMENT.—A person may be ordered to involuntary outpatient 1310 servicesplacementupon a finding of the court, by clear and 1311 convincing evidence, that the person meets all of the following 1312 criteriaby clear and convincing evidence: 1313 (a) The person is 18 years of age or older.;1314 (b) The person has a mental illness.;1315 (c) The person is unlikely to survive safely in the 1316 community without supervision, based on a clinical 1317 determination.;1318 (d) The person has a history of lack of compliance with 1319 treatment for mental illness.;1320 (e) The person has: 1321 1. At least twice within the immediately preceding 36 1322 months been involuntarily admitted to a receiving or treatment 1323 facility as defined in s. 394.455, or has received mental health 1324 services in a forensic or correctional facility. The 36-month 1325 period does not include any period during which the person was 1326 admitted or incarcerated; or 1327 2. Engaged in one or more acts of serious violent behavior 1328 toward self or others, or attempts at serious bodily harm to 1329 himself or herself or others, within the preceding 36 months.;1330 (f) The person is, as a result of his or her mental 1331 illness, unlikely to voluntarily participate in the recommended 1332 treatment plan andeither he or shehas refused voluntary 1333 servicesplacementfor treatment after sufficient and 1334 conscientious explanation and disclosure of why the services are 1335 necessarypurpose ofplacementfor treatmentorhe or sheis 1336 unable to determine for himself or herself whether services are 1337placement isnecessary.;1338 (g) In view of the person’s treatment history and current 1339 behavior, the person is in need of involuntary outpatient 1340 servicesplacementin order to prevent a relapse or 1341 deterioration that would be likely to result in serious bodily 1342 harm to himself or herself or others, or a substantial harm to 1343 his or her well-being as set forth in s. 394.463(1).;1344 (h) It is likely that the person will benefit from 1345 involuntary outpatient services.placement; and1346 (i) All available, less restrictive alternatives that would 1347 offer an opportunity for improvement of his or her condition 1348 have been judged to be inappropriate or unavailable. 1349 (2) INVOLUNTARY OUTPATIENT SERVICESPLACEMENT.— 1350 (a)1. A patient who is being recommended for involuntary 1351 outpatient servicesplacementby the administrator of the 1352receivingfacility where the patient has been examined may be 1353 retained by the facility after adherence to the notice 1354 procedures provided in s. 394.4599. The recommendation must be 1355 supported by the opinion of two qualified professionalsa1356psychiatrist and the second opinion of a clinical psychologist1357or another psychiatrist, both of whom have personally examined 1358 the patient within the preceding 72 hours, that the criteria for 1359 involuntary outpatient servicesplacementare met. However, in a 1360 county having a population of fewer than 50,000, if the 1361 administrator certifies that a qualified professional 1362psychiatrist or clinical psychologistis not available to 1363 provide the second opinion, the second opinion may be provided 1364 by alicensedphysician who has postgraduate training and 1365 experience in diagnosis and treatment of mentaland nervous1366 disorders or by a psychiatric nurse. Any second opinion 1367 authorized in this subparagraph may be conducted through a face 1368 to-face examination, in person or by electronic means, including 1369 telemedicine. Such recommendation must be entered on an 1370 involuntary outpatient servicesplacementcertificate that 1371 authorizes thereceivingfacility to retain the patient pending 1372 completion of a hearing. The certificate mustshallbe made a 1373 part of the patient’s clinical record. 1374 2. If the patient has been stabilized and no longer meets 1375 the criteria for involuntary examination pursuant to s. 1376 394.463(1), the patient must be released from thereceiving1377 facility while awaiting the hearing for involuntary outpatient 1378 servicesplacement. Before filing a petition for involuntary 1379 outpatient servicestreatment, the administrator of thea1380receivingfacility or a designated department representative 1381 must identify the service provider that will have primary 1382 responsibility for service provision under an order for 1383 involuntary outpatient servicesplacement, unless the person is 1384 otherwise participating in outpatient psychiatric treatment and 1385 is not in need of public financing for that treatment, in which 1386 case the individual, if eligible, may be ordered to involuntary 1387 treatment pursuant to the existing psychiatric treatment 1388 relationship. 1389 3. The service provider shall prepare a written proposed 1390 treatment plan in consultation with the patient or the patient’s 1391 guardian advocate, if appointed, for the court’s consideration 1392 for inclusion in the involuntary outpatient servicesplacement1393 order. The service provider shall also provide a copy of the 1394 proposed treatment plan to the patient and the administrator of 1395 thereceivingfacility. The treatment plan must specify the 1396 nature and extent of the patient’s mental illness, address the 1397 reduction of symptoms that necessitate involuntary outpatient 1398 servicesplacement, and include measurable goals and objectives 1399 for the servicesand treatmentthat are provided to treat the 1400 person’s mental illness and assist the person in living and 1401 functioning in the community or to prevent a relapse or 1402 deterioration. Service providers may select and supervise other 1403 individuals to implement specific aspects of the treatment plan. 1404 The services in thetreatmentplan must be deemed clinically 1405 appropriate by a physician,clinicalpsychologist, psychiatric 1406 nurse, mental health counselor, marriage and family therapist, 1407 or clinical social worker who consults with, or is employed or 1408 contracted by, the service provider. The service provider must 1409 certify to the court in the proposed treatment plan whether 1410 sufficient services for improvement and stabilization are 1411 currently available and whether the service provider agrees to 1412 provide those services. If the service provider certifies that 1413 the services in the proposed treatment plan are not available, 1414 the petitioner may not file the petition. The service provider 1415 must document its inquiry with the department and the managing 1416 entity as to the availability of the requested services. The 1417 managing entity must document such efforts to obtain the 1418 requested services. 1419 (b) If a patient in involuntary inpatient placement meets 1420 the criteria for involuntary outpatient servicesplacement, the 1421 administrator of thetreatmentfacility may, before the 1422 expiration of the period during which thetreatmentfacility is 1423 authorized to retain the patient, recommend involuntary 1424 outpatient servicesplacement. The recommendation must be 1425 supported by the opinion of two qualified professionalsa1426psychiatrist and the second opinion of a clinical psychologist1427or another psychiatrist, both of whom have personally examined 1428 the patient within the preceding 72 hours, that the criteria for 1429 involuntary outpatient servicesplacementare met. However, in a 1430 county having a population of fewer than 50,000, if the 1431 administrator certifies that a qualified professional 1432psychiatrist or clinical psychologistis not available to 1433 provide the second opinion, the second opinion may be provided 1434 by alicensedphysician who has postgraduate training and 1435 experience in diagnosis and treatment of mentaland nervous1436 disorders or by a psychiatric nurse. Any second opinion 1437 authorized in this paragraphsubparagraphmay be conducted 1438 through a face-to-face examination, in person or by electronic 1439 means including telemedicine. Such recommendation must be 1440 entered on an involuntary outpatient servicesplacement1441 certificate, and the certificate must be made a part of the 1442 patient’s clinical record. 1443 (c)1. The administrator of thetreatmentfacility shall 1444 provide a copy of the involuntary outpatient servicesplacement1445 certificate and a copy of the state mental health discharge form 1446 to a department representative in the county where the patient 1447 will be residing. For persons who are leaving a state mental 1448 health treatment facility, the petition for involuntary 1449 outpatient servicesplacementmust be filed in the county where 1450 the patient will be residing. 1451 2. The service provider that will have primary 1452 responsibility for service provision shall be identified by the 1453 designated department representative beforeprior tothe order 1454 for involuntary outpatient servicesplacementand must, before 1455prior tofiling a petition for involuntary outpatient services 1456placement, certify to the court whether the services recommended 1457 in the patient’s discharge plan are availablein the local1458communityand whether the service provider agrees to provide 1459 those services. The service provider must develop with the 1460 patient, or the patient’s guardian advocate, if appointed, a 1461 treatment or service plan that addresses the needs identified in 1462 the discharge plan. The plan must be deemed to be clinically 1463 appropriate by a physician,clinicalpsychologist, psychiatric 1464 nurse, mental health counselor, marriage and family therapist, 1465 or clinical social worker, as defined in this chapter, who 1466 consults with, or is employed or contracted by, the service 1467 provider. 1468 3. If the service provider certifies that the services in 1469 the proposed treatment or service plan are not available, the 1470 petitioner may not file the petition. The service provider must 1471 document its inquiry with the department and the managing entity 1472 as to the availability of the requested services. The managing 1473 entity must document such efforts to obtain the requested 1474 services. 1475 (3) PETITION FOR INVOLUNTARY OUTPATIENT SERVICES 1476PLACEMENT.— 1477 (a) A petition for involuntary outpatient services 1478placementmay be filed by: 1479 1. The administrator of a receiving facility; or 1480 2. The administrator of a treatment facility. 1481 (b) Each required criterion for involuntary outpatient 1482 servicesplacementmust be alleged and substantiated in the 1483 petition for involuntary outpatient servicesplacement. A copy 1484 of the certificate recommending involuntary outpatient services 1485placementcompleted by twoaqualified professionals 1486professionalspecified in subsection (2)must be attached to the 1487 petition. A copy of the proposed treatment plan must be attached 1488 to the petition. Before the petition is filed, the service 1489 provider shall certify that the services in the proposed 1490 treatment plan are available. If the necessary services are not 1491 availablein the patient’s local community to respond to the1492person’s individual needs, the petition may not be filed. The 1493 service provider must document its inquiry with the department 1494 and the managing entity as to the availability of the requested 1495 services. The managing entity must document such efforts to 1496 obtain the requested services. 1497 (c) The petition for involuntary outpatient services 1498placementmust be filed in the county where the patient is 1499 located, unless the patient is being placed from a state 1500 treatment facility, in which case the petition must be filed in 1501 the county where the patient will reside. When the petition has 1502 been filed, the clerk of the court shall provide copies of the 1503 petition and the proposed treatment plan to the department, the 1504 managing entity, the patient, the patient’s guardian or 1505 representative, the state attorney, and the public defender or 1506 the patient’s private counsel. A fee may not be charged for 1507 filing a petition under this subsection. 1508 (4) APPOINTMENT OF COUNSEL.—Within 1 court working day 1509 after the filing of a petition for involuntary outpatient 1510 servicesplacement, the court shall appoint the public defender 1511 to represent the person who is the subject of the petition, 1512 unless the person is otherwise represented by counsel. The clerk 1513 of the court shall immediately notify the public defender of the 1514 appointment. The public defender shall represent the person 1515 until the petition is dismissed, the court order expires, or the 1516 patient is discharged from involuntary outpatient services 1517placement. An attorney who represents the patient must be 1518 providedshall haveaccess to the patient, witnesses, and 1519 records relevant to the presentation of the patient’s case and 1520 shall represent the interests of the patient, regardless of the 1521 source of payment to the attorney. 1522 (5) CONTINUANCE OF HEARING.—The patient is entitled, with 1523 the concurrence of the patient’s counsel, to at least one 1524 continuance of the hearing. The continuance shall be for a 1525 period of up to 4 weeks. 1526 (6) HEARING ON INVOLUNTARY OUTPATIENT SERVICESPLACEMENT.— 1527 (a)1. The court shall hold the hearing on involuntary 1528 outpatient servicesplacementwithin 5 working days after the 1529 filing of the petition, unless a continuance is granted. The 1530 hearing mustshallbe held in the county where the petition is 1531 filed, mustshallbe as convenient to the patient as is 1532 consistent with orderly procedure, and mustshallbe conducted 1533 in physical settings not likely to be injurious to the patient’s 1534 condition. If the court finds that the patient’s attendance at 1535 the hearing is not consistent with the best interests of the 1536 patient and if the patient’s counsel does not object, the court 1537 may waive the presence of the patient from all or any portion of 1538 the hearing. The state attorney for the circuit in which the 1539 patient is located shall represent the state, rather than the 1540 petitioner, as the real party in interest in the proceeding. 1541 2. The court may appoint a general or special master to 1542 preside at the hearing. One of the professionals who executed 1543 the involuntary outpatient servicesplacementcertificate shall 1544 be a witness. The patient and the patient’s guardian or 1545 representative shall be informed by the court of the right to an 1546 independent expert examination. If the patient cannot afford 1547 such an examination, the court shall ensure that one is 1548 provided, as otherwise provided by lawprovide for one. The 1549 independent expert’s report isshall beconfidential and not 1550 discoverable, unless the expert is to be called as a witness for 1551 the patient at the hearing. The court shall allow testimony from 1552 individuals, including family members, deemed by the court to be 1553 relevant under state law, regarding the person’s prior history 1554 and how that prior history relates to the person’s current 1555 condition. The testimony in the hearing must be given under 1556 oath, and the proceedings must be recorded. The patient may 1557 refuse to testify at the hearing. 1558 (b)1. If the court concludes that the patient meets the 1559 criteria for involuntary outpatient servicesplacementpursuant 1560 to subsection (1), the court shall issue an order for 1561 involuntary outpatient servicesplacement. The court order shall 1562 be for a period of up to 90 days6 months. However, an order for 1563 involuntary services in a state treatment facility may be for up 1564 to 6 months. The order must specify the nature and extent of the 1565 patient’s mental illness. The order of the court and the 1566 treatment plan mustshallbe made part of the patient’s clinical 1567 record. The service provider shall discharge a patient from 1568 involuntary outpatient servicesplacementwhen the order expires 1569 or any time the patient no longer meets the criteria for 1570 involuntary servicesplacement. Upon discharge, the service 1571 provider shall send a certificate of discharge to the court. 1572 2. The court may not order the department or the service 1573 provider to provide services if the program or service is not 1574 available in the patient’s local community, if there is no space 1575 available in the program or service for the patient, or if 1576 funding is not available for the program or service. The service 1577 provider must document its inquiry with the department and the 1578 managing entity as to the availability of the requested 1579 services. The managing entity must document such efforts to 1580 obtain the requested services. A copy of the order must be sent 1581 to the department and the managing entityAgency for Health Care1582Administrationby the service provider within 1 working day 1583 after it is received from the court. After theplacementorder 1584 for involuntary services is issued, the service provider and the 1585 patient may modifyprovisions ofthe treatment plan. For any 1586 material modification of the treatment plan to which the patient 1587 or, if one is appointed, the patient’s guardian advocate agrees,1588if appointed, does agree, the service provider shall send notice 1589 of the modification to the court. Any material modifications of 1590 the treatment plan which are contested by the patient or the 1591 patient’s guardian advocate, if applicableappointed, must be 1592 approved or disapproved by the court consistent with subsection 1593 (2). 1594 3. If, in the clinical judgment of a physician, the patient 1595 has failed orhasrefused to comply with the treatment ordered 1596 by the court, and, in the clinical judgment of the physician, 1597 efforts were made to solicit compliance and the patient may meet 1598 the criteria for involuntary examination, a person may be 1599 brought to a receiving facility pursuant to s. 394.463. If, 1600 after examination, the patient does not meet the criteria for 1601 involuntary inpatient placement pursuant to s. 394.467, the 1602 patient must be discharged from thereceivingfacility. The 1603 involuntary outpatient servicesplacementorder shall remain in 1604 effect unless the service provider determines that the patient 1605 no longer meets the criteria for involuntary outpatient services 1606placementor until the order expires. The service provider must 1607 determine whether modifications should be made to the existing 1608 treatment plan and must attempt to continue to engage the 1609 patient in treatment. For any material modification of the 1610 treatment plan to which the patient or the patient’s guardian 1611 advocate, if applicableappointed, agreesdoes agree, the 1612 service provider shall send notice of the modification to the 1613 court. Any material modifications of the treatment plan which 1614 are contested by the patient or the patient’s guardian advocate, 1615 if applicableappointed, must be approved or disapproved by the 1616 court consistent with subsection (2). 1617 (c) If, at any time before the conclusion of the initial 1618 hearing on involuntary outpatient servicesplacement, it appears 1619 to the court that the person does not meet the criteria for 1620 involuntary outpatient servicesplacementunder this section 1621 but, instead, meets the criteria for involuntary inpatient 1622 placement, the court may order the person admitted for 1623 involuntary inpatient examination under s. 394.463. If the 1624 person instead meets the criteria for involuntary assessment, 1625 protective custody, or involuntary admission pursuant to s. 1626 397.675, the court may order the person to be admitted for 1627 involuntary assessment for a period of 5 days pursuant to s. 1628 397.6811. Thereafter, all proceedings areshall begoverned by 1629 chapter 397. 1630 (d) At the hearing on involuntary outpatient services 1631placement, the court shall consider testimony and evidence 1632 regarding the patient’s competence to consent to treatment. If 1633 the court finds that the patient is incompetent to consent to 1634 treatment, it shall appoint a guardian advocate as provided in 1635 s. 394.4598. The guardian advocate shall be appointed or 1636 discharged in accordance with s. 394.4598. 1637 (e) The administrator of the receiving facility or the 1638 designated department representative shall provide a copy of the 1639 court order and adequate documentation of a patient’s mental 1640 illness to the service provider for involuntary outpatient 1641 servicesplacement. Such documentation must include any advance 1642 directives made by the patient, a psychiatric evaluation of the 1643 patient, and any evaluations of the patient performed by a 1644clinicalpsychologist or a clinical social worker. 1645 (7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT SERVICES 1646PLACEMENT.— 1647 (a)1. If the person continues to meet the criteria for 1648 involuntary outpatient servicesplacement, the service provider 1649 shall, at least 10 days before the expiration of the period 1650 during which the treatment is ordered for the person, file in 1651 the county or circuit court a petition for continued involuntary 1652 outpatient servicesplacement. The court shall immediately 1653 schedule a hearing on the petition to be held within 15 days 1654 after the petition is filed. 1655 2. The existing involuntary outpatient servicesplacement1656 order remains in effect until disposition on the petition for 1657 continued involuntary outpatient servicesplacement. 1658 3. A certificate shall be attached to the petition which 1659 includes a statement from the person’s physician orclinical1660 psychologist justifying the request, a brief description of the 1661 patient’s treatment during the time he or she was receiving 1662 involuntarily servicesplaced, and an individualized plan of 1663 continued treatment. 1664 4. The service provider shall develop the individualized 1665 plan of continued treatment in consultation with the patient or 1666 the patient’s guardian advocate, if applicableappointed. When 1667 the petition has been filed, the clerk of the court shall 1668 provide copies of the certificate and the individualized plan of 1669 continued treatment to the department, the patient, the 1670 patient’s guardian advocate, the state attorney, and the 1671 patient’s private counsel or the public defender. 1672 (b) Within 1 court working day after the filing of a 1673 petition for continued involuntary outpatient services 1674placement, the court shall appoint the public defender to 1675 represent the person who is the subject of the petition, unless 1676 the person is otherwise represented by counsel. The clerk of the 1677 court shall immediately notify the public defender of such 1678 appointment. The public defender shall represent the person 1679 until the petition is dismissed or the court order expires or 1680 the patient is discharged from involuntary outpatient services 1681placement. Any attorney representing the patient shall have 1682 access to the patient, witnesses, and records relevant to the 1683 presentation of the patient’s case and shall represent the 1684 interests of the patient, regardless of the source of payment to 1685 the attorney. 1686 (c) Hearings on petitions for continued involuntary 1687 outpatient services mustplacementshallbe before the circuit 1688 court. The court may appoint a general or special master to 1689 preside at the hearing. The procedures for obtaining an order 1690 pursuant to this paragraph must meet the requirements ofshall1691be in accordance withsubsection (6), except that the time 1692 period included in paragraph (1)(e) does not apply whenis not1693applicable indetermining the appropriateness of additional 1694 periods of involuntary outpatient servicesplacement. 1695 (d) Notice of the hearing mustshallbe provided as set 1696 forth in s. 394.4599. The patient and the patient’s attorney may 1697 agree to a period of continued outpatient servicesplacement1698 without a court hearing. 1699 (e) The same procedure mustshallbe repeated before the 1700 expiration of each additional period the patient is placed in 1701 treatment. 1702 (f) If the patient has previously been found incompetent to 1703 consent to treatment, the court shall consider testimony and 1704 evidence regarding the patient’s competence. Section 394.4598 1705 governs the discharge of the guardian advocate if the patient’s 1706 competency to consent to treatment has been restored. 1707 Section 12. Section 394.467, Florida Statutes, is amended 1708 to read: 1709 394.467 Involuntary inpatient placement.— 1710 (1) CRITERIA.—A person may be ordered forplaced in1711 involuntary inpatient placement for treatment upon a finding of 1712 the court by clear and convincing evidence that: 1713 (a) He or she has a mental illnessis mentally illand 1714 because of his or her mental illness: 1715 1.a. He or she has refused voluntary inpatient placement 1716 for treatment after sufficient and conscientious explanation and 1717 disclosure of the purpose of inpatient placement for treatment; 1718 or 1719 b. He or she is unable to determine for himself or herself 1720 whether inpatient placement is necessary; and 1721 2.a. He or she ismanifestlyincapable of surviving alone 1722 or with the help of willing and responsible family or friends, 1723 including available alternative services, and, without 1724 treatment, is likely to suffer from neglect or refuse to care 1725 for himself or herself, and such neglect or refusal poses a real 1726 and present threat of substantial physical or mental harm to his 1727 or her well-being; or 1728 b. There is substantial likelihood that in the near future 1729 he or she will inflict serious bodily harm on self or others 1730himself or herself or another person, as evidenced by recent 1731 behavior causing, attempting, or threatening such harm; and 1732 (b) All available, less restrictive treatment alternatives 1733 thatwhichwould offer an opportunity for improvement of his or 1734 her condition have been judged to be inappropriate. 1735 (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be 1736 retained by areceivingfacility or involuntarily placed in a 1737 treatment facility upon the recommendation of the administrator 1738 of thereceivingfacility where the patient has been examined 1739 and after adherence to the notice and hearing procedures 1740 provided in s. 394.4599. The recommendation must be supported by 1741 the opinion of a psychiatrist and the second opinion of a 1742 psychiatric nurse,clinicalpsychologist, or another 1743 psychiatrist, both of whom have personally examined the patient 1744 within the preceding 72 hours, that the criteria for involuntary 1745 inpatient placement are met. However, in a county that has a 1746 population of fewer than 50,000, if the administrator certifies 1747 that a psychiatrist, psychiatric nurse, orclinicalpsychologist 1748 is not available to provide the second opinion, the second 1749 opinion may be provided by alicensedphysician who has 1750 postgraduate training and experience in diagnosis and treatment 1751 of mental illnessand nervous disordersor by a psychiatric 1752 nurse. Any second opinion authorized in this subsection may be 1753 conducted through a face-to-face examination, in person or by 1754 electronic means, including telemedicine. Such recommendation 1755 shall be entered on a petition foraninvoluntary inpatient 1756 placement certificate that authorizes thereceivingfacility to 1757 retain the patient pending transfer to a treatment facility or 1758 completion of a hearing. 1759 (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.— 1760 (a) The administrator of the facility shall file a petition 1761 for involuntary inpatient placement in the court in the county 1762 where the patient is located. Upon filing, the clerk of the 1763 court shall provide copies to the department, the patient, the 1764 patient’s guardian or representative, and the state attorney and 1765 public defender of the judicial circuit in which the patient is 1766 located. ANofee may notshallbe charged for the filing of a 1767 petition under this subsection. 1768 (b) A facility filing a petition under this subsection for 1769 involuntary inpatient placement shall send a copy of the 1770 petition to the department and the managing entity in its area. 1771 (4) APPOINTMENT OF COUNSEL.—Within 1 court working day 1772 after the filing of a petition for involuntary inpatient 1773 placement, the court shall appoint the public defender to 1774 represent the person who is the subject of the petition, unless 1775 the person is otherwise represented by counsel. The clerk of the 1776 court shall immediately notify the public defender of such 1777 appointment. Any attorney representing the patient shall have 1778 access to the patient, witnesses, and records relevant to the 1779 presentation of the patient’s case and shall represent the 1780 interests of the patient, regardless of the source of payment to 1781 the attorney. 1782 (5) CONTINUANCE OF HEARING.—The patient is entitled, with 1783 the concurrence of the patient’s counsel, to at least one 1784 continuance of the hearing. The continuance shall befora1785periodofup to 4 weeks. 1786 (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.— 1787 (a)1. The court shall hold the hearing on involuntary 1788 inpatient placement within 5 court working days, unless a 1789 continuance is granted. 1790 2. Except for good cause documented in the court file, the 1791 hearing mustshallbe held in the county or the facility, as 1792 appropriate, where the patient is located, mustand shallbe as 1793 convenient to the patient as ismay beconsistent with orderly 1794 procedure, and shall be conducted in physical settings not 1795 likely to be injurious to the patient’s condition. If the court 1796 finds that the patient’s attendance at the hearing is not 1797 consistent with the best interests of the patient, and the 1798 patient’s counsel does not object, the court may waive the 1799 presence of the patient from all or any portion of the hearing. 1800 The state attorney for the circuit in which the patient is 1801 located shall represent the state, rather than the petitioning 1802 facility administrator, as the real party in interest in the 1803 proceeding. 1804 3.2.The court may appoint a general or special magistrate 1805 to preside at the hearing. One of the two professionals who 1806 executed the petition for involuntary inpatient placement 1807 certificate shall be a witness. The patient and the patient’s 1808 guardian or representative shall be informed by the court of the 1809 right to an independent expert examination. If the patient 1810 cannot afford such an examination, the court shall ensure that 1811 one is provided, as otherwise provided for by lawprovide for1812one. The independent expert’s report isshall beconfidential 1813 and not discoverable, unless the expert is to be called as a 1814 witness for the patient at the hearing. The testimony in the 1815 hearing must be given under oath, and the proceedings must be 1816 recorded. The patient may refuse to testify at the hearing. 1817 (b) If the court concludes that the patient meets the 1818 criteria for involuntary inpatient placement, it mayshallorder 1819 that the patient be transferred to a treatment facility or, if 1820 the patient is at a treatment facility, that the patient be 1821 retained there or be treated at any other appropriatereceiving1822or treatmentfacility, or that the patient receive services from 1823 such areceiving or treatmentfacility or service provider, on 1824 an involuntary basis, for a period of up to 90 days6 months. 1825 However, any order for involuntary mental health services in a 1826 state treatment facility may be for up to 6 months. The order 1827 shall specify the nature and extent of the patient’s mental 1828 illness. The facility shall discharge a patient any time the 1829 patient no longer meets the criteria for involuntary inpatient 1830 placement, unless the patient has transferred to voluntary 1831 status. 1832 (c) If at any time beforeprior tothe conclusion of the 1833 hearing on involuntary inpatient placement it appears to the 1834 court that the person does not meet the criteria for involuntary 1835 inpatient placement under this section, but instead meets the 1836 criteria for involuntary outpatient servicesplacement, the 1837 court may order the person evaluated for involuntary outpatient 1838 servicesplacementpursuant to s. 394.4655. The petition and 1839 hearing procedures set forth in s. 394.4655 shall apply. If the 1840 person instead meets the criteria for involuntary assessment, 1841 protective custody, or involuntary admission pursuant to s. 1842 397.675, then the court may order the person to be admitted for 1843 involuntary assessment for a period of 5 days pursuant to s. 1844 397.6811. Thereafter, all proceedings areshall begoverned by 1845 chapter 397. 1846 (d) At the hearing on involuntary inpatient placement, the 1847 court shall consider testimony and evidence regarding the 1848 patient’s competence to consent to treatment. If the court finds 1849 that the patient is incompetent to consent to treatment, it 1850 shall appoint a guardian advocate as provided in s. 394.4598. 1851 (e) The administrator of the petitioningreceivingfacility 1852 shall provide a copy of the court order and adequate 1853 documentation of a patient’s mental illness to the administrator 1854 of a treatment facility if thewhenever apatient is ordered for 1855 involuntary inpatient placement, whether by civil or criminal 1856 court. The documentation mustshallinclude any advance 1857 directives made by the patient, a psychiatric evaluation of the 1858 patient, and any evaluations of the patient performed by a 1859clinicalpsychologist, a marriage and family therapist, a mental 1860 health counselor, or a clinical social worker. The administrator 1861 of a treatment facility may refuse admission to any patient 1862 directed to its facilities on an involuntary basis, whether by 1863 civil or criminal court order, who is not accompaniedat the1864same timeby adequate orders and documentation. 1865 (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT 1866 PLACEMENT.— 1867 (a) Hearings on petitions for continued involuntary 1868 inpatient placement of an individual placed at any state 1869 treatment facility areshall beadministrative hearings and must 1870shallbe conducted in accordance withthe provisions ofs. 1871 120.57(1), except that any order entered by the administrative 1872 law judge isshall befinal and subject to judicial review in 1873 accordance with s. 120.68. Orders concerning patients committed 1874 after successfully pleading not guilty by reason of insanity are 1875shall begoverned bythe provisions ofs. 916.15. 1876 (b) If the patient continues to meet the criteria for 1877 involuntary inpatient placement and is being treated at a state 1878 treatment facility, the administrator shall, beforeprior tothe 1879 expiration of the periodduring whichthe state treatment 1880 facility is authorized to retain the patient, file a petition 1881 requesting authorization for continued involuntary inpatient 1882 placement. The request mustshallbe accompanied by a statement 1883 from the patient’s physician, psychiatrist, psychiatric nurse, 1884 orclinicalpsychologist justifying the request, a brief 1885 description of the patient’s treatment during the time he or she 1886 was involuntarily placed, and an individualized plan of 1887 continued treatment. Notice of the hearing mustshallbe 1888 provided as providedset forthin s. 394.4599. If a patient’s 1889 attendance at the hearing is voluntarily waived, the 1890 administrative law judge must determine that the waiver is 1891 knowing and voluntary before waiving the presence of the patient 1892 from all or a portion of the hearing. Alternatively, if at the 1893 hearing the administrative law judge finds that attendance at 1894 the hearing is not consistent with the best interests of the 1895 patient, the administrative law judge may waive the presence of 1896 the patient from all or any portion of the hearing, unless the 1897 patient, through counsel, objects to the waiver of presence. The 1898 testimony in the hearing must be under oath, and the proceedings 1899 must be recorded. 1900 (c) Unless the patient is otherwise represented or is 1901 ineligible, he or she shall be represented at the hearing on the 1902 petition for continued involuntary inpatient placement by the 1903 public defender of the circuit in which the facility is located. 1904 (d) If at a hearing it is shown that the patient continues 1905 to meet the criteria for involuntary inpatient placement, the 1906 administrative law judge shall sign the order for continued 1907 involuntary inpatient placement for a period of up to 90 days 1908not to exceed 6 months. However, any order for involuntary 1909 mental health services in a state treatment facility may be for 1910 up to 6 monthsThe same procedure shall be repeated prior to the1911expiration of each additional period the patient is retained. 1912 (e) If continued involuntary inpatient placement is 1913 necessary for a patient admitted while serving a criminal 1914 sentence, but his or herwhosesentence is about to expire, or 1915 for a minorpatientinvoluntarily placed,while a minorbut who 1916 is about to reach the age of 18, the administrator shall 1917 petition the administrative law judge for an order authorizing 1918 continued involuntary inpatient placement. 1919 (f) If the patient has been previously found incompetent to 1920 consent to treatment, the administrative law judge shall 1921 consider testimony and evidence regarding the patient’s 1922 competence. If the administrative law judge finds evidence that 1923 the patient is now competent to consent to treatment, the 1924 administrative law judge may issue a recommended order to the 1925 court that found the patient incompetent to consent to treatment 1926 that the patient’s competence be restored and that any guardian 1927 advocate previously appointed be discharged. 1928 (g) If the patient has been ordered to undergo involuntary 1929 inpatient placement and has previously been found incompetent to 1930 consent to treatment, the court shall consider testimony and 1931 evidence regarding the patient’s incompetence. If the patient’s 1932 competency to consent to treatment is restored, the discharge of 1933 the guardian advocate shall be governed by the provisions of s. 1934 394.4598. 1935 1936 The procedure required in this subsection must be followed 1937 before the expiration of each additional period the patient is 1938 involuntarily receiving services. 1939 (8) RETURN TO FACILITYOF PATIENTS.—If a patient 1940 involuntarily heldWhena patientat atreatmentfacility under 1941 this part leaves the facility without the administrator’s 1942 authorization, the administrator may authorize a search for the 1943 patient and his or herthereturnof the patientto the 1944 facility. The administrator may request the assistance of a law 1945 enforcement agency in this regardthe search for and return of1946the patient. 1947 Section 13. Section 394.46715, Florida Statutes, is amended 1948 to read: 1949 394.46715 Rulemaking authority.—The department may adopt 1950 rules to administer this partDepartment of Children and1951Families shall have rulemaking authority to implement the1952provisions of ss. 394.455, 394.4598, 394.4615, 394.463,1953394.4655, and 394.467 as amended or created by this act. These1954rules shall be for the purpose of protecting the health, safety,1955and well-being of persons examined, treated, or placed under1956this act. 1957 Section 14. Section 394.761, Florida Statutes, is created 1958 to read: 1959 394.761 Revenue maximization.—The agency and the department 1960 shall develop a plan to obtain federal approval for increasing 1961 the availability of federal Medicaid funding for behavioral 1962 health care. Increased funding shall be used to advance the goal 1963 of improved integration of behavioral health and primary care 1964 services through development and effective implementation of 1965 coordinated care as described in s. 394.9082. The agency and the 1966 department shall submit the written plan to the President of the 1967 Senate and the Speaker of the House of Representatives by 1968 November 1, 2016. The plan shall identify the amount of general 1969 revenue funding appropriated for mental health and substance 1970 abuse services which is eligible to be used as state Medicaid 1971 match. The plan must evaluate alternative uses of increased 1972 Medicaid funding, including expansion of Medicaid eligibility 1973 for the severely and persistently mentally ill; increased 1974 reimbursement rates for behavioral health services; adjustments 1975 to the capitation rate for Medicaid enrollees with chronic 1976 mental illness and substance abuse disorders; supplemental 1977 payments to mental health and substance abuse providers through 1978 a designated state health program or other mechanism; and 1979 innovative programs for incentivizing improved outcomes for 1980 behavioral health conditions. The plan must identify the 1981 advantages and disadvantages of each alternative and assess the 1982 potential of each for achieving improved integration of 1983 services. The plan must identify the federal approvals necessary 1984 to implement each alternative and project a timeline for 1985 implementation. 1986 Section 15. Subsection (11) is added to section 394.875, 1987 Florida Statutes, to read: 1988 394.875 Crisis stabilization units, residential treatment 1989 facilities, and residential treatment centers for children and 1990 adolescents; authorized services; license required.— 1991 (11) By January 1, 2017, the department shall modify 1992 licensure rules and procedures to create an option for a single, 1993 consolidated license for a provider who offers multiple types of 1994 mental health and substance abuse services regulated under this 1995 chapter and chapter 397. Providers eligible for a consolidated 1996 license shall operate these services through a single corporate 1997 entity and a unified management structure. Any provider serving 1998 adults and children must meet department standards for separate 1999 facilities and other requirements necessary to ensure children’s 2000 safety and promote therapeutic efficacy. 2001 Section 16. Section 394.9082, Florida Statutes, is amended 2002 to read: 2003 (Substantial rewording of section. See 2004 s. 394.9082, F.S., for present text.) 2005 394.9082 Behavioral health managing entities' purpose; 2006 definitions; duties; contracting; accountability.— 2007 (1) PURPOSE.—The purpose of the behavioral health managing 2008 entities is to plan for and coordinate the delivery of community 2009 mental health and substance abuse services, to improve access to 2010 care, to promote service continuity, and to support efficient 2011 and effective delivery of services. 2012 (2) DEFINITIONS.—As used in this section, the term: 2013 (a) “Behavioral health services” means mental health 2014 services and substance abuse prevention and treatment services 2015 as described in this chapter and chapter 397. 2016 (b) “Case management” means those direct services provided 2017 to a client in order to assess needs, plan or arrange services, 2018 coordinate service providers, monitor service delivery, and 2019 evaluate outcomes. 2020 (c) “Coordinated system of care” means the full array of 2021 behavioral health and related services in a region or a 2022 community offered by all service providers, whether 2023 participating under contract with the managing entity or through 2024 another method of community partnership or mutual agreement. 2025 (d) “Geographic area” means one or more contiguous 2026 counties, circuits, or regions as described in s. 409.966 or s. 2027 381.0406. 2028 (e) “High-need or high-utilization individual” means a 2029 recipient who meets one or more of the following criteria and 2030 may be eligible for intensive case management services: 2031 1. Has resided in a state mental health facility for at 2032 least 6 months in the last 36 months; 2033 2. Has had two or more admissions to a state mental health 2034 facility in the last 36 months; or 2035 3. Has had three or more admissions to a crisis 2036 stabilization unit, an addictions receiving facility, a short 2037 term residential facility, or an inpatient psychiatric unit 2038 within the last 12 months. 2039 (f) “Managing entity” means a corporation designated or 2040 filed as a nonprofit organization under s. 501(c)(3) of the 2041 Internal Revenue Code which is selected by, and is under 2042 contract with, the department to manage the daily operational 2043 delivery of behavioral health services through a coordinated 2044 system of care. 2045 (g) “Provider network” means the group of direct service 2046 providers, facilities, and organizations under contract with a 2047 managing entity to provide a comprehensive array of emergency, 2048 acute care, residential, outpatient, recovery support, and 2049 consumer support services. 2050 (h) “Receiving facility” means any public or private 2051 facility designated by the department to receive and hold or to 2052 refer, as appropriate, involuntary patients under emergency 2053 conditions for mental health or substance abuse evaluation and 2054 to provide treatment or transportation to the appropriate 2055 service provider. County jails may not be used or designated as 2056 a receiving facility, a triage center, or an access center. 2057 (3) DEPARTMENT DUTIES.—The department shall: 2058 (a) Designate, with input from the managing entity, 2059 facilities that meet the definitions in s. 394.455(1), (2), 2060 (12), and (41) and the receiving system developed by one or more 2061 counties pursuant to s. 394.4573(2)(b). 2062 (b) Contract with organizations to serve as the managing 2063 entity in accordance with the requirements of this section. 2064 (c) Specify the geographic area served. 2065 (d) Specify data reporting and use of shared data systems. 2066 (e) Develop strategies to divert persons with mental 2067 illness or substance abuse disorders from the criminal and 2068 juvenile justice systems. 2069 (f) Support the development and implementation of a 2070 coordinated system of care by requiring each provider that 2071 receives state funds for behavioral health services through a 2072 direct contract with the department to work with the managing 2073 entity in the provider’s service area to coordinate the 2074 provision of behavioral health services, as part of the contract 2075 with the department. 2076 (g) Set performance measures and performance standards for 2077 managing entities based on nationally recognized standards, such 2078 as those developed by the National Quality Forum, the National 2079 Committee for Quality Assurance, or similar credible sources. 2080 Performance standards must include all of the following: 2081 1. Annual improvement in the extent to which the need for 2082 behavioral health services is met by the coordinated system of 2083 care in the geographic area served. 2084 2. Annual improvement in the percentage of patients who 2085 receive services through the coordinated system of care and who 2086 achieve improved functional status as indicated by health 2087 condition, employment status, and housing stability. 2088 3. Annual reduction in the rates of readmissions to acute 2089 care facilities, jails, prisons, and forensic facilities. 2090 4. Annual improvement in consumer and family satisfaction. 2091 (h) Provide technical assistance to the managing entities. 2092 (i) Promote the integration of behavioral health care and 2093 primary care. 2094 (j) Facilitate the coordination between the managing entity 2095 and other payors of behavioral health care. 2096 (k) Develop and provide a unique identifier for clients 2097 receiving services under the managing entity to coordinate care. 2098 (l) Coordinate procedures for the referral and admission of 2099 patients to, and the discharge of patients from, state treatment 2100 facilities and their return to the community. 2101 (m) Ensure that managing entities comply with state and 2102 federal laws, rules, and regulations. 2103 (n) Develop rules for the operations of, and the 2104 requirements that must be met by, the managing entity, if 2105 necessary. 2106 (4) CONTRACT WITH MANAGING ENTITIES.— 2107 (a) The department’s contracts with managing entities must 2108 support efficient and effective administration of the behavioral 2109 health system and ensure accountability for performance. 2110 (b) Beginning July 1, 2018, managing entities under 2111 contract with the department are subject to a contract 2112 performance review. The review must include: 2113 1. Analysis of the duties and performance measures 2114 described in this section; 2115 2. The results of contract monitoring compiled during the 2116 term of the contract; and 2117 3. Related compliance and performance issues. 2118 (c) For the managing entities whose performance is 2119 determined satisfactory after completion of the review pursuant 2120 to paragraph (b), and before the end of the term of the 2121 contract, the department may negotiate and enter into a contract 2122 with the managing entity for a period of 4 years pursuant to s. 2123 287.057(3)(e). 2124 (d) The performance review must be completed by the 2125 beginning of the third year of the 4-year contract. In the event 2126 the managing entity does not meet the requirements of the 2127 performance review, a corrective action plan must be created by 2128 the department. The managing entity must complete the corrective 2129 action plan before the beginning of the fourth year of the 2130 contract. If the corrective action plan is not satisfactorily 2131 completed, the department shall provide notice to the managing 2132 entity that the contract will be terminated at the end of the 2133 contract term and the department shall initiate a competitive 2134 procurement process to select a new managing entity pursuant to 2135 s. 287.057. 2136 (5) MANAGING ENTITIES DUTIES.—A managing entity shall: 2137 (a) Maintain a board of directors that is representative of 2138 the community and that, at a minimum, includes consumers and 2139 family members, community stakeholders and organizations, and 2140 providers of mental health and substance abuse services, 2141 including public and private receiving facilities. 2142 (b) Conduct a community behavioral health care needs 2143 assessment in the geographic area served by the managing entity. 2144 The needs assessment must be updated annually and provided to 2145 the department. The assessment must include, at a minimum, the 2146 information the department needs for its annual report to the 2147 Governor and Legislature pursuant to s. 394.4573. 2148 (c) Develop local resources by pursuing third-party 2149 payments for services, applying for grants, securing local 2150 matching funds and in-kind services, and any other methods 2151 needed to ensure services are available and accessible. 2152 (d) Provide assistance to counties to develop a designated 2153 receiving system pursuant to s. 394.4573(2)(b) and a 2154 transportation plan pursuant to s. 394.462. 2155 (e) Promote the development and effective implementation of 2156 a coordinated system of care pursuant to s. 394.4573. 2157 (f) Develop a comprehensive network of qualified providers 2158 to deliver behavioral health services. The managing entity is 2159 not required to competitively procure network providers, but 2160 must have a process in place to publicize opportunities to join 2161 the network and to evaluate providers in the network to 2162 determine if they can remain in the network. These processes 2163 must be published on the website of the managing entity. The 2164 managing entity must ensure continuity of care for clients if a 2165 provider ceases to provide a service or leaves the network. 2166 (g) Enter into cooperative agreements with local homeless 2167 councils and organizations to allow the sharing of available 2168 resource information, shared client information, client referral 2169 services, and any other data or information that may be useful 2170 in addressing the homelessness of persons suffering from a 2171 behavioral health crisis. 2172 (h) Monitor network providers’ performance and their 2173 compliance with contract requirements and federal and state 2174 laws, rules, and regulations. 2175 (i) Provide or contract for case management services. 2176 (j) Manage and allocate funds for services to meet the 2177 requirements of law or rule. 2178 (k) Promote integration of behavioral health with primary 2179 care. 2180 (l) Implement shared data systems necessary for the 2181 delivery of coordinated care and integrated services, the 2182 assessment of managing entity performance and provider 2183 performance, and the reporting of outcomes and costs of 2184 services. 2185 (m) Operate in a transparent manner, providing public 2186 access to information, notice of meetings, and opportunities for 2187 public participation in managing entity decisionmaking. 2188 (n) Establish and maintain effective relationships with 2189 community stakeholders, including local governments and other 2190 organizations that serve individuals with behavioral health 2191 needs. 2192 (o) Collaborate with local criminal and juvenile justice 2193 systems to divert persons with mental illness or substance abuse 2194 disorders, or both, from the criminal and juvenile justice 2195 systems. 2196 (p) Collaborate with the local court system to develop 2197 procedures to maximize the use of involuntary outpatient 2198 services; reduce involuntary inpatient treatment; and increase 2199 diversion from the criminal and juvenile justice systems. 2200 (6) FUNDING FOR MANAGING ENTITIES.— 2201 (a) A contract established between the department and a 2202 managing entity under this section must be funded by general 2203 revenue, other applicable state funds, or applicable federal 2204 funding sources. A managing entity may carry forward documented 2205 unexpended state funds from one fiscal year to the next, but the 2206 cumulative amount carried forward may not exceed 8 percent of 2207 the total value of the contract. Any unexpended state funds in 2208 excess of that percentage must be returned to the department. 2209 The funds carried forward may not be used in a way that would 2210 increase future recurring obligations or for any program or 2211 service that was not authorized as of July 1, 2016, under the 2212 existing contract with the department. Expenditures of funds 2213 carried forward must be separately reported to the department. 2214 Any unexpended funds that remain at the end of the contract 2215 period must be returned to the department. Funds carried forward 2216 may be retained through contract renewals and new contract 2217 procurements as long as the same managing entity is retained by 2218 the department. 2219 (b) The method of payment for a fixed-price contract with a 2220 managing entity must provide for a 2-month advance payment at 2221 the beginning of each fiscal year and equal monthly payments 2222 thereafter. 2223 (7) CRISIS STABILIZATION SERVICES UTILIZATION DATABASE.—The 2224 department shall develop, implement, and maintain standards 2225 under which a managing entity shall collect utilization data 2226 from all public receiving facilities situated within its 2227 geographic service area. As used in this subsection, the term 2228 “public receiving facility” means an entity that meets the 2229 licensure requirements of, and is designated by, the department 2230 to operate as a public receiving facility under s. 394.875 and 2231 that is operating as a licensed crisis stabilization unit. 2232 (a) The department shall develop standards and protocols 2233 for managing entities and public receiving facilities to be used 2234 for data collection, storage, transmittal, and analysis. The 2235 standards and protocols must allow for compatibility of data and 2236 data transmittal between public receiving facilities, managing 2237 entities, and the department for the implementation and 2238 requirements of this subsection. 2239 (b) A managing entity shall require a public receiving 2240 facility within its provider network to submit data, in real 2241 time or at least daily, to the managing entity for: 2242 1. All admissions and discharges of clients receiving 2243 public receiving facility services who qualify as indigent, as 2244 defined in s. 394.4787; and 2245 2. The current active census of total licensed beds, the 2246 number of beds purchased by the department, the number of 2247 clients qualifying as indigent who occupy those beds, and the 2248 total number of unoccupied licensed beds regardless of funding. 2249 (c) A managing entity shall require a public receiving 2250 facility within its provider network to submit data, on a 2251 monthly basis, to the managing entity which aggregates the daily 2252 data submitted under paragraph (b). The managing entity shall 2253 reconcile the data in the monthly submission to the data 2254 received by the managing entity under paragraph (b) to check for 2255 consistency. If the monthly aggregate data submitted by a public 2256 receiving facility under this paragraph are inconsistent with 2257 the daily data submitted under paragraph (b), the managing 2258 entity shall consult with the public receiving facility to make 2259 corrections necessary to ensure accurate data. 2260 (d) A managing entity shall require a public receiving 2261 facility within its provider network to submit data, on an 2262 annual basis, to the managing entity which aggregates the data 2263 submitted and reconciled under paragraph (c). The managing 2264 entity shall reconcile the data in the annual submission to the 2265 data received and reconciled by the managing entity under 2266 paragraph (c) to check for consistency. If the annual aggregate 2267 data submitted by a public receiving facility under this 2268 paragraph are inconsistent with the data received and reconciled 2269 under paragraph (c), the managing entity shall consult with the 2270 public receiving facility to make corrections necessary to 2271 ensure accurate data. 2272 (e) After ensuring the accuracy of data pursuant to 2273 paragraphs (c) and (d), the managing entity shall submit the 2274 data to the department on a monthly and an annual basis. The 2275 department shall create a statewide database for the data 2276 described under paragraph (b) and submitted under this paragraph 2277 for the purpose of analyzing the payments for and the use of 2278 crisis stabilization services funded by the Baker Act on a 2279 statewide basis and on an individual public receiving facility 2280 basis. 2281 Section 17. Present subsections (20) through (45) of 2282 section 397.311, Florida Statutes, are redesignated as 2283 subsections (21) through (46), respectively, a new subsection 2284 (20) is added to that section, and present subsections (30) and 2285 (38) of that section are amended, to read: 2286 397.311 Definitions.—As used in this chapter, except part 2287 VIII, the term: 2288 (20) “Involuntary services” means court-ordered outpatient 2289 services or treatment for substance abuse disorders or services 2290 provided in an inpatient placement in a receiving facility or 2291 treatment facility. 2292 (31)(30)“Qualified professional” means a physician or a 2293 physician assistant licensed under chapter 458 or chapter 459; a 2294 professional licensed under chapter 490 or chapter 491; an 2295 advanced registered nurse practitionerhaving a specialty in2296psychiatrylicensed under part I of chapter 464; or a person who 2297 is certified through a department-recognized certification 2298 process for substance abuse treatment services and who holds, at 2299 a minimum, a bachelor’s degree. A person who is certified in 2300 substance abuse treatment services by a state-recognized 2301 certification process in another state at the time of employment 2302 with a licensed substance abuse provider in this state may 2303 perform the functions of a qualified professional as defined in 2304 this chapter but must meet certification requirements contained 2305 in this subsection no later than 1 year after his or her date of 2306 employment. 2307 (39)(38)“Service component” or “component” means a 2308 discrete operational entity within a service provider which is 2309 subject to licensing as defined by rule. Service components 2310 include prevention, intervention, and clinical treatment 2311 described in subsection (23)(22). 2312 Section 18. Section 397.675, Florida Statutes, is amended 2313 to read: 2314 397.675 Criteria for involuntary admissions, including 2315 protective custody, emergency admission, and other involuntary 2316 assessment, involuntary treatment, and alternative involuntary 2317 assessment for minors, for purposes of assessment and 2318 stabilization, and for involuntary treatment.—A person meets the 2319 criteria for involuntary admission if there is good faith reason 2320 to believe that the person has a substance abuse or co-occurring 2321 mental health disorderis substance abuse impairedand, because 2322 of such disorderimpairment: 2323 (1) Has lost the power of self-control with respect to 2324 substance abuseuse; andeither2325 (2)(a) Without care or treatment, is likely to suffer from 2326 neglect or to refuse to care for himself or herself, that such 2327 neglect or refusal poses a real and present threat of 2328 substantial harm to his or her well-being and that it is not 2329 apparent that such harm may be avoided through the help of 2330 willing family members or friends or the provision of other 2331 services, or there is substantial likelihood that the person has 2332 inflicted, or threatened to or attempted to inflict, or, unless 2333 admitted, is likely to inflict, physical harm on himself,or2334 herself, or another; or 2335 (b) Is in need of substance abuse services and, by reason 2336 of substance abuse impairment, his or her judgment has been so 2337 impaired that he or shethe personis incapable of appreciating 2338 his or her need for such services and of making a rational 2339 decision in that regard, althoughthereto; however,mere refusal 2340 to receive such services does not constitute evidence of lack of 2341 judgment with respect to his or her need for such services. 2342 Section 19. Section 397.679, Florida Statutes, is amended 2343 to read: 2344 397.679 Emergency admission; circumstances justifying.—A 2345 person who meets the criteria for involuntary admission in s. 2346 397.675 may be admitted to a hospital or to a licensed 2347 detoxification facility or addictions receiving facility for 2348 emergency assessment and stabilization, or to a less intensive 2349 component of a licensed service provider for assessment only, 2350 upon receipt by the facility of athephysician’scertificate by 2351 a physician, an advanced registered nurse practitioner, a 2352 clinical psychologist, a licensed clinical social worker, a 2353 licensed marriage and family therapist, a licensed mental health 2354 counselor, a physician assistant working under the scope of 2355 practice of the supervising physician, or a master’s-level 2356 certified addictions professional, if the certificate is 2357 specific to substance abuse disorders, and the completion of an 2358 application for emergency admission. 2359 Section 20. Section 397.6791, Florida Statutes, is amended 2360 to read: 2361 397.6791 Emergency admission; persons who may initiate.—The 2362 following professionalspersonsmay request a certificate foran2363 emergency assessment or admission: 2364 (1) In the case of an adult, physicians, advanced 2365 registered nurse practitioners, clinical psychologists, licensed 2366 clinical social workers, licensed marriage and family 2367 therapists, licensed mental health counselors, physician 2368 assistants working under the scope of practice of the 2369 supervising physician, and a master’s-level-certified addictions 2370 professional, if the certificate is specific to substance abuse 2371 disordersthe certifying physician, the person’s spouse or legal 2372 guardian, any relative of the person, or any other responsible 2373 adult who has personal knowledge of the person’s substance abuse 2374 impairment. 2375 (2) In the case of a minor, the minor’s parent, legal 2376 guardian, or legal custodian. 2377 Section 21. Section 397.6793, Florida Statutes, is amended 2378 to read: 2379 397.6793 Professional’sPhysician’scertificate for 2380 emergency admission.— 2381 (1) The professional’sphysician’scertificate must include 2382 the name of the person to be admitted, the relationship between 2383 the person and the professional executing the certificate 2384physician, the relationship between the applicant and the 2385 professionalphysician, any relationship between the 2386 professionalphysicianand the licensed service provider,anda 2387 statement that the person has been examined and assessed within 2388 the preceding 5 days of the application date, andmust include2389 factual allegations with respect to the need for emergency 2390 admission, including: 2391 (a) The reason for thephysician’sbelief that the person 2392 is substance abuse impaired; and 2393 (b) The reason for thephysician’sbelief that because of 2394 such impairment the person has lost the power of self-control 2395 with respect to substance abuse; andeither2396 (c)1. The reason for the beliefphysicianbelievesthat, 2397 without care or treatment, the person is likely to suffer from 2398 neglect or refuse to care for himself or herself; that such 2399 neglect or refusal poses a real and present threat of 2400 substantial harm to his or her well-being; and that it is not 2401 apparent that such harm may be avoided through the help of 2402 willing family members or friends or the provision of other 2403 services or there is substantial likelihood that the person has 2404 inflicted or is likely to inflict physical harm on himself or 2405 herself or others unless admitted; or 2406 2. The reason for the beliefphysician believesthat the 2407 person’s refusal to voluntarily receive care is based on 2408 judgment so impaired by reason of substance abuse that the 2409 person is incapable of appreciating his or her need for care and 2410 of making a rational decision regarding his or her need for 2411 care. 2412 (2) The professional’sphysician’scertificate must 2413 recommend the least restrictive type of service that is 2414 appropriate for the person. The certificate must be signed by 2415 the professionalphysician. If other less restrictive means are 2416 not available, such as voluntary appearance for outpatient 2417 evaluation, a law enforcement officer shall take the person 2418 named in the certificate into custody and deliver him or her to 2419 the appropriate facility for involuntary examination. 2420 (3) A signed copy of the professional’sphysician’s2421 certificate shall accompany the person,and shall be made a part 2422 of the person’s clinical record, together with a signed copy of 2423 the application. The application and the professional’s 2424physician’scertificate authorize the involuntary admission of 2425 the person pursuant to, and subject to the provisions of, ss. 2426 397.679-397.6797. 2427 (4) The professional’s certificate is valid for 7 days 2428 after issuance. 2429 (5) The professional’sphysician’scertificate must 2430 indicate whether the person requires transportation assistance 2431 for delivery for emergency admission and specify, pursuant to s. 2432 397.6795, the type of transportation assistance necessary. 2433 Section 22. Section 397.6795, Florida Statutes, is amended 2434 to read: 2435 397.6795 Transportation-assisted delivery of persons for 2436 emergency assessment.—An applicant for a person’s emergency 2437 admission,orthe person’s spouse or guardian, or a law 2438 enforcement officer,or a health officermay deliver a person 2439 named in the professional’sphysician’scertificate for 2440 emergency admission to a hospital or a licensed detoxification 2441 facility or addictions receiving facility for emergency 2442 assessment and stabilization. 2443 Section 23. Subsection (1) of section 397.681, Florida 2444 Statutes, is amended to read: 2445 397.681 Involuntary petitions; general provisions; court 2446 jurisdiction and right to counsel.— 2447 (1) JURISDICTION.—The courts have jurisdiction of 2448 involuntary assessment and stabilization petitions and 2449 involuntary treatment petitions for substance abuse impaired 2450 persons, and such petitions must be filed with the clerk of the 2451 court in the county where the person is located. The court may 2452 not charge a fee for the filing of a petition under this 2453 section. The chief judge may appoint a general or special 2454 magistrate to preside over all or part of the proceedings. The 2455 alleged impaired person is named as the respondent. 2456 Section 24. Subsection (1) of section 397.6811, Florida 2457 Statutes, is amended to read: 2458 397.6811 Involuntary assessment and stabilization.—A person 2459 determined by the court to appear to meet the criteria for 2460 involuntary admission under s. 397.675 may be admitted for a 2461 period of 5 days to a hospital or to a licensed detoxification 2462 facility or addictions receiving facility, for involuntary 2463 assessment and stabilization or to a less restrictive component 2464 of a licensed service provider for assessment only upon entry of 2465 a court order or upon receipt by the licensed service provider 2466 of a petition. Involuntary assessment and stabilization may be 2467 initiated by the submission of a petition to the court. 2468 (1) If the person upon whose behalf the petition is being 2469 filed is an adult, a petition for involuntary assessment and 2470 stabilization may be filed by the respondent’s spouseor, legal 2471 guardian, any relative, a private practitioner, the director of 2472 a licensed service provider or the director’s designee, or any 2473 individualthree adultswho has directhavepersonal knowledge 2474 of the respondent’s substance abuse impairment. 2475 Section 25. Section 397.6814, Florida Statutes, is amended 2476 to read: 2477 397.6814 Involuntary assessment and stabilization; contents 2478 of petition.—A petition for involuntary assessment and 2479 stabilization must contain the name of the respondent,;the name 2480 of the applicant or applicants,;the relationship between the 2481 respondent and the applicant, and;the name of the respondent’s 2482 attorney, if known,and a statement of the respondent’s ability2483to afford an attorney;and must state facts to support the need 2484 for involuntary assessment and stabilization, including: 2485 (1) The reason for the petitioner’s belief that the 2486 respondent is substance abuse impaired;and2487 (2) The reason for the petitioner’s belief that because of 2488 such impairment the respondent has lost the power of self 2489 control with respect to substance abuse; andeither2490 (3)(a) The reason the petitioner believes that the 2491 respondent has inflicted or is likely to inflict physical harm 2492 on himself or herself or others unless admitted; or 2493 (b) The reason the petitioner believes that the 2494 respondent’s refusal to voluntarily receive care is based on 2495 judgment so impaired by reason of substance abuse that the 2496 respondent is incapable of appreciating his or her need for care 2497 and of making a rational decision regarding that need for care. 2498 If the respondent has refused to submit to an assessment, such 2499 refusal must be alleged in the petition. 2500 2501 A fee may not be charged for the filing of a petition pursuant 2502 to this section. 2503 Section 26. Section 397.6819, Florida Statutes, is amended 2504 to read: 2505 397.6819 Involuntary assessment and stabilization; 2506 responsibility of licensed service provider.—A licensed service 2507 provider may admit an individual for involuntary assessment and 2508 stabilization for a period not to exceed 5 days unless a 2509 petition for involuntary outpatient services has been initiated 2510 which authorizes the licensed service provider to retain 2511 physical custody of the person pending further order of the 2512 court pursuant to s. 397.6822. The individual must be assessed 2513 within 24 hourswithout unnecessary delayby a qualified 2514 professional. The person may not be held pursuant to this 2515 section beyond the 24-hour assessment period unless the 2516 assessment has been reviewed and authorized by a licensed 2517 physician as necessary for continued stabilization. If an 2518 assessment is performed by a qualified professional who is not a 2519 physician, the assessment must be reviewed by a physician before 2520 the end of the assessment period. 2521 Section 27. Section 397.695, Florida Statutes, is amended 2522 to read: 2523 397.695 Involuntary outpatient servicestreatment; persons 2524 who may petition.— 2525 (1)(a) If the respondent is an adult, a petition for 2526 involuntary outpatient servicestreatmentmay be filed by the 2527 respondent’s spouse or legal guardian, any relative, a service 2528 provider, or any individualthree adultswho has directhave2529 personal knowledge of the respondent’s substance abuse 2530 impairment and his or her prior course of assessment and 2531 treatment. 2532 (b) The administrator of a receiving facility, a crisis 2533 stabilization unit, or an addictions receiving facility where 2534 the patient has been examined may retain the patient at the 2535 facility after adherence to the notice procedures provided in s. 2536 397.6955. The recommendation for involuntary outpatient services 2537 must be supported by the opinion of a qualified professional as 2538 defined in s. 397.311(31) or a master’s-level-certified 2539 addictions professional and by the second opinion of a 2540 psychologist, a physician, or an advanced registered nurse 2541 practitioner licensed under chapter 464, both of whom have 2542 personally examined the patient within the preceding 72 hours, 2543 that the criteria for involuntary outpatient services are met. 2544 However, in a county having a population of fewer than 50,000, 2545 if the administrator of the facility certifies that a qualified 2546 professional is not available to provide the second opinion, the 2547 second opinion may be provided by a physician who has 2548 postgraduate training and experience in the diagnosis and 2549 treatment of substance abuse disorders. Any second opinion 2550 authorized in this section may be conducted through face-to-face 2551 examination, in person, or by electronic means, including 2552 telemedicine. Such recommendation must be entered on an 2553 involuntary outpatient certificate that authorizes the facility 2554 to retain the patient pending completion of a hearing. The 2555 certificate must be made a part of the patient’s clinical 2556 record. 2557 (c) If the patient has been stabilized and no longer meets 2558 the criteria for involuntary assessment and stabilization 2559 pursuant to s. 397.6811, the patient must be released from the 2560 facility while awaiting the hearing for involuntary outpatient 2561 services. Before filing a petition for involuntary outpatient 2562 services, the administrator of the facility must identify the 2563 service provider that will have responsibility for service 2564 provision under the order for involuntary outpatient services, 2565 unless the person is otherwise participating in outpatient 2566 substance abuse disorder services and is not in need of public 2567 financing of the services, in which case the person, if 2568 eligible, may be ordered to involuntary outpatient services 2569 pursuant to the existing provision-of-services relationship he 2570 or she has for substance abuse disorder services. 2571 (d) The service provider shall prepare a written proposed 2572 treatment plan in consultation with the patient or the patient’s 2573 guardian advocate, if applicable, for the order for outpatient 2574 services and provide a copy of the proposed treatment plan to 2575 the patient and the administrator of the facility. The treatment 2576 plan must specify the nature and extent of the patient’s 2577 substance abuse disorder, address the reduction of symptoms that 2578 necessitate involuntary outpatient services, and include 2579 measurable goals and objectives for the services and treatment 2580 that are provided to treat the person’s substance abuse disorder 2581 and to assist the person in living and functioning in the 2582 community or prevent relapse or further deterioration. Service 2583 providers may coordinate, select, and supervise other 2584 individuals to implement specific aspects of the treatment plan. 2585 The services in the treatment plan must be deemed clinically 2586 appropriate by a qualified professional who consults with, or is 2587 employed by, the service provider. The service provider must 2588 certify that the recommended services in the treatment plan are 2589 available for the stabilization and improvement of the patient. 2590 If the service provider certifies that the recommended services 2591 in the proposed treatment plan are not available, the petition 2592 may not be filed. The service provider must document its inquiry 2593 with the department and the managing entity as to the 2594 availability of the requested services. The managing entity must 2595 document such efforts to obtain the requested services. 2596 (e) If a patient in involuntary inpatient placement meets 2597 the criteria for involuntary outpatient services, the 2598 administrator of the treatment facility may, before the 2599 expiration of the period during which the treatment facility is 2600 authorized to retain the patient, recommend involuntary 2601 outpatient services. The recommendation must be supported by the 2602 opinion of a qualified professional as defined in s. 397.311(31) 2603 or a master’s-level-certified addictions professional and by the 2604 second opinion of a psychologist, a physician, an advanced 2605 registered nurse practitioner licensed under chapter 464, or a 2606 mental health professional licensed under chapter 491, both of 2607 whom have personally examined the patient within the preceding 2608 72 hours, that the criteria for involuntary outpatient services 2609 are met. However, in a county having a population of fewer than 2610 50,000, if the administrator of the facility certifies that a 2611 qualified professional is not available to provide the second 2612 opinion, the second opinion may be provided by a physician who 2613 has postgraduate training and experience in the diagnosis and 2614 treatment of substance abuse disorders. Any second opinion 2615 authorized in this section may be conducted through face-to-face 2616 examination, in person, or by electronic means, including 2617 telemedicine. Such recommendation must be entered on an 2618 involuntary outpatient certificate that authorizes the facility 2619 to retain the patient pending completion of a hearing. The 2620 certificate must be made a part of the patient’s clinical 2621 record. 2622 (f) The service provider who is responsible for providing 2623 services under the order for involuntary outpatient services 2624 must be identified before the entry of the order for outpatient 2625 services. The service provider shall certify to the court that 2626 the recommended services in the treatment plan are available for 2627 the stabilization and improvement of the patient. If the service 2628 provider certifies that the recommended services in the proposed 2629 treatment plan are not available, the petition may not be filed. 2630 The service provider must document its inquiry with the 2631 department and the managing entity as to the availability of the 2632 requested services. The managing entity must document such 2633 efforts to obtain the requested services. 2634 (2) If the respondent is a minor, a petition for 2635 involuntary treatment may be filed by a parent, legal guardian, 2636 or service provider. 2637 Section 28. Section 397.6951, Florida Statutes, is amended 2638 to read: 2639 397.6951 Contents of petition for involuntary outpatient 2640 servicestreatment.—A petition for involuntary outpatient 2641 servicestreatmentmust contain the name of the respondentto be2642admitted; the name of the petitioner or petitioners; the 2643 relationship between the respondent and the petitioner; the name 2644 of the respondent’s attorney, if known, and a statement of the2645petitioner’s knowledge of the respondent’s ability to afford an2646attorney; the findings and recommendations of the assessment 2647 performed by the qualified professional; and the factual 2648 allegations presented by the petitioner establishing the need 2649 for involuntary outpatient services. The factual allegations 2650 must demonstratetreatment, including: 2651 (1) The reason for the petitioner’s belief that the 2652 respondent is substance abuse impaired;and2653 (2) The respondent’s history of failure to comply with 2654 requirements for treatment for substance abuse and that the 2655 respondent has been involuntarily admitted to a receiving or 2656 treatment facility at least twice within the immediately 2657 preceding 36 months;The reason for the petitioner’s belief that2658because of such impairment the respondent has lost the power of2659self-control with respect to substance abuse; and either2660 (3) That the respondent is, as a result of his or her 2661 substance abuse disorder, unlikely to voluntarily participate in 2662 the recommended services after sufficient and conscientious 2663 explanation and disclosure of the purpose of the services or he 2664 or she is unable to determine for himself or herself whether 2665 outpatient services are necessary; 2666 (4) That, in view of the person’s treatment history and 2667 current behavior, the person is in need of involuntary 2668 outpatient services; that without services, the person is likely 2669 to suffer from neglect or to refuse to care for himself or 2670 herself; that such neglect or refusal poses a real and present 2671 threat of substantial harm to his or her well-being; and that 2672 there is a substantial likelihood that without services the 2673 person will cause serious bodily harm to himself, herself, or 2674 others in the near future, as evidenced by recent behavior; and 2675 (5) That it is likely that the person will benefit from 2676 involuntary outpatient services. 2677(3)(a) The reason the petitioner believes that the2678respondent has inflicted or is likely to inflict physical harm2679on himself or herself or others unless admitted; or2680(b) The reason the petitioner believes that the2681respondent’s refusal to voluntarily receive care is based on2682judgment so impaired by reason of substance abuse that the2683respondent is incapable of appreciating his or her need for care2684and of making a rational decision regarding that need for care.2685 Section 29. Section 397.6955, Florida Statutes, is amended 2686 to read: 2687 397.6955 Duties of court upon filing of petition for 2688 involuntary outpatient servicestreatment.— 2689 (1) Upon the filing of a petition fortheinvoluntary 2690 outpatient services fortreatmentofa substance abuse impaired 2691 person with the clerk of the court, the court shall immediately 2692 determine whether the respondent is represented by an attorney 2693 or whether the appointment of counsel for the respondent is 2694 appropriate. If the court appoints counsel for the person, the 2695 clerk of the court shall immediately notify the regional 2696 conflict counsel, created pursuant to s. 27.511, of the 2697 appointment. The regional conflict counsel shall represent the 2698 person until the petition is dismissed, the court order expires, 2699 or the person is discharged from involuntary outpatient 2700 services. An attorney that represents the person named in the 2701 petition shall have access to the person, witnesses, and records 2702 relevant to the presentation of the person’s case and shall 2703 represent the interests of the person, regardless of the source 2704 of payment to the attorney. 2705 (2) The court shall schedule a hearing to be held on the 2706 petition within 510days unless a continuance is granted. The 2707 court may appoint a general or special master to preside at the 2708 hearing. 2709 (3) A copy of the petition and notice of the hearing must 2710 be provided to the respondent; the respondent’s parent, 2711 guardian, or legal custodian, in the case of a minor; the 2712 respondent’s attorney, if known; the petitioner; the 2713 respondent’s spouse or guardian, if applicable; and such other 2714 persons as the court may direct. If the respondent is a minor, a 2715 copy of the petition and notice of the hearing must beand have2716such petition and orderpersonally delivered to the respondent 2717if he or she is a minor. The court shall also issue a summons to 2718 the person whose admission is sought. 2719 Section 30. Section 397.6957, Florida Statutes, is amended 2720 to read: 2721 397.6957 Hearing on petition for involuntary outpatient 2722 servicestreatment.— 2723 (1) At a hearing on a petition for involuntary outpatient 2724 servicestreatment, the court shall hear and review all relevant 2725 evidence, including the review of results of the assessment 2726 completed by the qualified professional in connection with the 2727 respondent’s protective custody, emergency admission, 2728 involuntary assessment, or alternative involuntary admission. 2729 The respondent must be present unless the court finds that his 2730 or her presence is likely to be injurious to himself or herself 2731 or others, in which event the court must appoint a guardian 2732 advocate to act in behalf of the respondent throughout the 2733 proceedings. 2734 (2) The petitioner has the burden of proving by clear and 2735 convincing evidence that: 2736 (a) The respondent is substance abuse impaired and has a 2737 history of lack of compliance with treatment for substance 2738 abuse;, and2739 (b) Because of such impairment the respondent is unlikely 2740 to voluntarily participate in the recommended treatment or is 2741 unable to determine for himself or herself whether outpatient 2742 services are necessarythe respondent has lost the power of2743self-control with respect to substance abuse; andeither2744 1. Without services, the respondent is likely to suffer 2745 from neglect or to refuse to care for himself or herself; that 2746 such neglect or refusal poses a real and present threat of 2747 substantial harm to his or her well-being; and that there is a 2748 substantial likelihood that without services the respondent will 2749 cause serious bodily harm to himself or herself or others in the 2750 near future, as evidenced by recent behaviorThe respondent has2751inflicted or is likely to inflict physical harm on himself or2752herself or others unless admitted; or 2753 2. The respondent’s refusal to voluntarily receive care is 2754 based on judgment so impaired by reason of substance abuse that 2755 the respondent is incapable of appreciating his or her need for 2756 care and of making a rational decision regarding that need for 2757 care. 2758 (3) One of the qualified professionals who executed the 2759 involuntary outpatient services certificate must be a witness. 2760 The court shall allow testimony from individuals, including 2761 family members, deemed by the court to be relevant under state 2762 law, regarding the respondent’s prior history and how that prior 2763 history relates to the person’s current condition. The testimony 2764 in the hearing must be under oath, and the proceedings must be 2765 recorded. The patient may refuse to testify at the hearing. 2766 (4)(3)At the conclusion of the hearing the court shall 2767eitherdismiss the petition or order the respondent to receive 2768undergoinvoluntary outpatient services from his or her 2769substance abuse treatment, with the respondent’schosen licensed 2770 service provider ifto deliver the involuntarysubstance abuse2771treatmentwherepossible and appropriate. 2772 Section 31. Section 397.697, Florida Statutes, is amended 2773 to read: 2774 397.697 Court determination; effect of court order for 2775 involuntary outpatient servicessubstance abuse treatment.— 2776 (1) When the court finds that the conditions for 2777 involuntary outpatient servicessubstance abuse treatmenthave 2778 been proved by clear and convincing evidence, it may order the 2779 respondent to receiveundergoinvoluntary outpatient services 2780 fromtreatmentbya licensed service provider for a period not 2781 to exceed 60 days. If the court finds it necessary, it may 2782 direct the sheriff to take the respondent into custody and 2783 deliver him or her to the licensed service provider specified in 2784 the court order, or to the nearest appropriate licensed service 2785 provider, for involuntary outpatient servicestreatment. When 2786 the conditions justifying involuntary outpatient services 2787treatmentno longer exist, the individual must be released as 2788 provided in s. 397.6971. When the conditions justifying 2789 involuntary outpatient servicestreatmentare expected to exist 2790 after 60 days of servicestreatment, a renewal of the 2791 involuntary outpatient servicestreatmentorder may be requested 2792 pursuant to s. 397.6975 beforeprior tothe end of the 60-day 2793 period. 2794 (2) In all cases resulting in an order for involuntary 2795 outpatient servicessubstance abuse treatment, the court shall 2796 retain jurisdiction over the case and the parties for the entry 2797 of such further orders as the circumstances may require. The 2798 court’s requirements for notification of proposed release must 2799 be included in the originaltreatmentorder. 2800 (3) An involuntary outpatient servicestreatmentorder 2801 authorizes the licensed service provider to require the 2802 individual to receive services thatundergo such treatment as2803 will benefit him or her, including servicestreatmentat any 2804 licensable service component of a licensed service provider. 2805 (4) The court may not order involuntary outpatient services 2806 if the service provider certifies to the court that the 2807 recommended services are not available. The service provider 2808 must document its inquiry with the department and the managing 2809 entity as to the availability of the requested services. The 2810 managing entity must document such efforts to obtain the 2811 requested services. 2812 (5) If the court orders involuntary outpatient services, a 2813 copy of the order must be sent to the department and the 2814 managing entity within 1 working day after it is received from 2815 the court. After the order for outpatient services is issued, 2816 the service provider and the patient may modify provisions of 2817 the treatment plan. For any material modification of the 2818 treatment plan to which the patient or the patient’s guardian 2819 advocate, if appointed, agrees, the service provider shall send 2820 notice of the modification to the court. Any material 2821 modification of the treatment plan which is contested by the 2822 patient or the guardian advocate, if applicable, must be 2823 approved or disapproved by the court. 2824 Section 32. Section 397.6971, Florida Statutes, is amended 2825 to read: 2826 397.6971 Early release from involuntary outpatient services 2827substance abuse treatment.— 2828 (1) At any time beforeprior tothe end of the 60-day 2829 involuntary outpatient servicestreatmentperiod, orprior to2830 the end of any extension granted pursuant to s. 397.6975, an 2831 individual receivingadmitted forinvoluntary outpatient 2832 servicestreatmentmay be determined eligible for discharge to 2833 the most appropriate referral or disposition for the individual 2834 when any of the following apply: 2835 (a) The individual no longer meets the criteria for 2836 involuntary admission and has given his or her informed consent 2837 to be transferred to voluntary treatment status.;2838 (b) If the individual was admitted on the grounds of 2839 likelihood of infliction of physical harm upon himself or 2840 herself or others, such likelihood no longer exists.; or2841 (c) If the individual was admitted on the grounds of need 2842 for assessment and stabilization or treatment, accompanied by 2843 inability to make a determination respecting such need, either: 2844 1. Such inability no longer exists; or 2845 2. It is evident that further treatment will not bring 2846 about further significant improvements in the individual’s 2847 condition.;2848 (d) The individual is no longer in need of services.; or2849 (e) The director of the service provider determines that 2850 the individual is beyond the safe management capabilities of the 2851 provider. 2852 (2) Whenever a qualified professional determines that an 2853 individual admitted for involuntary outpatient services 2854 qualifiestreatmentis readyfor early release underfor any of2855the reasons listed insubsection (1), the service provider shall 2856 immediately discharge the individual,and must notify all 2857 persons specified by the court in the original treatment order. 2858 Section 33. Section 397.6975, Florida Statutes, is amended 2859 to read: 2860 397.6975 Extension of involuntary outpatient services 2861substance abuse treatmentperiod.— 2862 (1) Whenever a service provider believes that an individual 2863 who is nearing the scheduled date of his or her release from 2864 involuntary outpatient servicestreatmentcontinues to meet the 2865 criteria for involuntary outpatient servicestreatmentin s. 2866 397.693, a petition for renewal of the involuntary outpatient 2867 servicestreatmentorder may be filed with the court at least 10 2868 days before the expiration of the court-ordered outpatient 2869 servicestreatmentperiod. The court shall immediately schedule 2870 a hearing to be held not more than 15 days after filing of the 2871 petition. The court shall provide the copy of the petition for 2872 renewal and the notice of the hearing to all parties to the 2873 proceeding. The hearing is conducted pursuant to s. 397.6957. 2874 (2) If the court finds that the petition for renewal of the 2875 involuntary outpatient servicestreatmentorder should be 2876 granted, it may order the respondent to receiveundergo2877 involuntary outpatient servicestreatmentfor a period not to 2878 exceed an additional 90 days. When the conditions justifying 2879 involuntary outpatient servicestreatmentno longer exist, the 2880 individual must be released as provided in s. 397.6971. When the 2881 conditions justifying involuntary outpatient servicestreatment2882 continue to exist after an additional 90 days of service 2883additional treatment, a new petition requesting renewal of the 2884 involuntary outpatient servicestreatmentorder may be filed 2885 pursuant to this section. 2886 (3) Within 1 court working day after the filing of a 2887 petition for continued involuntary outpatient services, the 2888 court shall appoint the regional conflict counsel to represent 2889 the respondent, unless the respondent is otherwise represented 2890 by counsel. The clerk of the court shall immediately notify the 2891 regional conflict counsel of such appointment. The regional 2892 conflict counsel shall represent the respondent until the 2893 petition is dismissed or the court order expires or the 2894 respondent is discharged from involuntary outpatient services. 2895 Any attorney representing the respondent shall have access to 2896 the respondent, witnesses, and records relevant to the 2897 presentation of the respondent’s case and shall represent the 2898 interests of the respondent, regardless of the source of payment 2899 to the attorney. 2900 (4) Hearings on petitions for continued involuntary 2901 outpatient services shall be before the circuit court. The court 2902 may appoint a general or special master to preside at the 2903 hearing. The procedures for obtaining an order pursuant to this 2904 section shall be in accordance with s. 397.697. 2905 (5) Notice of hearing shall be provided to the respondent 2906 or his or her counsel. The respondent and the respondent’s 2907 counsel may agree to a period of continued outpatient services 2908 without a court hearing. 2909 (6) The same procedure shall be repeated before the 2910 expiration of each additional period of outpatient services. 2911 (7) If the respondent has previously been found incompetent 2912 to consent to treatment, the court shall consider testimony and 2913 evidence regarding the respondent’s competence. 2914 Section 34. Section 397.6977, Florida Statutes, is amended 2915 to read: 2916 397.6977 Disposition of individual upon completion of 2917 involuntary outpatient servicessubstance abuse treatment.—At 2918 the conclusion of the 60-day period of court-ordered involuntary 2919 outpatient servicestreatment, the respondentindividualis 2920 automatically discharged unless a motion for renewal of the 2921 involuntary outpatient servicestreatmentorder has been filed 2922 with the court pursuant to s. 397.6975. 2923 Section 35. Section 397.6978, Florida Statutes, is created 2924 to read: 2925 397.6978 Guardian advocate; patient incompetent to consent; 2926 substance abuse disorder.— 2927 (1) The administrator of a receiving facility or addictions 2928 receiving facility may petition the court for the appointment of 2929 a guardian advocate based upon the opinion of a qualified 2930 professional that the patient is incompetent to consent to 2931 treatment. If the court finds that a patient is incompetent to 2932 consent to treatment and has not been adjudicated incapacitated 2933 and that a guardian with the authority to consent to mental 2934 health treatment has not been appointed, it shall appoint a 2935 guardian advocate. The patient has the right to have an attorney 2936 represent him or her at the hearing. If the person is indigent, 2937 the court shall appoint the office of the regional conflict 2938 counsel to represent him or her at the hearing. The patient has 2939 the right to testify, cross-examine witnesses, and present 2940 witnesses. The proceeding shall be recorded electronically or 2941 stenographically, and testimony must be provided under oath. One 2942 of the qualified professionals authorized to give an opinion in 2943 support of a petition for involuntary placement, as described in 2944 s. 397.675 or s. 397.6981, must testify. A guardian advocate 2945 must meet the qualifications of a guardian contained in part IV 2946 of chapter 744. The person who is appointed as a guardian 2947 advocate must agree to the appointment. 2948 (2) The following persons are prohibited from appointment 2949 as a patient’s guardian advocate: 2950 (a) A professional providing clinical services to the 2951 individual under this part. 2952 (b) The qualified professional who initiated the 2953 involuntary examination of the individual, if the examination 2954 was initiated by a qualified professional’s certificate. 2955 (c) An employee, an administrator, or a board member of the 2956 facility providing the examination of the individual. 2957 (d) An employee, an administrator, or a board member of the 2958 treatment facility providing treatment of the individual. 2959 (e) A person providing any substantial professional 2960 services to the individual, including clinical and nonclinical 2961 services. 2962 (f) A creditor of the individual. 2963 (g) A person subject to an injunction for protection 2964 against domestic violence under s. 741.30, whether the order of 2965 injunction is temporary or final, and for which the individual 2966 was the petitioner. 2967 (h) A person subject to an injunction for protection 2968 against repeat violence, sexual violence, or dating violence 2969 under s. 784.046, whether the order of injunction is temporary 2970 or final, and for which the individual was the petitioner. 2971 (3) A facility requesting appointment of a guardian 2972 advocate must, before the appointment, provide the prospective 2973 guardian advocate with information about the duties and 2974 responsibilities of guardian advocates, including information 2975 about the ethics of medical decisionmaking. Before asking a 2976 guardian advocate to give consent to treatment for a patient, 2977 the facility must provide to the guardian advocate sufficient 2978 information so that the guardian advocate can decide whether to 2979 give express and informed consent to the treatment. Such 2980 information must include information that demonstrates that the 2981 treatment is essential to the care of the patient and does not 2982 present an unreasonable risk of serious, hazardous, or 2983 irreversible side effects. If possible, before giving consent to 2984 treatment, the guardian advocate must personally meet and talk 2985 with the patient and the patient’s physician. If that is not 2986 possible, the discussion may be conducted by telephone. The 2987 decision of the guardian advocate may be reviewed by the court, 2988 upon petition of the patient’s attorney, the patient’s family, 2989 or the facility administrator. 2990 (4) In lieu of the training required for guardians 2991 appointed pursuant to chapter 744, a guardian advocate shall 2992 attend at least a 4-hour training course approved by the court 2993 before exercising his or her authority. At a minimum, the 2994 training course must include information about patient rights, 2995 the diagnosis of substance abuse disorders, the ethics of 2996 medical decisionmaking, and the duties of guardian advocates. 2997 (5) The required training course and the information to be 2998 supplied to prospective guardian advocates before their 2999 appointment must be developed by the department, approved by the 3000 chief judge of the circuit court, and taught by a court-approved 3001 organization, which may include, but need not be limited to, a 3002 community college, a guardianship organization, a local bar 3003 association, or The Florida Bar. The court may waive some or all 3004 of the training requirements for guardian advocates or impose 3005 additional requirements. The court shall make its decision on a 3006 case-by-case basis and, in making its decision, shall consider 3007 the experience and education of the guardian advocate, the 3008 duties assigned to the guardian advocate, and the needs of the 3009 patient. 3010 (6) In selecting a guardian advocate, the court shall give 3011 preference to the patient’s health care surrogate, if one has 3012 already been designated by the patient. If the patient has not 3013 previously designated a health care surrogate, the selection 3014 shall be made, except for good cause documented in the court 3015 record, from among the following persons, listed in order of 3016 priority: 3017 (a) The patient’s spouse. 3018 (b) An adult child of the patient. 3019 (c) A parent of the patient. 3020 (d) The adult next of kin of the patient. 3021 (e) An adult friend of the patient. 3022 (f) An adult trained and willing to serve as the guardian 3023 advocate for the patient. 3024 (7) If a guardian with the authority to consent to medical 3025 treatment has not already been appointed, or if the patient has 3026 not already designated a health care surrogate, the court may 3027 authorize the guardian advocate to consent to medical treatment 3028 as well as substance abuse disorder treatment. Unless otherwise 3029 limited by the court, a guardian advocate with authority to 3030 consent to medical treatment has the same authority to make 3031 health care decisions and is subject to the same restrictions as 3032 a proxy appointed under part IV of chapter 765. Unless the 3033 guardian advocate has sought and received express court approval 3034 in a proceeding separate from the proceeding to determine the 3035 competence of the patient to consent to medical treatment, the 3036 guardian advocate may not consent to: 3037 (a) Abortion. 3038 (b) Sterilization. 3039 (c) Electroshock therapy. 3040 (d) Psychosurgery. 3041 (e) Experimental treatments that have not been approved by 3042 a federally approved institutional review board in accordance 3043 with 45 C.F.R. part 46 or 21 C.F.R. part 56. 3044 3045 The court must base its authorization on evidence that the 3046 treatment or procedure is essential to the care of the patient 3047 and that the treatment does not present an unreasonable risk of 3048 serious, hazardous, or irreversible side effects. In complying 3049 with this subsection, the court shall follow the procedures set 3050 forth in subsection (1). 3051 (8) The guardian advocate shall be discharged when the 3052 patient is discharged from an order for involuntary outpatient 3053 services or involuntary inpatient placement or when the patient 3054 is transferred from involuntary to voluntary status. The court 3055 or a hearing officer shall consider the competence of the 3056 patient as provided in subsection (1) and may consider an 3057 involuntarily placed patient’s competence to consent to 3058 treatment at any hearing. Upon sufficient evidence, the court 3059 may restore, or the hearing officer may recommend that the court 3060 restore, the patient’s competence. A copy of the order restoring 3061 competence or the certificate of discharge containing the 3062 restoration of competence shall be provided to the patient and 3063 the guardian advocate. 3064 Section 36. Paragraph (a) of subsection (3) of section 3065 39.407, Florida Statutes, is amended to read: 3066 39.407 Medical, psychiatric, and psychological examination 3067 and treatment of child; physical, mental, or substance abuse 3068 examination of person with or requesting child custody.— 3069 (3)(a)1. Except as otherwise provided in subparagraph (b)1. 3070 or paragraph (e), before the department provides psychotropic 3071 medications to a child in its custody, the prescribing physician 3072 shall attempt to obtain express and informed consent, as defined 3073 in s. 394.455(15)s. 394.455(9)and as described in s. 3074 394.459(3)(a), from the child’s parent or legal guardian. The 3075 department must take steps necessary to facilitate the inclusion 3076 of the parent in the child’s consultation with the physician. 3077 However, if the parental rights of the parent have been 3078 terminated, the parent’s location or identity is unknown or 3079 cannot reasonably be ascertained, or the parent declines to give 3080 express and informed consent, the department may, after 3081 consultation with the prescribing physician, seek court 3082 authorization to provide the psychotropic medications to the 3083 child. Unless parental rights have been terminated and if it is 3084 possible to do so, the department shall continue to involve the 3085 parent in the decisionmaking process regarding the provision of 3086 psychotropic medications. If, at any time, a parent whose 3087 parental rights have not been terminated provides express and 3088 informed consent to the provision of a psychotropic medication, 3089 the requirements of this section that the department seek court 3090 authorization do not apply to that medication until such time as 3091 the parent no longer consents. 3092 2. Any time the department seeks a medical evaluation to 3093 determine the need to initiate or continue a psychotropic 3094 medication for a child, the department must provide to the 3095 evaluating physician all pertinent medical information known to 3096 the department concerning that child. 3097 Section 37. Paragraph (e) of subsection (5) of section 3098 212.055, Florida Statutes, is amended to read: 3099 212.055 Discretionary sales surtaxes; legislative intent; 3100 authorization and use of proceeds.—It is the legislative intent 3101 that any authorization for imposition of a discretionary sales 3102 surtax shall be published in the Florida Statutes as a 3103 subsection of this section, irrespective of the duration of the 3104 levy. Each enactment shall specify the types of counties 3105 authorized to levy; the rate or rates which may be imposed; the 3106 maximum length of time the surtax may be imposed, if any; the 3107 procedure which must be followed to secure voter approval, if 3108 required; the purpose for which the proceeds may be expended; 3109 and such other requirements as the Legislature may provide. 3110 Taxable transactions and administrative procedures shall be as 3111 provided in s. 212.054. 3112 (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in 3113 s. 125.011(1) may levy the surtax authorized in this subsection 3114 pursuant to an ordinance either approved by extraordinary vote 3115 of the county commission or conditioned to take effect only upon 3116 approval by a majority vote of the electors of the county voting 3117 in a referendum. In a county as defined in s. 125.011(1), for 3118 the purposes of this subsection, “county public general 3119 hospital” means a general hospital as defined in s. 395.002 3120 which is owned, operated, maintained, or governed by the county 3121 or its agency, authority, or public health trust. 3122 (e) A governing board, agency, or authority shall be 3123 chartered by the county commission upon this act becoming law. 3124 The governing board, agency, or authority shall adopt and 3125 implement a health care plan for indigent health care services. 3126 The governing board, agency, or authority shall consist of no 3127 more than seven and no fewer than five members appointed by the 3128 county commission. The members of the governing board, agency, 3129 or authority shall be at least 18 years of age and residents of 3130 the county. No member may be employed by or affiliated with a 3131 health care provider or the public health trust, agency, or 3132 authority responsible for the county public general hospital. 3133 The following community organizations shall each appoint a 3134 representative to a nominating committee: the South Florida 3135 Hospital and Healthcare Association, the Miami-Dade County 3136 Public Health Trust, the Dade County Medical Association, the 3137 Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade 3138 County. This committee shall nominate between 10 and 14 county 3139 citizens for the governing board, agency, or authority. The 3140 slate shall be presented to the county commission and the county 3141 commission shall confirm the top five to seven nominees, 3142 depending on the size of the governing board. Until such time as 3143 the governing board, agency, or authority is created, the funds 3144 provided for in subparagraph (d)2. shall be placed in a 3145 restricted account set aside from other county funds and not 3146 disbursed by the county for any other purpose. 3147 1. The plan shall divide the county into a minimum of four 3148 and maximum of six service areas, with no more than one 3149 participant hospital per service area. The county public general 3150 hospital shall be designated as the provider for one of the 3151 service areas. Services shall be provided through participants’ 3152 primary acute care facilities. 3153 2. The plan and subsequent amendments to it shall fund a 3154 defined range of health care services for both indigent persons 3155 and the medically poor, including primary care, preventive care, 3156 hospital emergency room care, and hospital care necessary to 3157 stabilize the patient. For the purposes of this section, 3158 “stabilization” means stabilization as defined in s. 397.311(42) 3159s. 397.311(41). Where consistent with these objectives, the plan 3160 may include services rendered by physicians, clinics, community 3161 hospitals, and alternative delivery sites, as well as at least 3162 one regional referral hospital per service area. The plan shall 3163 provide that agreements negotiated between the governing board, 3164 agency, or authority and providers shall recognize hospitals 3165 that render a disproportionate share of indigent care, provide 3166 other incentives to promote the delivery of charity care to draw 3167 down federal funds where appropriate, and require cost 3168 containment, including, but not limited to, case management. 3169 From the funds specified in subparagraphs (d)1. and 2. for 3170 indigent health care services, service providers shall receive 3171 reimbursement at a Medicaid rate to be determined by the 3172 governing board, agency, or authority created pursuant to this 3173 paragraph for the initial emergency room visit, and a per-member 3174 per-month fee or capitation for those members enrolled in their 3175 service area, as compensation for the services rendered 3176 following the initial emergency visit. Except for provisions of 3177 emergency services, upon determination of eligibility, 3178 enrollment shall be deemed to have occurred at the time services 3179 were rendered. The provisions for specific reimbursement of 3180 emergency services shall be repealed on July 1, 2001, unless 3181 otherwise reenacted by the Legislature. The capitation amount or 3182 rate shall be determined beforeprior toprogram implementation 3183 by an independent actuarial consultant. In no event shall such 3184 reimbursement rates exceed the Medicaid rate. The plan must also 3185 provide that any hospitals owned and operated by government 3186 entities on or after the effective date of this act must, as a 3187 condition of receiving funds under this subsection, afford 3188 public access equal to that provided under s. 286.011 as to any 3189 meeting of the governing board, agency, or authority the subject 3190 of which is budgeting resources for the retention of charity 3191 care, as that term is defined in the rules of the Agency for 3192 Health Care Administration. The plan shall also include 3193 innovative health care programs that provide cost-effective 3194 alternatives to traditional methods of service and delivery 3195 funding. 3196 3. The plan’s benefits shall be made available to all 3197 county residents currently eligible to receive health care 3198 services as indigents or medically poor as defined in paragraph 3199 (4)(d). 3200 4. Eligible residents who participate in the health care 3201 plan shall receive coverage for a period of 12 months or the 3202 period extending from the time of enrollment to the end of the 3203 current fiscal year, per enrollment period, whichever is less. 3204 5. At the end of each fiscal year, the governing board, 3205 agency, or authority shall prepare an audit that reviews the 3206 budget of the plan, delivery of services, and quality of 3207 services, and makes recommendations to increase the plan’s 3208 efficiency. The audit shall take into account participant 3209 hospital satisfaction with the plan and assess the amount of 3210 poststabilization patient transfers requested, and accepted or 3211 denied, by the county public general hospital. 3212 Section 38. Paragraph (c) of subsection (2) of section 3213 394.4599, Florida Statutes, is amended to read: 3214 394.4599 Notice.— 3215 (2) INVOLUNTARY ADMISSION.— 3216 (c)1. A receiving facility shall give notice of the 3217 whereabouts of a minor who is being involuntarily held for 3218 examination pursuant to s. 394.463 to the minor’s parent, 3219 guardian, caregiver, or guardian advocate, in person or by 3220 telephone or other form of electronic communication, immediately 3221 after the minor’s arrival at the facility. The facility may 3222 delay notification for no more than 24 hours after the minor’s 3223 arrival if the facility has submitted a report to the central 3224 abuse hotline, pursuant to s. 39.201, based upon knowledge or 3225 suspicion of abuse, abandonment, or neglect and if the facility 3226 deems a delay in notification to be in the minor’s best 3227 interest. 3228 2. The receiving facility shall attempt to notify the 3229 minor’s parent, guardian, caregiver, or guardian advocate until 3230 the receiving facility receives confirmation from the parent, 3231 guardian, caregiver, or guardian advocate, verbally, by 3232 telephone or other form of electronic communication, or by 3233 recorded message, that notification has been received. Attempts 3234 to notify the parent, guardian, caregiver, or guardian advocate 3235 must be repeated at least once every hour during the first 12 3236 hours after the minor’s arrival and once every 24 hours 3237 thereafter and must continue until such confirmation is 3238 received, unless the minor is released at the end of the 72-hour 3239 examination period, or until a petition for involuntary services 3240placementis filed with the court pursuant to s. 394.463(2)(g) 3241s. 394.463(2)(i). The receiving facility may seek assistance 3242 from a law enforcement agency to notify the minor’s parent, 3243 guardian, caregiver, or guardian advocate if the facility has 3244 not received within the first 24 hours after the minor’s arrival 3245 a confirmation by the parent, guardian, caregiver, or guardian 3246 advocate that notification has been received. The receiving 3247 facility must document notification attempts in the minor’s 3248 clinical record. 3249 Section 39. Subsection (3) of section 394.495, Florida 3250 Statutes, is amended to read: 3251 394.495 Child and adolescent mental health system of care; 3252 programs and services.— 3253 (3) Assessments must be performed by: 3254 (a) A professional as defined in s. 394.455(7), (33), (36), 3255 (37), or (38)s. 394.455(2), (4), (21), (23), or (24); 3256 (b) A professional licensed under chapter 491; or 3257 (c) A person who is under the direct supervision of a 3258 professional as defined in s. 394.455(7), (33), (36), (37), or 3259 (38)s. 394.455(2), (4), (21), (23), or (24)or a professional 3260 licensed under chapter 491. 3261 Section 40. Subsection (5) of section 394.496, Florida 3262 Statutes, is amended to read: 3263 394.496 Service planning.— 3264 (5) A professional as defined in s. 394.455(7), (33), (36), 3265 (37), or (38)s. 394.455(2), (4), (21), (23), or (24)or a 3266 professional licensed under chapter 491 must be included among 3267 those persons developing the services plan. 3268 Section 41. Subsection (6) of section 394.9085, Florida 3269 Statutes, is amended to read: 3270 394.9085 Behavioral provider liability.— 3271 (6) For purposes of this section, the terms “detoxification 3272 services,” “addictions receiving facility,” and “receiving 3273 facility” have the same meanings as those provided in ss. 3274 397.311(23)(a)4., 397.311(23)(a)1., and 394.455(41)ss.3275397.311(22)(a)4., 397.311(22)(a)1., and 394.455(26), 3276 respectively. 3277 Section 42. Subsection (8) of section 397.405, Florida 3278 Statutes, is amended to read: 3279 397.405 Exemptions from licensure.—The following are exempt 3280 from the licensing provisions of this chapter: 3281 (8) A legally cognizable church or nonprofit religious 3282 organization or denomination providing substance abuse services, 3283 including prevention services, which are solely religious, 3284 spiritual, or ecclesiastical in nature. A church or nonprofit 3285 religious organization or denomination providing any of the 3286 licensed service components itemized under s. 397.311(23)s.3287397.311(22)is not exempt from substance abuse licensure but 3288 retains its exemption with respect to all services which are 3289 solely religious, spiritual, or ecclesiastical in nature. 3290 3291 The exemptions from licensure in this section do not apply to 3292 any service provider that receives an appropriation, grant, or 3293 contract from the state to operate as a service provider as 3294 defined in this chapter or to any substance abuse program 3295 regulated pursuant to s. 397.406. Furthermore, this chapter may 3296 not be construed to limit the practice of a physician or 3297 physician assistant licensed under chapter 458 or chapter 459, a 3298 psychologist licensed under chapter 490, a psychotherapist 3299 licensed under chapter 491, or an advanced registered nurse 3300 practitioner licensed under part I of chapter 464, who provides 3301 substance abuse treatment, so long as the physician, physician 3302 assistant, psychologist, psychotherapist, or advanced registered 3303 nurse practitioner does not represent to the public that he or 3304 she is a licensed service provider and does not provide services 3305 to individuals pursuant to part V of this chapter. Failure to 3306 comply with any requirement necessary to maintain an exempt 3307 status under this section is a misdemeanor of the first degree, 3308 punishable as provided in s. 775.082 or s. 775.083. 3309 Section 43. Subsections (1) and (5) of section 397.407, 3310 Florida Statutes, are amended to read: 3311 397.407 Licensure process; fees.— 3312 (1) The department shall establish the licensure process to 3313 include fees and categories of licenses and must prescribe a fee 3314 range that is based, at least in part, on the number and 3315 complexity of programs listed in s. 397.311(23)s. 397.311(22)3316 which are operated by a licensee. The fees from the licensure of 3317 service components are sufficient to cover at least 50 percent 3318 of the costs of regulating the service components. The 3319 department shall specify a fee range for public and privately 3320 funded licensed service providers. Fees for privately funded 3321 licensed service providers must exceed the fees for publicly 3322 funded licensed service providers. 3323 (5) The department may issue probationary, regular, and 3324 interim licenses. The department shall issue one license for 3325 each service component that is operated by a service provider 3326 and defined pursuant to s. 397.311(23)s. 397.311(22). The 3327 license is valid only for the specific service components listed 3328 for each specific location identified on the license. The 3329 licensed service provider shall apply for a new license at least 3330 60 days before the addition of any service components or 30 days 3331 before the relocation of any of its service sites. Provision of 3332 service components or delivery of services at a location not 3333 identified on the license may be considered an unlicensed 3334 operation that authorizes the department to seek an injunction 3335 against operation as provided in s. 397.401, in addition to 3336 other sanctions authorized by s. 397.415. Probationary and 3337 regular licenses may be issued only after all required 3338 information has been submitted. A license may not be 3339 transferred. As used in this subsection, the term “transfer” 3340 includes, but is not limited to, the transfer of a majority of 3341 the ownership interest in the licensed entity or transfer of 3342 responsibilities under the license to another entity by 3343 contractual arrangement. 3344 Section 44. Section 397.416, Florida Statutes, is amended 3345 to read: 3346 397.416 Substance abuse treatment services; qualified 3347 professional.—Notwithstanding any other provision of law, a 3348 person who was certified through a certification process 3349 recognized by the former Department of Health and Rehabilitative 3350 Services before January 1, 1995, may perform the duties of a 3351 qualified professional with respect to substance abuse treatment 3352 services as defined in this chapter, and need not meet the 3353 certification requirements contained in s. 397.311(31)s.3354397.311(30). 3355 Section 45. Paragraph (b) of subsection (1) of section 3356 409.972, Florida Statutes, is amended to read: 3357 409.972 Mandatory and voluntary enrollment.— 3358 (1) The following Medicaid-eligible persons are exempt from 3359 mandatory managed care enrollment required by s. 409.965, and 3360 may voluntarily choose to participate in the managed medical 3361 assistance program: 3362 (b) Medicaid recipients residing in residential commitment 3363 facilities operated through the Department of Juvenile Justice 3364 or amental healthtreatment facilityfacilitiesas defined in 3365bys. 394.455(50)s. 394.455(32). 3366 Section 46. Paragraphs (d) and (g) of subsection (1) of 3367 section 440.102, Florida Statutes, are amended to read: 3368 440.102 Drug-free workplace program requirements.—The 3369 following provisions apply to a drug-free workplace program 3370 implemented pursuant to law or to rules adopted by the Agency 3371 for Health Care Administration: 3372 (1) DEFINITIONS.—Except where the context otherwise 3373 requires, as used in this act: 3374 (d) “Drug rehabilitation program” means a service provider, 3375 established pursuant to s. 397.311(40)s. 397.311(39), that 3376 provides confidential, timely, and expert identification, 3377 assessment, and resolution of employee drug abuse. 3378 (g) “Employee assistance program” means an established 3379 program capable of providing expert assessment of employee 3380 personal concerns; confidential and timely identification 3381 services with regard to employee drug abuse; referrals of 3382 employees for appropriate diagnosis, treatment, and assistance; 3383 and followup services for employees who participate in the 3384 program or require monitoring after returning to work. If, in 3385 addition to the above activities, an employee assistance program 3386 provides diagnostic and treatment services, these services shall 3387 in all cases be provided by service providers pursuant to s. 3388 397.311(40)s. 397.311(39). 3389 Section 47. Subsection (7) of section 744.704, Florida 3390 Statutes, is amended to read: 3391 744.704 Powers and duties.— 3392 (7) A public guardian mayshallnot commit a ward to a 3393mental healthtreatment facility, as defined in s. 394.455(50) 3394s. 394.455(32), without an involuntary placement proceeding as 3395 provided by law. 3396 Section 48. Paragraph (a) of subsection (2) of section 3397 790.065, Florida Statutes, is amended to read: 3398 790.065 Sale and delivery of firearms.— 3399 (2) Upon receipt of a request for a criminal history record 3400 check, the Department of Law Enforcement shall, during the 3401 licensee’s call or by return call, forthwith: 3402 (a) Review any records available to determine if the 3403 potential buyer or transferee: 3404 1. Has been convicted of a felony and is prohibited from 3405 receipt or possession of a firearm pursuant to s. 790.23; 3406 2. Has been convicted of a misdemeanor crime of domestic 3407 violence, and therefore is prohibited from purchasing a firearm; 3408 3. Has had adjudication of guilt withheld or imposition of 3409 sentence suspended on any felony or misdemeanor crime of 3410 domestic violence unless 3 years have elapsed since probation or 3411 any other conditions set by the court have been fulfilled or 3412 expunction has occurred; or 3413 4. Has been adjudicated mentally defective or has been 3414 committed to a mental institution by a court or as provided in 3415 sub-sub-subparagraph b.(II), and as a result is prohibited by 3416 state or federal law from purchasing a firearm. 3417 a. As used in this subparagraph, “adjudicated mentally 3418 defective” means a determination by a court that a person, as a 3419 result of marked subnormal intelligence, or mental illness, 3420 incompetency, condition, or disease, is a danger to himself or 3421 herself or to others or lacks the mental capacity to contract or 3422 manage his or her own affairs. The phrase includes a judicial 3423 finding of incapacity under s. 744.331(6)(a), an acquittal by 3424 reason of insanity of a person charged with a criminal offense, 3425 and a judicial finding that a criminal defendant is not 3426 competent to stand trial. 3427 b. As used in this subparagraph, “committed to a mental 3428 institution” means: 3429 (I) Involuntary commitment, commitment for mental 3430 defectiveness or mental illness, and commitment for substance 3431 abuse. The phrase includes involuntary inpatient placement as 3432 defined in s. 394.467, involuntary outpatient servicesplacement3433 as defined in s. 394.4655, involuntary assessment and 3434 stabilization under s. 397.6818, and involuntary substance abuse 3435 treatment under s. 397.6957, but does not include a person in a 3436 mental institution for observation or discharged from a mental 3437 institution based upon the initial review by the physician or a 3438 voluntary admission to a mental institution; or 3439 (II) Notwithstanding sub-sub-subparagraph (I), voluntary 3440 admission to a mental institution for outpatient or inpatient 3441 treatment of a person who had an involuntary examination under 3442 s. 394.463, where each of the following conditions have been 3443 met: 3444 (A) An examining physician found that the person is an 3445 imminent danger to himself or herself or others. 3446 (B) The examining physician certified that if the person 3447 did not agree to voluntary treatment, a petition for involuntary 3448 outpatient or inpatient servicestreatmentwould have been filed 3449 under s. 394.463(2)(g)s. 394.463(2)(i)4., or the examining 3450 physician certified that a petition was filed and the person 3451 subsequently agreed to voluntary treatment beforeprior toa 3452 court hearing on the petition. 3453 (C) Before agreeing to voluntary treatment, the person 3454 received written notice of that finding and certification, and 3455 written notice that as a result of such finding, he or she may 3456 be prohibited from purchasing a firearm, and may not be eligible 3457 to apply for or retain a concealed weapon or firearms license 3458 under s. 790.06 and the person acknowledged such notice in 3459 writing, in substantially the following form: 3460 3461 “I understand that the doctor who examined me believes 3462 I am a danger to myself or to others. I understand 3463 that if I do not agree to voluntary treatment, a 3464 petition will be filed in court to require me to 3465 receive involuntary treatment. I understand that if 3466 that petition is filed, I have the right to contest 3467 it. In the event a petition has been filed, I 3468 understand that I can subsequently agree to voluntary 3469 treatment prior to a court hearing. I understand that 3470 by agreeing to voluntary treatment in either of these 3471 situations, I may be prohibited from buying firearms 3472 and from applying for or retaining a concealed weapons 3473 or firearms license until I apply for and receive 3474 relief from that restriction under Florida law.” 3475 3476 (D) A judge or a magistrate has, pursuant to sub-sub 3477 subparagraph c.(II), reviewed the record of the finding, 3478 certification, notice, and written acknowledgment classifying 3479 the person as an imminent danger to himself or herself or 3480 others, and ordered that such record be submitted to the 3481 department. 3482 c. In order to check for these conditions, the department 3483 shall compile and maintain an automated database of persons who 3484 are prohibited from purchasing a firearm based on court records 3485 of adjudications of mental defectiveness or commitments to 3486 mental institutions. 3487 (I) Except as provided in sub-sub-subparagraph (II), clerks 3488 of court shall submit these records to the department within 1 3489 month after the rendition of the adjudication or commitment. 3490 Reports shall be submitted in an automated format. The reports 3491 must, at a minimum, include the name, along with any known alias 3492 or former name, the sex, and the date of birth of the subject. 3493 (II) For persons committed to a mental institution pursuant 3494 to sub-sub-subparagraph b.(II), within 24 hours after the 3495 person’s agreement to voluntary admission, a record of the 3496 finding, certification, notice, and written acknowledgment must 3497 be filed by the administrator of the receiving or treatment 3498 facility, as defined in s. 394.455, with the clerk of the court 3499 for the county in which the involuntary examination under s. 3500 394.463 occurred. No fee shall be charged for the filing under 3501 this sub-sub-subparagraph. The clerk must present the records to 3502 a judge or magistrate within 24 hours after receipt of the 3503 records. A judge or magistrate is required and has the lawful 3504 authority to review the records ex parte and, if the judge or 3505 magistrate determines that the record supports the classifying 3506 of the person as an imminent danger to himself or herself or 3507 others, to order that the record be submitted to the department. 3508 If a judge or magistrate orders the submittal of the record to 3509 the department, the record must be submitted to the department 3510 within 24 hours. 3511 d. A person who has been adjudicated mentally defective or 3512 committed to a mental institution, as those terms are defined in 3513 this paragraph, may petition the circuit court that made the 3514 adjudication or commitment, or the court that ordered that the 3515 record be submitted to the department pursuant to sub-sub 3516 subparagraph c.(II), for relief from the firearm disabilities 3517 imposed by such adjudication or commitment. A copy of the 3518 petition shall be served on the state attorney for the county in 3519 which the person was adjudicated or committed. The state 3520 attorney may object to and present evidence relevant to the 3521 relief sought by the petition. The hearing on the petition may 3522 be open or closed as the petitioner may choose. The petitioner 3523 may present evidence and subpoena witnesses to appear at the 3524 hearing on the petition. The petitioner may confront and cross 3525 examine witnesses called by the state attorney. A record of the 3526 hearing shall be made by a certified court reporter or by court 3527 approved electronic means. The court shall make written findings 3528 of fact and conclusions of law on the issues before it and issue 3529 a final order. The court shall grant the relief requested in the 3530 petition if the court finds, based on the evidence presented 3531 with respect to the petitioner’s reputation, the petitioner’s 3532 mental health record and, if applicable, criminal history 3533 record, the circumstances surrounding the firearm disability, 3534 and any other evidence in the record, that the petitioner will 3535 not be likely to act in a manner that is dangerous to public 3536 safety and that granting the relief would not be contrary to the 3537 public interest. If the final order denies relief, the 3538 petitioner may not petition again for relief from firearm 3539 disabilities until 1 year after the date of the final order. The 3540 petitioner may seek judicial review of a final order denying 3541 relief in the district court of appeal having jurisdiction over 3542 the court that issued the order. The review shall be conducted 3543 de novo. Relief from a firearm disability granted under this 3544 sub-subparagraph has no effect on the loss of civil rights, 3545 including firearm rights, for any reason other than the 3546 particular adjudication of mental defectiveness or commitment to 3547 a mental institution from which relief is granted. 3548 e. Upon receipt of proper notice of relief from firearm 3549 disabilities granted under sub-subparagraph d., the department 3550 shall delete any mental health record of the person granted 3551 relief from the automated database of persons who are prohibited 3552 from purchasing a firearm based on court records of 3553 adjudications of mental defectiveness or commitments to mental 3554 institutions. 3555 f. The department is authorized to disclose data collected 3556 pursuant to this subparagraph to agencies of the Federal 3557 Government and other states for use exclusively in determining 3558 the lawfulness of a firearm sale or transfer. The department is 3559 also authorized to disclose this data to the Department of 3560 Agriculture and Consumer Services for purposes of determining 3561 eligibility for issuance of a concealed weapons or concealed 3562 firearms license and for determining whether a basis exists for 3563 revoking or suspending a previously issued license pursuant to 3564 s. 790.06(10). When a potential buyer or transferee appeals a 3565 nonapproval based on these records, the clerks of court and 3566 mental institutions shall, upon request by the department, 3567 provide information to help determine whether the potential 3568 buyer or transferee is the same person as the subject of the 3569 record. Photographs and any other data that could confirm or 3570 negate identity must be made available to the department for 3571 such purposes, notwithstanding any other provision of state law 3572 to the contrary. Any such information that is made confidential 3573 or exempt from disclosure by law shall retain such confidential 3574 or exempt status when transferred to the department. 3575 Section 49. This act shall take effect July 1, 2016.