Bill Text: FL S0012 | 2016 | Regular Session | Engrossed
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-Engrossed.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-Engrossed.html
CS for SB 12 Third Engrossed 201612e3 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. 39.01, F.S.; 7 defining a term; amending s. 39.407, F.S.; requiring 8 assessment findings to be provided to the plan that is 9 financially responsible for a child’s care in 10 residential treatment under certain circumstances; 11 amending s. 394.453, F.S.; revising legislative 12 intent; amending s. 394.4573, F.S.; requiring the 13 Department of Children and Families to submit a 14 certain assessment to the Governor and Legislature by 15 a specified date; defining and revising terms; 16 providing essential elements of a coordinated system 17 of care; providing requirements for the department’s 18 annual assessment; authorizing the department to award 19 certain grants; deleting duties and measures of the 20 department regarding continuity of care management 21 systems; amending s. 394.461, F.S.; creating a 22 designated receiving system that functions as a no 23 wrong-door model, based on certain receiving system 24 models; authorizing, rather than requiring, the 25 department to adopt rules to implement the designated 26 receiving system; repealing s. 394.675, F.S., relating 27 to the substance abuse and mental health service 28 system; amending ss. 394.75 and 394.76, F.S.; 29 conforming provisions and cross-references to changes 30 made by the act; amending s. 394.4597, F.S.; revising 31 the prioritization of health care surrogates to be 32 selected for involuntary patients; specifying certain 33 persons who are prohibited from being selected as an 34 individual’s representative; amending s. 394.4598, 35 F.S.; specifying certain persons who are prohibited 36 from being appointed as a person’s guardian advocate; 37 amending s. 394.462, F.S.; requiring that counties 38 develop and implement transportation plans; providing 39 requirements for the plans; revising requirements for 40 transportation to receiving facilities and treatment 41 facilities; revising exceptions to such requirements; 42 amending s. 394.467, F.S.; revising criteria for 43 involuntary inpatient placement; revising criteria for 44 a procedure for continued involuntary inpatient 45 services; specifying requirements for a certain waiver 46 of the patient’s attendance at a hearing; requiring 47 the court to consider certain testimony and evidence 48 regarding a patient’s incompetence; amending s. 49 394.46715, F.S.; revising rulemaking authority of the 50 department; amending s. 394.4685, F.S.; requiring a 51 public receiving facility initiating a patient 52 transfer to a licensed hospital for certain mental 53 health services to provide notice and transfer patient 54 records to the hospital; amending s. 394.656, F.S.; 55 revising the membership of the Criminal Justice, 56 Mental Health, and Substance Abuse Statewide Grant 57 Review Committee; providing duties for the committee; 58 authorizing a not-for-profit community provider or 59 managing entity to apply for certain grants; revising 60 eligibility for such grants; defining a term; creating 61 s. 394.761, F.S.; requiring the agency and the 62 department to develop a plan for revenue maximization; 63 providing requirements for the plan; providing duties 64 for the agency and department relating to the plan; 65 requiring the plan to be submitted to the Legislature 66 by a certain date; amending s. 394.879, F.S.; 67 providing that certain facilities may be in a multi 68 story building and authorized on certain floors; 69 requiring the department to develop a plan to create 70 an option for a single, consolidated license for 71 certain providers by a specified date; amending s. 72 394.9082, F.S.; providing a purpose for behavioral 73 health managing entities; revising definitions; 74 providing duties of the department; requiring the 75 department to revise its contracts with managing 76 entities; providing duties for managing entities; 77 providing requirements for network accreditation and 78 systems coordination agreements; providing for 79 performance measurement and accountability and 80 enhancements plans; providing a funding mechanism for 81 managing entities; renaming the Crisis Stabilization 82 Services Utilization Database as the Acute Care 83 Services Utilization Database; requiring certain 84 providers to provide utilization data; deleting 85 provisions relating to legislative findings and 86 intent, service delivery strategies, essential 87 elements, reporting requirements, and rulemaking 88 authority; amending s. 397.305, F.S.; providing 89 legislative intent; amending s. 397.311, F.S.; 90 defining and redefining terms; conforming a cross 91 reference; amending s. 397.321, F.S.; deleting a 92 requirement for the department to appoint a substance 93 abuse impairment coordinator; requiring the department 94 to develop certain forms, display such forms on its 95 website, and notify certain entities of the existence 96 and availability of such forms; amending s. 397.675, 97 F.S.; revising the criteria for involuntary admissions 98 due to substance abuse or co-occurring mental health 99 disorders; amending s. 397.6772, F.S.; requiring law 100 enforcement officers to use standard forms developed 101 by the department to execute a certain written report; 102 amending s. 397.6773, F.S.; revising a cross 103 reference; amending s. 397.679, F.S.; authorizing 104 specified licensed professionals to complete a 105 certificate for the involuntary admission of an 106 individual; amending s. 397.6791, F.S.; providing a 107 list of professionals authorized to initiate a 108 certificate for an emergency assessment or admission 109 of a person who has a substance abuse disorder; 110 amending s. 397.6793, F.S.; revising the criteria for 111 initiation of a certificate for an emergency admission 112 for a person who is substance abuse impaired; amending 113 s. 397.6795, F.S.; revising the list of persons 114 authorized to deliver a person for an emergency 115 assessment; amending s. 397.681, F.S.; prohibiting the 116 court from charging a fee for involuntary petitions; 117 amending s. 397.6811, F.S.; revising the list of 118 persons authorized to file a petition for an 119 involuntary assessment and stabilization; amending s. 120 397.6814, F.S.; prohibiting a fee from being charged 121 for the filing of a petition for involuntary 122 assessment and stabilization; amending s. 397.6818, 123 F.S.; limiting the validity of an order for 124 involuntary admission to 7 days after it is signed 125 unless otherwise specified in the order; amending s. 126 397.6819, F.S.; revising the responsibilities of 127 service providers who admit an individual for an 128 involuntary assessment and stabilization; amending s. 129 397.695, F.S.; authorizing certain persons to file a 130 petition for involuntary outpatient services of an 131 individual; providing procedures and requirements for 132 such petitions; amending s. 397.6951, F.S.; requiring 133 that certain additional information be included in a 134 petition for involuntary outpatient services; amending 135 s. 397.6955, F.S.; requiring a court to fulfill 136 certain additional duties upon the filing of a 137 petition for involuntary outpatient services; amending 138 s. 397.6957, F.S.; providing additional requirements 139 for a hearing on a petition for involuntary outpatient 140 services; amending s. 397.697, F.S.; authorizing a 141 court to make a determination of involuntary 142 outpatient services; extending the timeframe a 143 respondent receives certain publicly funded licensed 144 services; authorizing a court to order a respondent to 145 undergo treatment through a publicly or privately 146 funded licensed service provider under certain 147 circumstances; requiring a copy of the court’s order 148 to be sent to the managing entity; amending s. 149 397.6971, F.S.; establishing the requirements for an 150 early release from involuntary outpatient services; 151 amending s. 397.6975, F.S.; requiring the court to 152 appoint certain counsel; providing requirements for 153 hearings on petitions for continued involuntary 154 outpatient services; requiring notice of such 155 hearings; amending s. 397.6977, F.S.; conforming 156 provisions to changes made by the act; creating s. 157 397.6978, F.S.; providing for the appointment of 158 guardian advocates if an individual is found 159 incompetent to consent to treatment; prohibiting 160 specified persons from being appointed as an 161 individual’s guardian advocate; providing requirements 162 for a facility requesting the appointment of a 163 guardian advocate; requiring a training course for 164 guardian advocates; providing requirements for the 165 training course; providing requirements for the 166 prioritization of individuals to be selected as 167 guardian advocates; authorizing certain guardian 168 advocates to consent to medical treatment; providing 169 exceptions; providing procedures for the discharge of 170 a guardian advocate; amending s. 409.967, F.S.; 171 requiring managed care plans to provide for quality 172 care; amending s. 409.973, F.S.; providing an 173 integrated behavioral health initiative; reenacting s. 174 409.975(6), F.S., relating to provider payment; 175 providing legislative intent; amending s. 491.0045, 176 F.S.; revising registration requirements for interns; 177 repealing s. 394.4674, F.S., relating to the 178 comprehensive plan and report on the 179 deinstitutionalization of patients in a treatment 180 facility; repealing s. 394.4985, F.S., relating to the 181 implementation of a districtwide information and 182 referral network; repealing s. 394.745, F.S., relating 183 to the annual report on the compliance of providers 184 under contract with the department; repealing s. 185 397.331, F.S., relating to definitions and legislative 186 intent; repealing part IX of chapter 397, F.S., 187 consisting of ss. 397.801, 397.811, and 397.821, F.S., 188 relating to substance abuse impairment coordination, 189 juvenile substance abuse impairment coordination, and 190 juvenile substance abuse impairment prevention and 191 early intervention councils, respectively; repealing 192 s. 397.901, F.S., relating to prototype juvenile 193 addictions receiving facilities; repealing s. 397.93, 194 F.S., relating to target populations for children’s 195 substance abuse services; repealing s. 397.94, F.S., 196 relating to the information and referral network for 197 children’s substance abuse services; repealing s. 198 397.951, F.S., relating to substance abuse treatment 199 and sanctions; repealing s. 397.97, F.S., relating to 200 demonstration models for children’s substance abuse 201 services; repealing s. 397.98, F.S., relating to 202 utilization management for children’s substance abuse 203 services; amending ss. 39.407, 39.524, 212.055, 204 394.4599, 394.495, 394.496, 394.9085, 397.321, 205 397.405, 397.407, 397.416, 397.4871, 409.1678, 206 409.966, 409.972, 440.102, 744.704, and 960.065, F.S.; 207 conforming cross-references; requiring the Secretary 208 of Children and Families to appoint a workgroup on the 209 use of advance directives for substance use disorders; 210 requiring a report to the Governor and Legislature by 211 a specified date; providing for expiration of the 212 workgroup; amending s. 61.13, F.S.; providing that a 213 parenting plan that provides for shared parental 214 responsibility over health care decisions must 215 authorize either parent to consent to mental health 216 treatment for the child; amending s. 39.001, F.S.; 217 conforming provisions to changes made by the act; 218 amending ss. 39.507 and 39.521, F.S.; providing for 219 consideration of mental health issues and involvement 220 in mental health programs in adjudicatory hearings and 221 orders; providing requirements for certain court 222 orders; revising the qualifications for administrators 223 of mental health and substance abuse assessments or 224 evaluations; amending s. 394.4655, F.S.; defining the 225 terms “court” and “criminal county court”; providing 226 for involuntary outpatient services; authorizing 227 certain licensed physicians and psychiatric nurses to 228 provide a second opinion regarding a recommendation 229 for involuntary outpatient services under certain 230 circumstances; requiring a service provider to 231 document certain inquiries; requiring the managing 232 entity to document certain efforts; making technical 233 changes; amending s. 394.4599, F.S.; conforming 234 provisions to changes made by the act; amending s. 235 394.455, F.S.; defining and redefining terms; amending 236 s. 394.463, F.S.; authorizing circuit or county courts 237 to enter ex parte orders for involuntary examinations; 238 requiring a facility to provide copies of ex parte 239 orders, reports, and certificates to the department, 240 rather than the Agency for Health Care Administration; 241 requiring the department to receive certain orders, 242 certificates, and reports; requiring the department to 243 receive and maintain copies of certain documents; 244 prohibiting a person from being held for involuntary 245 examination for more than a specified period of time; 246 providing exceptions; requiring certain individuals to 247 be released to law enforcement custody; providing 248 exceptions; conforming cross-references; amending s. 249 394.4615, F.S.; conforming a cross-reference; 250 providing an appropriation; providing an effective 251 date. 252 253 Be It Enacted by the Legislature of the State of Florida: 254 255 Section 1. Paragraph (e) is added to subsection (10) of 256 section 29.004, Florida Statutes, to read: 257 29.004 State courts system.—For purposes of implementing s. 258 14, Art. V of the State Constitution, the elements of the state 259 courts system to be provided from state revenues appropriated by 260 general law are as follows: 261 (10) Case management. Case management includes: 262 (e) Service referral, coordination, monitoring, and 263 tracking for treatment-based mental health court programs under 264 chapter 394. 265 266 Case management may not include costs associated with the 267 application of therapeutic jurisprudence principles by the 268 courts. Case management also may not include case intake and 269 records management conducted by the clerk of court. 270 Section 2. Subsections (65) through (79) of section 39.01, 271 Florida Statutes, are renumbered as subsections (66) through 272 (80), respectively, and a new subsection (65) is added to that 273 section to read: 274 39.01 Definitions.—When used in this chapter, unless the 275 context otherwise requires: 276 (65) “Qualified professional” means a physician or a 277 physician assistant licensed under chapter 458 or chapter 459; a 278 psychiatrist licensed under chapter 458 or chapter 459; a 279 psychologist as defined in s. 490.003(7) or a professional 280 licensed under chapter 491; or a psychiatric nurse as defined in 281 s. 394.455. 282 Section 3. Paragraph (c) of subsection (6) of section 283 39.407, Florida Statutes, is amended to read: 284 39.407 Medical, psychiatric, and psychological examination 285 and treatment of child; physical, mental, or substance abuse 286 examination of person with or requesting child custody.— 287 (6) Children who are in the legal custody of the department 288 may be placed by the department, without prior approval of the 289 court, in a residential treatment center licensed under s. 290 394.875 or a hospital licensed under chapter 395 for residential 291 mental health treatment only pursuant to this section or may be 292 placed by the court in accordance with an order of involuntary 293 examination or involuntary placement entered pursuant to s. 294 394.463 or s. 394.467. All children placed in a residential 295 treatment program under this subsection must have a guardian ad 296 litem appointed. 297 (c) Before a child is admitted under this subsection, the 298 child shall be assessed for suitability for residential 299 treatment by a qualified evaluator who has conducted a personal 300 examination and assessment of the child and has made written 301 findings that: 302 1. The child appears to have an emotional disturbance 303 serious enough to require residential treatment and is 304 reasonably likely to benefit from the treatment. 305 2. The child has been provided with a clinically 306 appropriate explanation of the nature and purpose of the 307 treatment. 308 3. All available modalities of treatment less restrictive 309 than residential treatment have been considered, and a less 310 restrictive alternative that would offer comparable benefits to 311 the child is unavailable. 312 313 A copy of the written findings of the evaluation and suitability 314 assessment must be provided to the department,andto the 315 guardian ad litem, and, if the child is a member of a Medicaid 316 managed care plan, to the plan that is financially responsible 317 for the child’s care in residential treatment, all of whom must 318 be provided withwho shall havethe opportunity to discuss the 319 findings with the evaluator. 320 Section 4. Section 394.453, Florida Statutes, is amended to 321 read: 322 394.453 Legislative intent.— 323 (1) It is the intent of the Legislature: 324 (a) To authorize and direct the Department of Children and 325 Families to evaluate, research, plan, and recommend to the 326 Governor and the Legislature programs designed to reduce the 327 occurrence, severity, duration, and disabling aspects of mental, 328 emotional, and behavioral disorders. 329 (b)It is the intent of the LegislatureThat treatment 330 programs for such disordersshallinclude, but not be limited 331 to, comprehensive health, social, educational, and 332 rehabilitative services to persons requiring intensive short 333 term and continued treatment in order to encourage them to 334 assume responsibility for their treatment and recovery. It is 335 intended that: 336 1. Such persons be provided with emergency service and 337 temporary detention for evaluation when required; 338 2. Such personsthat theybe admitted to treatment 339 facilities on a voluntary basis when extended or continuing care 340 is needed and unavailable in the community; 341 3.thatInvoluntary placement be provided only when expert 342 evaluation determinesthatit is necessary; 343 4.thatAny involuntary treatment or examination be 344 accomplished in a setting thatwhichis clinically appropriate 345 and most likely to facilitate the person’s return to the 346 community as soon as possible; and 347 5.thatIndividual dignity and human rights be guaranteed 348 to all persons who are admitted to mental health facilities or 349 who are being held under s. 394.463. 350 (c) That services provided to persons in this state use the 351 coordination-of-care principles characteristic of recovery 352 oriented services and include social support services, such as 353 housing support, life skills and vocational training, and 354 employment assistance, necessary for persons with mental health 355 disorders and co-occurring mental health and substance use 356 disorders to live successfully in their communities. 357 (d) That licensed, qualified health professionals be 358 authorized to practice to the fullest extent of their education 359 and training in the performance of professional functions 360 necessary to carry out the intent of this part. 361 (2)It is the further intent of the Legislature that the362least restrictive means of intervention be employed based on the363individual needs of each person, within the scope of available364services.It is the policy of this state that the use of 365 restraint and seclusion on clients is justified only as an 366 emergency safety measure to be used in response to imminent 367 danger to the client or others. It is, therefore, the intent of 368 the Legislature to achieve an ongoing reduction in the use of 369 restraint and seclusion in programs and facilities serving 370 persons with mental illness. 371 Section 5. Section 394.4573, Florida Statutes, is amended 372 to read: 373 394.4573 Coordinated system of care; annual assessment; 374 essential elementsContinuity of care management system; 375 measures of performance; system improvement grants; reports.—On 376 or before December 1 of each year, the department shall submit 377 to the Governor, the President of the Senate, and the Speaker of 378 the House of Representatives an assessment of the behavioral 379 health services in this state. The assessment shall consider, at 380 a minimum, the extent to which designated receiving systems 381 function as no-wrong-door models, the availability of treatment 382 and recovery services that use recovery-oriented and peer 383 involved approaches, the availability of less-restrictive 384 services, and the use of evidence-informed practices. The 385 department’s assessment shall consider, at a minimum, the needs 386 assessments conducted by the managing entities pursuant to s. 387 394.9082(5). Beginning in 2017, the department shall compile and 388 include in the report all plans submitted by managing entities 389 pursuant to s. 394.9082(8) and the department’s evaluation of 390 each plan. 391 (1) As used inFor the purposes ofthis section: 392 (a) “Care coordination” means the implementation of 393 deliberate and planned organizational relationships and service 394 procedures that improve the effectiveness and efficiency of the 395 behavioral health system by engaging in purposeful interactions 396 with individuals who are not yet effectively connected with 397 services to ensure service linkage. Examples of care 398 coordination activities include development of referral 399 agreements, shared protocols, and information exchange 400 procedures. The purpose of care coordination is to enhance the 401 delivery of treatment services and recovery supports and to 402 improve outcomes among priority populations. 403 (b)(a)“Case management” means those direct services 404 provided to a client in order to assess his or heractivities405aimed at assessing clientneeds, plan, or arrangeplanning406 services, coordinate service providers, linklinkingthe service 407 system to a client, monitorcoordinating the various system408components, monitoringservice delivery, and evaluate patient 409 outcomes to ensure the client is receiving the appropriate 410 servicesevaluating the effect of service delivery. 411(b)“Case manager” means an individual who works with412clients, and their families and significant others, to provide413case management.414(c)“Client manager” means an employee of the department415who is assigned to specific provider agencies and geographic416areas to ensure that the full range of needed services is417available to clients.418 (c)(d)“Coordinated systemContinuityof caremanagement419system” meansa system that assures, within available resources,420that clients have access tothe full array of behavioral and 421 related services in a region or community offered by all service 422 providers, whether participating under contract with the 423 managing entity or by another method of community partnership or 424 mutual agreementwithin the mental health services delivery425system. 426 (d) “No-wrong-door model” means a model for the delivery of 427 acute care services to persons who have mental health or 428 substance use disorders, or both, which optimizes access to 429 care, regardless of the entry point to the behavioral health 430 care system. 431 (2) The essential elements of a coordinated system of care 432 include: 433 (a) Community interventions, such as prevention, primary 434 care for behavioral health needs, therapeutic and supportive 435 services, crisis response services, and diversion programs. 436 (b) A designated receiving system that consists of one or 437 more facilities serving a defined geographic area and 438 responsible for assessment and evaluation, both voluntary and 439 involuntary, and treatment or triage of patients who have a 440 mental health or substance use disorder, or co-occurring 441 disorders. 442 1. A county or several counties shall plan the designated 443 receiving system using a process that includes the managing 444 entity and is open to participation by individuals with 445 behavioral health needs and their families, service providers, 446 law enforcement agencies, and other parties. The county or 447 counties, in collaboration with the managing entity, shall 448 document the designated receiving system through written 449 memoranda of agreement or other binding arrangements. The county 450 or counties and the managing entity shall complete the plan and 451 implement the designated receiving system by July 1, 2017, and 452 the county or counties and the managing entity shall review and 453 update, as necessary, the designated receiving system at least 454 once every 3 years. 455 2. To the extent permitted by available resources, the 456 designated receiving system shall function as a no-wrong-door 457 model. The designated receiving system may be organized in any 458 manner which functions as a no-wrong-door model that responds to 459 individual needs and integrates services among various 460 providers. Such models include, but are not limited to: 461 a. A central receiving system that consists of a designated 462 central receiving facility that serves as a single entry point 463 for persons with mental health or substance use disorders, or 464 co-occurring disorders. The central receiving facility shall be 465 capable of assessment, evaluation, and triage or treatment or 466 stabilization of persons with mental health or substance use 467 disorders, or co-occurring disorders. 468 b. A coordinated receiving system that consists of multiple 469 entry points that are linked by shared data systems, formal 470 referral agreements, and cooperative arrangements for care 471 coordination and case management. Each entry point shall be a 472 designated receiving facility and shall, within existing 473 resources, provide or arrange for necessary services following 474 an initial assessment and evaluation. 475 c. A tiered receiving system that consists of multiple 476 entry points, some of which offer only specialized or limited 477 services. Each service provider shall be classified according to 478 its capabilities as either a designated receiving facility or 479 another type of service provider, such as a triage center, a 480 licensed detoxification facility, or an access center. All 481 participating service providers shall, within existing 482 resources, be linked by methods to share data, formal referral 483 agreements, and cooperative arrangements for care coordination 484 and case management. 485 486 An accurate inventory of the participating service providers 487 which specifies the capabilities and limitations of each 488 provider and its ability to accept patients under the designated 489 receiving system agreements and the transportation plan 490 developed pursuant to this section shall be maintained and made 491 available at all times to all first responders in the service 492 area. 493 (c) Transportation in accordance with a plan developed 494 under s. 394.462. 495 (d) Crisis services, including mobile response teams, 496 crisis stabilization units, addiction receiving facilities, and 497 detoxification facilities. 498 (e) Case management. Each case manager or person directly 499 supervising a case manager who provides Medicaid-funded targeted 500 case management services shall hold a valid certification from a 501 department-approved credentialing entity as defined in s. 502 397.311(9) by July 1, 2017, and, thereafter, within 6 months 503 after hire. 504 (f) Care coordination that involves coordination with other 505 local systems and entities, public and private, which are 506 involved with the individual, such as primary care, child 507 welfare, behavioral health care, and criminal and juvenile 508 justice organizations. 509 (g) Outpatient services. 510 (h) Residential services. 511 (i) Hospital inpatient care. 512 (j) Aftercare and other post-discharge services. 513 (k) Medication-assisted treatment and medication 514 management. 515 (l) Recovery support, including, but not limited to, 516 support for competitive employment, educational attainment, 517 independent living skills development, family support and 518 education, wellness management and self-care, and assistance in 519 obtaining housing that meets the individual’s needs. Such 520 housing may include mental health residential treatment 521 facilities, limited mental health assisted living facilities, 522 adult family care homes, and supportive housing. Housing 523 provided using state funds must provide a safe and decent 524 environment free from abuse and neglect. 525 (m) Care plans shall assign specific responsibility for 526 initial and ongoing evaluation of the supervision and support 527 needs of the individual and the identification of housing that 528 meets such needs. For purposes of this paragraph, the term 529 “supervision” means oversight of and assistance with compliance 530 with the clinical aspects of an individual’s care plan. 531 (3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific 532 appropriation by the Legislature, the department may award 533 system improvement grants to managing entities based on a 534 detailed plan to enhance services in accordance with the no 535 wrong-door model as defined in subsection (1) and to address 536 specific needs identified in the assessment prepared by the 537 department pursuant to this section. Such a grant must be 538 awarded through a performance-based contract that links payments 539 to the documented and measurable achievement of system 540 improvements.The department is directed to implement a541continuity of care management system for the provision of mental542health care, through the provision of client and case543management, including clients referred from state treatment544facilities to community mental health facilities. Such system545shall include a network of client managers and case managers546throughout the state designed to:547(a)Reduce the possibility of a client’s admission or548readmission to a state treatment facility.549(b)Provide for the creation or designation of an agency in550each county to provide single intake services for each person551seeking mental health services. Such agency shall provide552information and referral services necessary to ensure that553clients receive the most appropriate and least restrictive form554of care, based on the individual needs of the person seeking555treatment. Such agency shall have a single telephone number,556operating 24 hours per day, 7 days per week, where practicable,557at a central location, where each client will have a central558record.559(c)Advocate on behalf of the client to ensure that all560appropriate services are afforded to the client in a timely and561dignified manner.562(d)Require that any public receiving facility initiating a563patient transfer to a licensed hospital for acute care mental564health services not accessible through the public receiving565facility shall notify the hospital of such transfer and send all566records relating to the emergency psychiatric or medical567condition.568(3)The department is directed to develop and include in569contracts with service providers measures of performance with570regard to goals and objectives as specified in the state plan.571Such measures shall use, to the extent practical, existing data572collection methods and reports and shall not require, as a573result of this subsection, additional reports on the part of574service providers. The department shall plan monitoring visits575of community mental health facilities with other state, federal,576and local governmental and private agencies charged with577monitoring such facilities.578 Section 6. Section 394.461, Florida Statutes, is amended to 579 read: 580 394.461 Designation of receiving and treatment facilities 581 and receiving systems.—The department is authorized to designate 582 and monitor receiving facilities,andtreatment facilities, and 583 receiving systems and may suspend or withdraw such designation 584 for failure to comply with this part and rules adopted under 585 this part. Unless designated by the department, facilities are 586 not permitted to hold or treat involuntary patients under this 587 part. 588 (1) RECEIVING FACILITY.—The department may designate any 589 community facility as a receiving facility. Any other facility 590 within the state, including a private facility or a federal 591 facility, may be so designated by the department, provided that 592 such designation is agreed to by the governing body or authority 593 of the facility. 594 (2) TREATMENT FACILITY.—The department may designate any 595 state-owned, state-operated, or state-supported facility as a 596 state treatment facility. A civil patient shall not be admitted 597 to a state treatment facility without previously undergoing a 598 transfer evaluation. Before a court hearing for involuntary 599 placement in a state treatment facility, the court shall receive 600 and consider the information documented in the transfer 601 evaluation. Any other facility, including a private facility or 602 a federal facility, may be designated as a treatment facility by 603 the department, provided that such designation is agreed to by 604 the appropriate governing body or authority of the facility. 605 (3) PRIVATE FACILITIES.—Private facilities designated as 606 receiving and treatment facilities by the department may provide 607 examination and treatment of involuntary patients, as well as 608 voluntary patients, and are subject to all the provisions of 609 this part. 610 (4) REPORTING REQUIREMENTS.— 611 (a) A facility designated as a public receiving or 612 treatment facility under this section shall report to the 613 department on an annual basis the following data, unless these 614 data are currently being submitted to the Agency for Health Care 615 Administration: 616 1. Number of licensed beds. 617 2. Number of contract days. 618 3. Number of admissions by payor class and diagnoses. 619 4. Number of bed days by payor class. 620 5. Average length of stay by payor class. 621 6. Total revenues by payor class. 622 (b) For the purposes of this subsection, “payor class” 623 means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private 624 pay health insurance, private-pay health maintenance 625 organization, private preferred provider organization, the 626 Department of Children and Families, other government programs, 627 self-pay patients, and charity care. 628 (c) The data required under this subsection shall be 629 submitted to the department no later than 90 days following the 630 end of the facility’s fiscal year. A facility designated as a 631 public receiving or treatment facility shall submit its initial 632 report for the 6-month period ending June 30, 2008. 633 (d) The department shall issue an annual report based on 634 the data required pursuant to this subsection. The report shall 635 include individual facilities’ data, as well as statewide 636 totals. The report shall be submitted to the Governor, the 637 President of the Senate, and the Speaker of the House of 638 Representatives. 639 (5) RECEIVING SYSTEM.—The department shall designate as a 640 receiving system one or more facilities serving a defined 641 geographic area developed pursuant to s. 394.4573 which is 642 responsible for assessment and evaluation, both voluntary and 643 involuntary, and treatment, stabilization, or triage for 644 patients who have a mental illness, a substance use disorder, or 645 co-occurring disorders. Any transportation plans developed 646 pursuant to s. 394.462 must support the operation of the 647 receiving system. 648 (6)(5)RULES.—The department mayshalladopt rules relating 649 to: 650 (a) Procedures and criteria for receiving and evaluating 651 facility applications for designation, which may include onsite 652 facility inspection and evaluation of an applicant’s licensing 653 status and performance history, as well as consideration of 654 local service needs. 655 (b) Minimum standards consistent with this part that a 656 facility must meet and maintain in order to be designated as a 657 receiving or treatment facility and procedures for monitoring 658 continued adherence to such standards. 659 (c) Procedures and criteria for designating receiving 660 systems which may include consideration of the adequacy of 661 services provided by facilities within the receiving system to 662 meet the needs of the geographic area using available resources. 663 (d)(c)Procedures for receiving complaints against a 664 designated facility or designated receiving system and for 665 initiating inspections and investigations of facilities or 666 receiving systems alleged to have violated the provisions of 667 this part or rules adopted under this part. 668 (e)(d)Procedures and criteria for the suspension or 669 withdrawal of designation as a receiving facility or receiving 670 system. 671 Section 7. Section 394.675, Florida Statutes, is repealed. 672 Section 8. Subsection (3) and paragraph (b) of subsection 673 (4) of section 394.75, Florida Statutes, are amended to read: 674 394.75 State and district substance abuse and mental health 675 plans.— 676 (3) The district health and human services board shall 677 prepare an integrated district substance abuse and mental health 678 plan. The plan shall be prepared and updated on a schedule 679 established by the Alcohol, Drug Abuse, and Mental Health 680 Program Office. The plan shall reflect the needs and program 681 priorities established by the department and the needs of the 682 district established under ss. 394.4573 and 394.674and 394.675. 683 The plan must list in order of priority the mental health and 684 the substance abuse treatment needs of the district and must 685 rank each program separately. The plan shall include: 686 (a) A record of the total amount of money available in the 687 district for mental health and substance abuse services. 688 (b) A description of each service that will be purchased 689 with state funds. 690 (c) A record of the amount of money allocated for each 691 service identified in the plan as being purchased with state 692 funds. 693 (d) A record of the total funds allocated to each provider. 694 (e) A record of the total funds allocated to each provider 695 by type of service to be purchased with state funds. 696 (f) Input from community-based persons, organizations, and 697 agencies interested in substance abuse and mental health 698 treatment services; local government entities that contribute 699 funds to the public substance abuse and mental health treatment 700 systems; and consumers of publicly funded substance abuse and 701 mental health services, and their family members. The plan must 702 describe the means by which this local input occurred. 703 704 The plan shall be submitted by the district board to the 705 district administrator and to the governing bodies for review, 706 comment, and approval. 707 (4) The district plan shall: 708 (b) Provide the means for meeting the needs of the 709 district’s eligible clients, specified in ss. 394.4573 and 710 394.674and 394.675, for substance abuse and mental health 711 services. 712 Section 9. Paragraph (a) of subsection (3) of section 713 394.76, Florida Statutes, is amended to read: 714 394.76 Financing of district programs and services.—If the 715 local match funding level is not provided in the General 716 Appropriations Act or the substantive bill implementing the 717 General Appropriations Act, such funding level shall be provided 718 as follows: 719 (3) The state share of financial participation shall be 720 determined by the following formula: 721 (a) The state share of approved program costs shall be a 722 percentage of the net balance determined by deducting from the 723 total operating cost of services and programs, as specified in 724 s. 394.4573394.675(1), those expenditures which are ineligible 725 for state participation as provided in subsection (7) and those 726 ineligible expenditures established by rule of the department 727 pursuant to s. 394.78. 728 Section 10. Paragraphs (d) and (e) of subsection (2) of 729 section 394.4597, Florida Statutes, are amended to read: 730 394.4597 Persons to be notified; patient’s representative.— 731 (2) INVOLUNTARY PATIENTS.— 732 (d) When the receiving or treatment facility selects a 733 representative, first preference shall be given to a health care 734 surrogate, if one has been previously selected by the patient. 735 If the patient has not previously selected a health care 736 surrogate, the selection, except for good cause documented in 737 the patient’s clinical record, shall be made from the following 738 list in the order of listing: 739 1. The patient’s spouse. 740 2. An adult child of the patient. 741 3. A parent of the patient. 742 4. The adult next of kin of the patient. 743 5. An adult friend of the patient. 7446.The appropriate Florida local advocacy council as745provided in s. 402.166.746 (e) The following persons are prohibited from selection as 747 a patient’s representative: 748 1. A professional providing clinical services to the 749 patient under this part. 750 2. The licensed professional who initiated the involuntary 751 examination of the patient, if the examination was initiated by 752 professional certificate. 753 3. An employee, an administrator, or a board member of the 754 facility providing the examination of the patient. 755 4. An employee, an administrator, or a board member of a 756 treatment facility providing treatment for the patient. 757 5. A person providing any substantial professional services 758 to the patient, including clinical services. 759 6. A creditor of the patient. 760 7. A person subject to an injunction for protection against 761 domestic violence under s. 741.30, whether the order of 762 injunction is temporary or final, and for which the patient was 763 the petitioner. 764 8. A person subject to an injunction for protection against 765 repeat violence, stalking, sexual violence, or dating violence 766 under s. 784.046, whether the order of injunction is temporary 767 or final, and for which the patient was the petitionerA768licensed professional providing services to the patient under769this part, an employee of a facility providing direct services770to the patient under this part, a department employee, a person771providing other substantial services to the patient in a772professional or business capacity, or a creditor of the patient773shall not be appointed as the patient’s representative. 774 Section 11. Subsections (2) through (7) of section 775 394.4598, Florida Statutes, are renumbered as subsections (3) 776 through (8), respectively, a new subsection (2) is added to that 777 section, and present subsections (3) and (4) of that section are 778 amended, to read: 779 394.4598 Guardian advocate.— 780 (2) The following persons are prohibited from appointment 781 as a patient’s guardian advocate: 782 (a) A professional providing clinical services to the 783 patient under this part. 784 (b) The licensed professional who initiated the involuntary 785 examination of the patient, if the examination was initiated by 786 professional certificate. 787 (c) An employee, an administrator, or a board member of the 788 facility providing the examination of the patient. 789 (d) An employee, an administrator, or a board member of a 790 treatment facility providing treatment of the patient. 791 (e) A person providing any substantial professional 792 services, excluding public and professional guardians, to the 793 patient, including clinical services. 794 (f) A creditor of the patient. 795 (g) A person subject to an injunction for protection 796 against domestic violence under s. 741.30, whether the order of 797 injunction is temporary or final, and for which the patient was 798 the petitioner. 799 (h) A person subject to an injunction for protection 800 against repeat violence, stalking, sexual violence, or dating 801 violence under s. 784.046, whether the order of injunction is 802 temporary or final, and for which the patient was the 803 petitioner. 804 (4)(3)In lieu of the training required of guardians 805 appointed pursuant to chapter 744,Prior toa guardian advocate 806 must, at a minimum, participate in a 4-hour training course 807 approved by the court before exercising his or her authority,808the guardian advocate shall attend a training course approved by809the court. At a minimum, this training course, of not less than8104 hours,must include, at minimum,information aboutthepatient 811 rights, psychotropic medications, the diagnosis of mental 812 illness, the ethics of medical decisionmaking, and duties of 813 guardian advocates.This training course shall take the place of814the training required for guardians appointed pursuant to815chapter 744.816 (5)(4)The required training course and the information to 817 be supplied to prospective guardian advocates beforeprior to818 their appointmentand the training course for guardian advocates819 must be developedand completed through a course developedby 820 the department,andapproved by the chief judge of the circuit 821 court, and taught by a court-approved organization, which.822Court-approved organizationsmay include, but isarenot limited 823 to, a community collegecommunity or junior colleges, a 824 guardianship organizationguardianship organizations, aand the825 local bar association, or The Florida Bar. The training course 826 may be web-based, provided in video format, or other electronic 827 means but must be capable of ensuring the identity and 828 participation of the prospective guardian advocate. The court 829 may, in its discretion,waive some or all of the training 830 requirements for guardian advocates or impose additional 831 requirements. The court shall make its decision on a case-by 832 case basis and, in making its decision, shall consider the 833 experience and education of the guardian advocate, the duties 834 assigned to the guardian advocate, and the needs of the patient. 835 Section 12. Section 394.462, Florida Statutes, is amended 836 to read: 837 394.462 Transportation.—A transportation plan shall be 838 developed and implemented by each county by July 1, 2017, in 839 collaboration with the managing entity in accordance with this 840 section. A county may enter into a memorandum of understanding 841 with the governing boards of nearby counties to establish a 842 shared transportation plan. When multiple counties enter into a 843 memorandum of understanding for this purpose, the counties shall 844 notify the managing entity and provide it with a copy of the 845 agreement. The transportation plan shall describe methods of 846 transport to a facility within the designated receiving system 847 for individuals subject to involuntary examination under s. 848 394.463 or involuntary admission under s. 397.6772, s. 397.679, 849 s. 397.6798, or s. 397.6811, and may identify responsibility for 850 other transportation to a participating facility when necessary 851 and agreed to by the facility. The plan may rely on emergency 852 medical transport services or private transport companies, as 853 appropriate. The plan shall comply with the transportation 854 provisions of this section and ss. 397.6772, 397.6795, 397.6822, 855 and 397.697. 856 (1) TRANSPORTATION TO A RECEIVING FACILITY.— 857 (a) Each county shall designate a single law enforcement 858 agency within the county, or portions thereof, to take a person 859 into custody upon the entry of an ex parte order or the 860 execution of a certificate for involuntary examination by an 861 authorized professional and to transport that person to the 862 appropriate facility within the designated receiving system 863 pursuant to a transportation plan or an exception under 864 subsection (4), or to the nearest receiving facility if neither 865 applyfor examination. 866 (b)1. The designated law enforcement agency may decline to 867 transport the person to a receiving facility only if: 868 a.1.The jurisdiction designated by the county has 869 contracted on an annual basis with an emergency medical 870 transport service or private transport company for 871 transportation of persons to receiving facilities pursuant to 872 this section at the sole cost of the county; and 873 b.2.The law enforcement agency and the emergency medical 874 transport service or private transport company agree that the 875 continued presence of law enforcement personnel is not necessary 876 for the safety of the person or others. 877 2.3.The entity providing transportationjurisdiction878designated by the countymay seek reimbursement for 879 transportation expenses. The party responsible for payment for 880 such transportation is the person receiving the transportation. 881 The county shall seek reimbursement from the following sources 882 in the following order: 883 a. From a private or public third-party payoran insurance884company, health care corporation, or other source, if the person 885 receiving the transportation has applicable coverageis covered886by an insurance policy or subscribes to a health care887corporation or other source for payment of such expenses. 888 b. From the person receiving the transportation. 889 c. From a financial settlement for medical care, treatment, 890 hospitalization, or transportation payable or accruing to the 891 injured party. 892 (c)(b)AAnycompany that transports a patient pursuant to 893 this subsection is considered an independent contractor and is 894 solely liable for the safe and dignified transport 895transportationof the patient. Such company must be insured and 896 provide no less than $100,000 in liability insurance with 897 respect to the transporttransportationof patients. 898 (d)(c)Any company that contracts with a governing board of 899 a county to transport patients shall comply with the applicable 900 rules of the department to ensure the safety and dignity ofthe901 patients. 902 (e)(d)When a law enforcement officer takes custody of a 903 person pursuant to this part, the officer may request assistance 904 from emergency medical personnel if such assistance is needed 905 for the safety of the officer or the person in custody. 906 (f)(e)When a member of a mental health overlay program or 907 a mobile crisis response service is a professional authorized to 908 initiate an involuntary examination pursuant to s. 394.463 or s. 909 397.675 and that professional evaluates a person and determines 910 that transportation to a receiving facility is needed, the 911 service, at its discretion, may transport the person to the 912 facility or may call on the law enforcement agency or other 913 transportation arrangement best suited to the needs of the 914 patient. 915 (g)(f)When any law enforcement officer has custody of a 916 person based on either noncriminal or minor criminal behavior 917 that meets the statutory guidelines for involuntary examination 918 pursuant to s. 394.463under this part, the law enforcement 919 officer shall transport the person to the appropriate facility 920 within the designated receiving system pursuant to a 921 transportation plan or an exception under subsection (4), or to 922 the nearest receiving facility if neither applyfor examination. 923 Persons who meet the statutory guidelines for involuntary 924 admission pursuant to s. 397.675 may also be transported by law 925 enforcement officers to the extent resources are available and 926 as otherwise provided by law. Such persons shall be transported 927 to an appropriate facility within the designated receiving 928 system pursuant to a transportation plan or an exception under 929 subsection (4), or to the nearest facility if neither apply. 930 (h)(g)When any law enforcement officer has arrested a 931 person for a felony and it appears that the person meets the 932 statutory guidelines for involuntary examination or placement 933 under this part, such person mustshallfirst be processed in 934 the same manner as any other criminal suspect. The law 935 enforcement agency shall thereafter immediately notify the 936 appropriate facility within the designated receiving system 937 pursuant to a transportation plan or an exception under 938 subsection (4), or to the nearestpublicreceiving facility if 939 neither apply. The receiving facility,whichshall be 940 responsible for promptly arranging for the examination and 941 treatment of the person. A receiving facility is not required to 942 admit a person charged with a crime for whom the facility 943 determines and documents that it is unable to provide adequate 944 security, but shall providemental healthexamination and 945 treatment to the person where he or she is held. 946 (i)(h)If the appropriate law enforcement officer believes 947 that a person has an emergency medical condition as defined in 948 s. 395.002, the person may be first transported to a hospital 949 for emergency medical treatment, regardless of whether the 950 hospital is a designated receiving facility. 951 (j)(i)The costs of transportation, evaluation, 952 hospitalization, and treatment incurred under this subsection by 953 persons who have been arrested for violations of any state law 954 or county or municipal ordinance may be recovered as provided in 955 s. 901.35. 956 (k)(j)The appropriate facility within the designated 957 receiving system pursuant to a transportation plan or an 958 exception under subsection (4), or the nearest receiving 959 facility if neither apply, must accept persons brought by law 960 enforcement officers, or an emergency medical transport service 961 or a private transport company authorized by the county, for 962 involuntary examination pursuant to s. 394.463. 963 (l) The appropriate facility within the designated 964 receiving system pursuant to a transportation plan or an 965 exception under subsection (4), or the nearest receiving 966 facility if neither apply, must provide persons brought by law 967 enforcement officers, or an emergency medical transport service 968 or a private transport company authorized by the county, 969 pursuant to s. 397.675, a basic screening or triage sufficient 970 to refer the person to the appropriate services. 971 (m)(k)Each law enforcement agency designated pursuant to 972 paragraph (a) shall establish a policy thatdevelop a memorandum973of understanding with each receiving facility within the law974enforcement agency’s jurisdiction whichreflects a single set of 975 protocols for the safe and secure transportationof the person976 and transfer of custody of the person. Each law enforcement 977 agency shall provide a copy of the protocols to the managing 978 entity.These protocols must also address crisis intervention979measures.980 (n)(l)When a jurisdiction has entered into a contract with 981 an emergency medical transport service or a private transport 982 company for transportation of persons toreceivingfacilities 983 within the designated receiving system, such service or company 984 shall be given preference for transportation of persons from 985 nursing homes, assisted living facilities, adult day care 986 centers, or adult family-care homes, unless the behavior of the 987 person being transported is such that transportation by a law 988 enforcement officer is necessary. 989 (o)(m)Nothing inThis section may notshallbe construed 990 to limit emergency examination and treatment of incapacitated 991 persons provided in accordance withthe provisions ofs. 992 401.445. 993 (2) TRANSPORTATION TO A TREATMENT FACILITY.— 994 (a) If neither the patient nor any person legally obligated 995 or responsible for the patient is able to pay for the expense of 996 transporting a voluntary or involuntary patient to a treatment 997 facility, the transportation plan established by the governing 998 board of the county or counties must specify howin whichthe 999 hospitalized patient will be transported to, from, and between 1000 facilities in ais hospitalized shall arrange for such required1001transportation and shall ensure thesafe and dignified manner 1002transportation of the patient.The governing board of each1003county is authorized to contract with private transport1004companies for the transportation of such patients to and from a1005treatment facility.1006 (b) AAnycompany that transports a patient pursuant to 1007 this subsection is considered an independent contractor and is 1008 solely liable for the safe and dignified transportation of the 1009 patient. Such company must be insured and provide no less than 1010 $100,000 in liability insurance with respect to the transport 1011transportationof patients. 1012 (c) AAnycompany that contracts with one or more counties 1013the governing board of a countyto transport patients in 1014 accordance with this section shall comply with the applicable 1015 rules of the department to ensure the safety and dignity ofthe1016 patients. 1017 (d) County or municipal law enforcement and correctional 1018 personnel and equipment mayshallnot be used to transport 1019 patients adjudicated incapacitated or found by the court to meet 1020 the criteria for involuntary placement pursuant to s. 394.467, 1021 except in small rural counties where there are no cost-efficient 1022 alternatives. 1023 (3) TRANSFER OF CUSTODY.—Custody of a person who is 1024 transported pursuant to this part, along with related 1025 documentation, shall be relinquished to a responsible individual 1026 at the appropriate receiving or treatment facility. 1027 (4) EXCEPTIONS.—An exception to the requirements of this 1028 section may be granted by the secretary of the department for 1029 the purposes of improving service coordination or better meeting 1030 the special needs of individuals. A proposal for an exception 1031 must be submitted to the departmentby the district1032administratorafter being approved by the governing boards of 1033 any affected counties,prior to submission to the secretary. 1034 (a) A proposal for an exception must identify the specific 1035 provision from which an exception is requested; describe how the 1036 proposal will be implemented by participating law enforcement 1037 agencies and transportation authorities; and provide a plan for 1038 the coordination of servicessuch as case management. 1039 (b) The exception may be granted only for: 1040 1. An arrangement centralizing and improving the provision 1041 of services within a district, which may include an exception to 1042 the requirement for transportation to the nearest receiving 1043 facility; 1044 2. An arrangement by which a facility may provide, in 1045 addition to required psychiatric or substance use disorder 1046 services, an environment and services which are uniquely 1047 tailored to the needs of an identified group of persons with 1048 special needs, such as persons with hearing impairments or 1049 visual impairments, or elderly persons with physical frailties; 1050 or 1051 3. A specialized transportation system that provides an 1052 efficient and humane method of transporting patients to 1053 receiving facilities, among receiving facilities, and to 1054 treatment facilities. 1055(c)Any exception approved pursuant to this subsection1056shall be reviewed and approved every 5 years by the secretary.1057 1058 The exceptions provided in this subsection shall expire on June 1059 30, 2017, and no new exceptions shall be granted after that 1060 date. After June 30, 2017, the transport of a patient to a 1061 facility that is not the nearest facility must be made pursuant 1062 to a plan as provided in this section. 1063 Section 13. Section 394.467, Florida Statutes, is amended 1064 to read: 1065 394.467 Involuntary inpatient placement.— 1066 (1) CRITERIA.—A person may be ordered forplaced in1067 involuntary inpatient placement for treatment upon a finding of 1068 the court by clear and convincing evidence that: 1069 (a) He or she has a mental illnessis mentally illand 1070 because of his or her mental illness: 1071 1.a. He or she has refused voluntary inpatient placement 1072 for treatment after sufficient and conscientious explanation and 1073 disclosure of the purpose of inpatient placement for treatment; 1074 or 1075 b. He or she is unable to determine for himself or herself 1076 whether inpatient placement is necessary; and 1077 2.a. He or she ismanifestlyincapable of surviving alone 1078 or with the help of willing and responsible family or friends, 1079 including available alternative services, and, without 1080 treatment, is likely to suffer from neglect or refuse to care 1081 for himself or herself, and such neglect or refusal poses a real 1082 and present threat of substantial harm to his or her well-being; 1083 or 1084 b. There is substantial likelihood that in the near future 1085 he or she will inflict serious bodily harm on self or others 1086himself or herself or another person, as evidenced by recent 1087 behavior causing, attempting, or threatening such harm; and 1088 (b) All available less restrictive treatment alternatives 1089 thatwhichwould offer an opportunity for improvement of his or 1090 her condition have been judged to be inappropriate. 1091 (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be 1092 retained by areceivingfacility or involuntarily placed in a 1093 treatment facility upon the recommendation of the administrator 1094 of thereceivingfacility where the patient has been examined 1095 and after adherence to the notice and hearing procedures 1096 provided in s. 394.4599. The recommendation must be supported by 1097 the opinion of a psychiatrist and the second opinion of a 1098 clinical psychologist or another psychiatrist, both of whom have 1099 personally examined the patient within the preceding 72 hours, 1100 that the criteria for involuntary inpatient placement are met. 1101 However, in a county that has a population of fewer than 50,000, 1102 if the administrator certifies that a psychiatrist or clinical 1103 psychologist is not available to provide the second opinion, the 1104 second opinion may be provided by a licensed physician who has 1105 postgraduate training and experience in diagnosis and treatment 1106 of mental illnessand nervousdisordersor by a psychiatric 1107 nurse. Any second opinion authorized in this subsection may be 1108 conducted through a face-to-face examination, in person, or by 1109 electronic means. Such recommendation shall be entered on a 1110 petition foraninvoluntary inpatient placement certificate that 1111 authorizes thereceivingfacility to retain the patient pending 1112 transfer to a treatment facility or completion of a hearing. 1113 (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.—The 1114 administrator of the facility shall file a petition for 1115 involuntary inpatient placement in the court in the county where 1116 the patient is located. Upon filing, the clerk of the court 1117 shall provide copies to the department, the patient, the 1118 patient’s guardian or representative, and the state attorney and 1119 public defender of the judicial circuit in which the patient is 1120 located. ANofee may notshallbe charged for the filing of a 1121 petition under this subsection. 1122 (4) APPOINTMENT OF COUNSEL.—Within 1 court working day 1123 after the filing of a petition for involuntary inpatient 1124 placement, the court shall appoint the public defender to 1125 represent the person who is the subject of the petition, unless 1126 the person is otherwise represented by counsel. The clerk of the 1127 court shall immediately notify the public defender of such 1128 appointment. Any attorney representing the patient shall have 1129 access to the patient, witnesses, and records relevant to the 1130 presentation of the patient’s case and shall represent the 1131 interests of the patient, regardless of the source of payment to 1132 the attorney. 1133 (5) CONTINUANCE OF HEARING.—The patient is entitled, with 1134 the concurrence of the patient’s counsel, to at least one 1135 continuance of the hearing. The continuance shall befora1136period ofup to 4 weeks. 1137 (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.— 1138 (a)1. The court shall hold the hearing on involuntary 1139 inpatient placement within 5 court working days, unless a 1140 continuance is granted. 1141 2. Except for good cause documented in the court file, the 1142 hearing mustshallbe held in the county or the facility, as 1143 appropriate, where the patient is located, mustand shallbe as 1144 convenient to the patient as ismay beconsistent with orderly 1145 procedure, and shall be conducted in physical settings not 1146 likely to be injurious to the patient’s condition. If the court 1147 finds that the patient’s attendance at the hearing is not 1148 consistent with the best interests of the patient, and the 1149 patient’s counsel does not object, the court may waive the 1150 presence of the patient from all or any portion of the hearing. 1151 The state attorney for the circuit in which the patient is 1152 located shall represent the state, rather than the petitioning 1153 facility administrator, as the real party in interest in the 1154 proceeding. 1155 3.2.The court may appoint ageneral or specialmagistrate 1156 to preside at the hearing. One of the professionals who executed 1157 the petition for involuntary inpatient placement certificate 1158 shall be a witness. The patient and the patient’s guardian or 1159 representative shall be informed by the court of the right to an 1160 independent expert examination. If the patient cannot afford 1161 such an examination, the court shall ensure that one is 1162 provided, as otherwise provided for by lawprovide for one. The 1163 independent expert’s report isshall beconfidential and not 1164 discoverable, unless the expert is to be called as a witness for 1165 the patient at the hearing. The testimony in the hearing must be 1166 given under oath, and the proceedings must be recorded. The 1167 patient may refuse to testify at the hearing. 1168 (b) If the court concludes that the patient meets the 1169 criteria for involuntary inpatient placement, it mayshallorder 1170 that the patient be transferred to a treatment facility or, if 1171 the patient is at a treatment facility, that the patient be 1172 retained there or be treated at any other appropriatereceiving1173or treatmentfacility, or that the patient receive servicesfrom1174a receiving or treatment facility, on an involuntary basis, for 1175a period ofup to 90 days6 months. However, any order for 1176 involuntary mental health services in a treatment facility may 1177 be for up to 6 months. The order shall specify the nature and 1178 extent of the patient’s mental illness. The court may not order 1179 an individual with traumatic brain injury or dementia who lacks 1180 a co-occurring mental illness to be involuntarily placed in a 1181 state treatment facility. The facility shall discharge a patient 1182 any time the patient no longer meets the criteria for 1183 involuntary inpatient placement, unless the patient has 1184 transferred to voluntary status. 1185 (c) If at any time beforeprior tothe conclusion of the 1186 hearing on involuntary inpatient placement it appears to the 1187 court that the person does not meet the criteria for involuntary 1188 inpatient placement under this section, but instead meets the 1189 criteria for involuntary outpatient servicesplacement, the 1190 court may order the person evaluated for involuntary outpatient 1191 servicesplacementpursuant to s. 394.4655. The petition and 1192 hearing procedures set forth in s. 394.4655 shall apply. If the 1193 person instead meets the criteria for involuntary assessment, 1194 protective custody, or involuntary admission pursuant to s. 1195 397.675, then the court may order the person to be admitted for 1196 involuntary assessment for a period of 5 days pursuant to s. 1197 397.6811. Thereafter, all proceedings areshall begoverned by 1198 chapter 397. 1199 (d) At the hearing on involuntary inpatient placement, the 1200 court shall consider testimony and evidence regarding the 1201 patient’s competence to consent to treatment. If the court finds 1202 that the patient is incompetent to consent to treatment, it 1203 shall appoint a guardian advocate as provided in s. 394.4598. 1204 (e) The administrator of the petitioningreceivingfacility 1205 shall provide a copy of the court order and adequate 1206 documentation of a patient’s mental illness to the administrator 1207 of a treatment facility if thewhenever apatient is ordered for 1208 involuntary inpatient placement, whether by civil or criminal 1209 court. The documentation mustshallinclude any advance 1210 directives made by the patient, a psychiatric evaluation of the 1211 patient, and any evaluations of the patient performed by a 1212 psychiatric nurse, a clinical psychologist, a marriage and 1213 family therapist, a mental health counselor, or a clinical 1214 social worker. The administrator of a treatment facility may 1215 refuse admission to any patient directed to its facilities on an 1216 involuntary basis, whether by civil or criminal court order, who 1217 is not accompaniedat the same timeby adequate orders and 1218 documentation. 1219 (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT 1220 PLACEMENT.— 1221 (a) Hearings on petitions for continued involuntary 1222 inpatient placement of an individual placed at any treatment 1223 facility areshall beadministrative hearings and mustshallbe 1224 conducted in accordance withthe provisions ofs. 120.57(1), 1225 except that any order entered by the administrative law judge is 1226shall befinal and subject to judicial review in accordance with 1227 s. 120.68. Orders concerning patients committed after 1228 successfully pleading not guilty by reason of insanity areshall1229begoverned bythe provisions ofs. 916.15. 1230 (b) If the patient continues to meet the criteria for 1231 involuntary inpatient placement and is being treated at a 1232 treatment facility, the administrator shall, beforeprior tothe 1233 expiration of the periodduring whichthe treatment facility is 1234 authorized to retain the patient, file a petition requesting 1235 authorization for continued involuntary inpatient placement. The 1236 request mustshallbe accompanied by a statement from the 1237 patient’s physician, psychiatrist, psychiatric nurse, or 1238 clinical psychologist justifying the request, a brief 1239 description of the patient’s treatment during the time he or she 1240 was involuntarily placed, and an individualized plan of 1241 continued treatment. Notice of the hearing mustshallbe 1242 provided as providedset forthin s. 394.4599. If a patient’s 1243 attendance at the hearing is voluntarily waived, the 1244 administrative law judge must determine that the waiver is 1245 knowing and voluntary before waiving the presence of the patient 1246 from all or a portion of the hearing. Alternatively, if at the 1247 hearing the administrative law judge finds that attendance at 1248 the hearing is not consistent with the best interests of the 1249 patient, the administrative law judge may waive the presence of 1250 the patient from all or any portion of the hearing, unless the 1251 patient, through counsel, objects to the waiver of presence. The 1252 testimony in the hearing must be under oath, and the proceedings 1253 must be recorded. 1254 (c) Unless the patient is otherwise represented or is 1255 ineligible, he or she shall be represented at the hearing on the 1256 petition for continued involuntary inpatient placement by the 1257 public defender of the circuit in which the facility is located. 1258 (d) If at a hearing it is shown that the patient continues 1259 to meet the criteria for involuntary inpatient placement, the 1260 administrative law judge shall sign the order for continued 1261 involuntary inpatient placement for up to 90 daysa periodnot1262to exceed 6 months. However, any order for involuntary mental 1263 health services in a treatment facility may be for up to 6 1264 months. The same procedure shall be repeated beforeprior tothe 1265 expiration of each additional period the patient is retained. 1266 (e) If continued involuntary inpatient placement is 1267 necessary for a patient admitted while serving a criminal 1268 sentence, but his or herwhosesentence is about to expire, or 1269 for a minorpatientinvoluntarily placed,while a minorbut who 1270 is about to reach the age of 18, the administrator shall 1271 petition the administrative law judge for an order authorizing 1272 continued involuntary inpatient placement. 1273 (f) If the patient has been previously found incompetent to 1274 consent to treatment, the administrative law judge shall 1275 consider testimony and evidence regarding the patient’s 1276 competence. If the administrative law judge finds evidence that 1277 the patient is now competent to consent to treatment, the 1278 administrative law judge may issue a recommended order to the 1279 court that found the patient incompetent to consent to treatment 1280 that the patient’s competence be restored and that any guardian 1281 advocate previously appointed be discharged. 1282 (g) If the patient has been ordered to undergo involuntary 1283 inpatient placement and has previously been found incompetent to 1284 consent to treatment, the court shall consider testimony and 1285 evidence regarding the patient’s incompetence. If the patient’s 1286 competency to consent to treatment is restored, the discharge of 1287 the guardian advocate shall be governed by s. 394.4598. 1288 1289 The procedure required in this subsection must be followed 1290 before the expiration of each additional period the patient is 1291 involuntarily receiving services. 1292 (8) RETURN TO FACILITYOF PATIENTS.—If a patient 1293 involuntarily heldWhen a patientat a treatment facility under 1294 this part leaves the facility without the administrator’s 1295 authorization, the administrator may authorize a search for the 1296 patient and his or herthereturnof the patientto the 1297 facility. The administrator may request the assistance of a law 1298 enforcement agency in this regardthe search for and return of1299the patient. 1300 Section 14. Section 394.46715, Florida Statutes, is amended 1301 to read: 1302 394.46715 Rulemaking authority.—The department may adopt 1303 rules to administer this partDepartment of Children and1304Families shall have rulemaking authority to implement the1305provisions of ss. 394.455, 394.4598, 394.4615, 394.463,1306394.4655, and 394.467 as amended or created by this act. These1307rules shall be for the purpose of protecting the health, safety,1308and well-being of persons examined, treated, or placed under1309this act. 1310 Section 15. Subsection (2) of section 394.4685, Florida 1311 Statutes, is amended to read: 1312 394.4685 Transfer of patients among facilities.— 1313 (2) TRANSFER FROM PUBLIC TO PRIVATE FACILITIES.— 1314 (a) A patient who has been admitted to a public receiving 1315 or public treatment facility and has requested, either 1316 personally or through his or her guardian or guardian advocate, 1317 and is able to pay for treatment in a private facility shall be 1318 transferred at the patient’s expense to a private facility upon 1319 acceptance of the patient by the private facility. 1320 (b) A public receiving facility initiating a patient 1321 transfer to a licensed hospital for acute care mental health 1322 services not accessible through the public receiving facility 1323 shall notify the hospital of such transfer and send the hospital 1324 all records relating to the emergency psychiatric or medical 1325 condition. 1326 Section 16. Section 394.656, Florida Statutes, is amended 1327 to read: 1328 394.656 Criminal Justice, Mental Health, and Substance 1329 Abuse Reinvestment Grant Program.— 1330 (1) There is created within the Department of Children and 1331 Families the Criminal Justice, Mental Health, and Substance 1332 Abuse Reinvestment Grant Program. The purpose of the program is 1333 to provide funding to countieswithwhich they may use tocan1334 plan, implement, or expand initiatives that increase public 1335 safety, avert increased spending on criminal justice, and 1336 improve the accessibility and effectiveness of treatment 1337 services for adults and juveniles who have a mental illness, 1338 substance abuse disorder, or co-occurring mental health and 1339 substance abuse disorders and who are in, or at risk of 1340 entering, the criminal or juvenile justice systems. 1341 (2) The department shall establish a Criminal Justice, 1342 Mental Health, and Substance Abuse Statewide Grant Review 1343 Committee. The committee shall include: 1344 (a) One representative of the Department of Children and 1345 Families; 1346 (b) One representative of the Department of Corrections; 1347 (c) One representative of the Department of Juvenile 1348 Justice; 1349 (d) One representative of the Department of Elderly 1350 Affairs;and1351 (e) One representative of the Office of the State Courts 1352 Administrator;.1353 (f) One representative of the Department of Veterans’ 1354 Affairs; 1355 (g) One representative of the Florida Sheriffs Association; 1356 (h) One representative of the Florida Police Chiefs 1357 Association; 1358 (i) One representative of the Florida Association of 1359 Counties; 1360 (j) One representative of the Florida Alcohol and Drug 1361 Abuse Association; 1362 (k) One representative of the Florida Association of 1363 Managing Entities; 1364 (l) One representative of the Florida Council for Community 1365 Mental Health; 1366 (m) One representative of the National Alliance of Mental 1367 Illness; 1368 (n) One representative of the Florida Prosecuting Attorneys 1369 Association; 1370 (o) One representative of the Florida Public Defender 1371 Association; and 1372 (p) One administrator of an assisted living facility that 1373 holds a limited mental health license. 1374 (3) The committee shall serve as the advisory body to 1375 review policy and funding issues that help reduce the impact of 1376 persons with mental illness and substance abuse disorders on 1377 communities, criminal justice agencies, and the court system. 1378 The committee shall advise the department in selecting 1379 priorities for grants and investing awarded grant moneys. 1380 (4) The committee must have experience in substance use and 1381 mental health disorders, community corrections, and law 1382 enforcement. To the extent possible, themembers of the1383 committee shall have expertise in grant reviewwriting, grant1384reviewing,and grant application scoring. 1385 (5)(a)(3)(a)A county, or a not-for-profit community 1386 provider or managing entity designated by the county planning 1387 council or committee, as described in s. 394.657, may apply for 1388 a 1-year planning grant or a 3-year implementation or expansion 1389 grant. The purpose of the grants is to demonstrate that 1390 investment in treatment efforts related to mental illness, 1391 substance abuse disorders, or co-occurring mental health and 1392 substance abuse disorders results in a reduced demand on the 1393 resources of the judicial, corrections, juvenile detention, and 1394 health and social services systems. 1395 (b) To be eligible to receive a 1-year planning grant or a 1396 3-year implementation or expansion grant:,1397 1. A county applicant must have acountyplanning council 1398 or committee that is in compliance with the membership 1399 requirements set forth in this section. 1400 2. A not-for-profit community provider or managing entity 1401 must be designated by the county planning council or committee 1402 and have written authorization to submit an application. A not 1403 for-profit community provider or managing entity must have 1404 written authorization for each submitted application. 1405 (c) The department may award a 3-year implementation or 1406 expansion grant to an applicant who has not received a 1-year 1407 planning grant. 1408 (d) The department may require an applicant to conduct 1409 sequential intercept mapping for a project. For purposes of this 1410 paragraph, the term “sequential intercept mapping” means a 1411 process for reviewing a local community’s mental health, 1412 substance abuse, criminal justice, and related systems and 1413 identifying points of interceptions where interventions may be 1414 made to prevent an individual with a substance abuse disorder or 1415 mental illness from deeper involvement in the criminal justice 1416 system. 1417 (6)(4)The grant review and selection committee shall 1418 select the grant recipients and notify the departmentof1419Children and Familiesin writing of the recipients’ namesof the1420applicants who have been selected by the committee to receive a1421grant. Contingent upon the availability of funds and upon 1422 notification by the grant review and selection committee of 1423 those applicants approved to receive planning, implementation, 1424 or expansion grants, the departmentof Children and Familiesmay 1425 transfer funds appropriated for the grant program to a selected 1426 grant recipientto any county awarded a grant. 1427 Section 17. Section 394.761, Florida Statutes, is created 1428 to read: 1429 394.761 Revenue maximization.— 1430 (1) The agency and the department shall develop a plan to 1431 obtain federal approval for increasing the availability of 1432 federal Medicaid funding for behavioral health care. Increased 1433 funding shall be used to advance the goal of improved 1434 integration of behavioral health services and primary care 1435 services for individuals eligible for Medicaid through the 1436 development and effective implementation of the behavioral 1437 health system of care as described in s. 394.4573. 1438 (2) The agency and the department shall identify in the 1439 plan the amount of general revenue funding appropriated for 1440 mental health and substance abuse services eligible to be used 1441 as state Medicaid match. The agency and the department shall 1442 evaluate alternative uses of increased Medicaid funding, 1443 including seeking Medicaid eligibility for the severely and 1444 persistently mentally ill or persons with substance use 1445 disorders, increased reimbursement rates for behavioral health 1446 services, adjustments to the capitation rate for Medicaid 1447 enrollees with chronic mental illness and substance use 1448 disorders, targeted case management for individuals with 1449 substance use disorders as a Medicaid-funded service, 1450 supplemental payments to mental health and substance abuse 1451 service providers through a designated state health program or 1452 other mechanisms, and innovative programs to provide incentives 1453 for improved outcomes for behavioral health conditions. The 1454 agency and the department shall identify in the plan the 1455 advantages and disadvantages of each alternative and assess each 1456 alternative’s potential for achieving improved integration of 1457 services. The agency and the department shall identify in the 1458 plan the types of federal approvals necessary to implement each 1459 alternative and project a timeline for implementation. 1460 (3) The department, in coordination with the agency and the 1461 managing entities, shall compile detailed documentation of the 1462 cost and reimbursements for Medicaid covered services provided 1463 to Medicaid eligible individuals by providers of behavioral 1464 health services that are also funded for programs authorized by 1465 this chapter and chapter 397. The department’s documentation, 1466 along with a report of general revenue funds supporting 1467 behavioral health services that are not counted as maintenance 1468 of effort or match for any other federal program, must be 1469 submitted to the agency by December 31, 2016. 1470 (4) If the report presents clear evidence that Medicaid 1471 reimbursements are less than the costs of providing the 1472 services, the agency and the department shall request such 1473 additional trust fund authority as is necessary to draw federal 1474 Medicaid funds as a match for the documented general revenue 1475 expenditures supporting covered services delivered to eligible 1476 individuals. Payment of the federal funds shall be made to 1477 providers in such a manner as is allowed by federal law and 1478 regulations. 1479 (5) The agency and the department shall submit the written 1480 plan and report required in this section to the President of the 1481 Senate and the Speaker of the House of Representatives by 1482 December 31, 2016. 1483 Section 18. Subsection (5) of section 394.879, Florida 1484 Statutes, is amended, and subsection (6) is added to that 1485 section, to read: 1486 394.879 Rules; enforcement.— 1487 (5) The agency or the department may not adopt any rule 1488 governing the design, construction, erection, alteration, 1489 modification, repair, or demolition of crisis stabilization 1490 units. It is the intent of the Legislature to preempt that 1491 function to the Florida Building commission and the State Fire 1492 Marshal through adoption and maintenance of the Florida Building 1493 Code and the Florida Fire Prevention Code. However, a crisis 1494 stabilization unit, a short-term residential treatment facility, 1495 or an integrated adult mental health crisis stabilization and 1496 addictions receiving facility that is collocated with a 1497 centralized receiving facility may be in a multi-story building 1498 and may be authorized on floors other than the ground floor. The 1499 agency shall provide technical assistance to the commission and 1500 the State Fire Marshal in updating the construction standards of 1501 the Florida Building Code and the Florida Fire Prevention Code 1502 which govern crisis stabilization units. In addition, the agency 1503 may enforce the special-occupancy provisions of the Florida 1504 Building code and the Florida Fire Prevention Code which apply 1505 to crisis stabilization units in conducting any inspection 1506 authorized under this part or part II of chapter 408. 1507 (6) The department and the Agency for Health Care 1508 Administration shall develop a plan to provide options for a 1509 single, consolidated license for a provider that offers multiple 1510 types of either mental health services or substance abuse 1511 services, or both, regulated under chapters 394 and 397, 1512 respectively. In the plan, the department and the agency shall 1513 identify the statutory revisions necessary to accomplish the 1514 consolidation. To the extent possible, the department and the 1515 agency shall accomplish such consolidation administratively and 1516 by rule. The department and the agency shall submit the plan to 1517 the Governor, the President of the Senate, and the Speaker of 1518 the House of Representatives by November 1, 2016. 1519 Section 19. Section 394.9082, Florida Statutes, is amended 1520 to read: 1521 (Substantial rewording of section. See 1522 s. 394.9082, F.S., for present text.) 1523 394.9082 Behavioral health managing entities.— 1524 (1) INTENT AND PURPOSE.— 1525 (a) The Legislature finds that untreated behavioral health 1526 disorders constitute major health problems for residents of this 1527 state, are a major economic burden to the citizens of this 1528 state, and substantially increase demands on the state’s 1529 juvenile and adult criminal justice systems, the child welfare 1530 system, and health care systems. The Legislature finds that 1531 behavioral health disorders respond to appropriate treatment, 1532 rehabilitation, and supportive intervention. The Legislature 1533 finds that local communities have also made substantial 1534 investments in behavioral health services, contracting with 1535 safety net providers who by mandate and mission provide 1536 specialized services to vulnerable and hard-to-serve populations 1537 and have strong ties to local public health and public safety 1538 agencies. The Legislature finds that a regional management 1539 structure that facilitates a comprehensive and cohesive system 1540 of coordinated care for behavioral health treatment and 1541 prevention services will improve access to care, promote service 1542 continuity, and provide for more efficient and effective 1543 delivery of substance abuse and mental health services. It is 1544 the intent of the Legislature that managing entities work to 1545 create linkages among various services and systems, including 1546 juvenile justice and adult criminal justice, child welfare, 1547 housing services, homeless systems of care, and health care. 1548 (b) The purpose of the behavioral health managing entities 1549 is to plan, coordinate, and contract for the delivery of 1550 community mental health and substance abuse services, to improve 1551 access to care, to promote service continuity, to purchase 1552 services, and to support efficient and effective delivery of 1553 services. 1554 (2) DEFINITIONS.—As used in this section, the term: 1555 (a) “Behavioral health services” means mental health 1556 services and substance abuse prevention and treatment services 1557 as described in this chapter and chapter 397. 1558 (b) “Coordinated system of care” means the array of mental 1559 health services and substance abuse services described in s. 1560 394.4573. 1561 (c) “Geographic area” means one or more contiguous 1562 counties, circuits, or regions as described in s. 409.966. 1563 (d) “Managed behavioral health organization” means a 1564 Medicaid managed care organization currently under contract with 1565 the statewide Medicaid managed medical assistance program in 1566 this state pursuant to part IV of chapter 409, including a 1567 managed care organization operating as a behavioral health 1568 specialty plan. 1569 (e) “Managing entity” means a corporation selected by and 1570 under contract with the department to manage the daily 1571 operational delivery of behavioral health services through a 1572 coordinated system of care. 1573 (f) “Provider network” means the group of direct service 1574 providers, facilities, and organizations under contract with a 1575 managing entity to provide a comprehensive array of emergency, 1576 acute care, residential, outpatient, recovery support, and 1577 consumer support services, including prevention services. 1578 (g) “Subregion” means a distinct portion of a managing 1579 entity’s geographic region defined by unifying service and 1580 provider utilization patterns. 1581 (3) DEPARTMENT DUTIES.—The department shall: 1582 (a) Contract with organizations to serve as managing 1583 entities in accordance with the requirements of this section and 1584 conduct a readiness review of any new managing entities before 1585 such entities assume their responsibilities. 1586 (b) Specify data reporting requirements and use of shared 1587 data systems. 1588 (c) Define the priority populations that will benefit from 1589 receiving care coordination. In defining such populations, the 1590 department shall take into account the availability of resources 1591 and consider: 1592 1. The number and duration of involuntary admissions within 1593 a specified time. 1594 2. The degree of involvement with the criminal justice 1595 system and the risk to public safety posed by the individual. 1596 3. Whether the individual has recently resided in or is 1597 currently awaiting admission to or discharge from a treatment 1598 facility as defined in s. 394.455. 1599 4. The degree of utilization of behavioral health services. 1600 5. Whether the individual is a parent or caregiver who is 1601 involved with the child welfare system. 1602 (d) Support the development and implementation of a 1603 coordinated system of care by requiring each provider that 1604 receives state funds for behavioral health services through a 1605 direct contract with the department to work with the managing 1606 entity in the provider’s service area to coordinate the 1607 provision of behavioral health services as part of the contract 1608 with the department. 1609 (e) Provide technical assistance to the managing entities. 1610 (f) Promote the coordination of behavioral health care and 1611 primary care. 1612 (g) Facilitate coordination between the managing entity and 1613 other payors of behavioral health care. 1614 (h) Develop and provide a unique identifier for clients 1615 receiving behavioral health services through the managing entity 1616 to coordinate care. 1617 (i) Coordinate procedures for the referral and admission of 1618 patients to, and the discharge of patients from, treatment 1619 facilities as defined in s. 394.455 and their return to the 1620 community. 1621 (j) Ensure that managing entities comply with state and 1622 federal laws, rules, regulations, and grant requirements. 1623 (k) Develop rules for the operations of, and the 1624 requirements that shall be met by, the managing entity, if 1625 necessary. 1626 (l) Periodically review contract and reporting requirements 1627 and reduce costly, duplicative, and unnecessary administrative 1628 requirements. 1629 (4) CONTRACT WITH MANAGING ENTITIES.— 1630 (a) In contracting for services with managing entities 1631 under this section, the department shall first attempt to 1632 contract with not-for-profit, community-based organizations with 1633 competence in managing provider networks serving persons with 1634 mental health and substance use disorders to serve as managing 1635 entities. 1636 (b) The department shall issue an invitation to negotiate 1637 under s. 287.057 to select an organization to serve as a 1638 managing entity. If the department receives fewer than two 1639 responsive bids to the solicitation, the department shall 1640 reissue the solicitation and managed behavioral health 1641 organizations shall be eligible to bid and be awarded a 1642 contract. 1643 (c) If the managing entity is a not-for-profit, community 1644 based organization, it must have a governing board that is 1645 representative. At a minimum, the governing board must include 1646 consumers and their family members; representatives of local 1647 government, area law enforcement agencies, health care 1648 facilities, and community-based care lead agencies; business 1649 leaders; and providers of substance abuse and mental health 1650 services as defined in this chapter and chapter 397. 1651 (d) If the managing entity is a managed behavioral health 1652 organization, it must establish an advisory board that meets the 1653 same requirements specified in paragraph (c) for a governing 1654 board. 1655 (e) If the department issues an invitation to negotiate 1656 pursuant to paragraph (b), the department shall consider, at a 1657 minimum, the following factors: 1658 1. Experience serving persons with mental health and 1659 substance use disorders. 1660 2. Established community partnerships with behavioral 1661 health care providers. 1662 3. Demonstrated organizational capabilities for network 1663 management functions. 1664 4. Capability to coordinate behavioral health services with 1665 primary care services. 1666 5. Willingness to provide recovery-oriented services and 1667 systems of care and work collaboratively with persons with 1668 mental health and substance use disorders and their families in 1669 designing such systems and delivering such services. 1670 (f) The department’s contracts with managing entities must 1671 support efficient and effective administration of the behavioral 1672 health system and ensure accountability for performance. 1673 (g) A contractor serving as a managing entity shall operate 1674 under the same data reporting, administrative, and 1675 administrative rate requirements, regardless of whether it is a 1676 for-profit or not-for-profit entity. 1677 (h) The contract must designate the geographic area that 1678 will be served by the managing entity, which area must be of 1679 sufficient size in population, funding, and services to allow 1680 for flexibility and efficiency. 1681 (i) The contract must require that, when there is a change 1682 in the managing entity in a geographic area, the managing entity 1683 work with the department to develop and implement a transition 1684 plan that ensures continuity of care for patients receiving 1685 behavioral health services. 1686 (j) By June 30, 2019, if all other contract requirements 1687 and performance standards are met and the department determines 1688 that a managing entity under contract as of July 1, 2016, has 1689 received network accreditation pursuant to subsection (6), the 1690 department may continue its contract with the managing entity 1691 for up to, but not exceeding, 5 years, including any and all 1692 renewals and extensions. Thereafter, the department must issue a 1693 competitive solicitation pursuant to paragraph (b). 1694 (5) MANAGING ENTITY DUTIES.—A managing entity shall: 1695 (a) Maintain a governing board or, if a managed behavioral 1696 health organization, an advisory board as provided in paragraph 1697 (4)(c) or paragraph (4)(d), respectively. 1698 (b) Conduct a community behavioral health care needs 1699 assessment every 3 years in the geographic area served by the 1700 managing entity which identifies needs by subregion. The process 1701 for conducting the needs assessment shall include an opportunity 1702 for public participation. The assessment shall include, at a 1703 minimum, the information the department needs for its annual 1704 report to the Governor and Legislature pursuant to s. 394.4573. 1705 The managing entity shall provide the needs assessment to the 1706 department. 1707 (c) Determine the optimal array of services to meet the 1708 needs identified in the community behavioral health care needs 1709 assessment and expand the scope of services as resources become 1710 available. 1711 (d) Promote the development and effective implementation of 1712 a coordinated system of care pursuant to s. 394.4573. 1713 (e) Provide assistance to counties to develop a designated 1714 receiving system pursuant to s. 394.4573 and a transportation 1715 plan pursuant to s. 394.462. 1716 (f) Develop strategies to divert persons with mental 1717 illness or substance use disorders from the criminal and 1718 juvenile justice systems in collaboration with the court system 1719 and the Department of Juvenile Justice and to integrate 1720 behavioral health services with the child welfare system. 1721 (g) Promote and support care coordination activities that 1722 will improve outcomes among individuals identified as priority 1723 populations pursuant to paragraph (3)(c). 1724 (h) Work independently and collaboratively with 1725 stakeholders to improve access to and effectiveness, quality, 1726 and outcomes of behavioral health services. This work may 1727 include, but is not limited to, facilitating the dissemination 1728 and use of evidence-informed practices. 1729 (i) Develop a comprehensive provider network of qualified 1730 providers to deliver behavioral health services. The managing 1731 entity is not required to competitively procure network 1732 providers but shall publicize opportunities to join the provider 1733 network and evaluate providers in the network to determine if 1734 they may remain in the network. The managing entity shall 1735 publish these processes on its website. The managing entity 1736 shall ensure continuity of care for clients if a provider ceases 1737 to provide a service or leaves the network. 1738 (j) As appropriate, develop resources by pursuing third 1739 party payments for services, applying for grants, assisting 1740 providers in securing local matching funds and in-kind services, 1741 and employing any other method needed to ensure that services 1742 are available and accessible. 1743 (k) Enter into cooperative agreements with local homeless 1744 councils and organizations for sharing information about 1745 clients, available resources, and other data or information for 1746 addressing the homelessness of persons suffering from a 1747 behavioral health crisis. All information sharing must comply 1748 with federal and state privacy and confidentiality laws, 1749 statutes, and regulations. 1750 (l) Work collaboratively with public receiving facilities 1751 and licensed housing providers to establish a network of 1752 licensed housing resources for mental health consumers that will 1753 prevent and reduce readmissions to public receiving facilities. 1754 (m) Monitor network providers’ performance and their 1755 compliance with contract requirements and federal and state 1756 laws, rules, regulations, and grant requirements. 1757 (n) Manage and allocate funds for services to meet federal 1758 and state laws, rules, and regulations. 1759 (o) Promote coordination of behavioral health care with 1760 primary care. 1761 (p) Implement shared data systems necessary for the 1762 delivery of coordinated care and integrated services, the 1763 assessment of managing entity performance and provider 1764 performance, and the reporting of outcomes and costs of 1765 services. 1766 (q) Operate in a transparent manner, providing public 1767 access to information, notice of meetings, and opportunities for 1768 public participation in managing entity decisionmaking. 1769 (r) Establish and maintain effective relationships with 1770 community stakeholders, including individuals served by the 1771 behavioral health system of care and their families, local 1772 governments, and other community organizations that meet the 1773 needs of individuals with mental illness or substance use 1774 disorders. 1775 (s) Collaborate with and encourage increased coordination 1776 between the provider network and other systems, programs, and 1777 entities, such as the child welfare system, law enforcement 1778 agencies, the criminal and juvenile justice systems, the 1779 Medicaid program, offices of the public defender, and offices of 1780 criminal conflict and civil regional counsel. 1781 1. Collaboration with the criminal and juvenile justice 1782 systems shall seek, at a minimum, to divert persons with mental 1783 illness, substance use disorders, or co-occurring conditions 1784 from these systems. 1785 2. Collaboration with the court system shall seek, at a 1786 minimum, to develop specific written procedures and agreements 1787 to maximize the use of involuntary outpatient services, reduce 1788 involuntary inpatient treatment, and increase diversion from the 1789 criminal and juvenile justice systems. 1790 3. Collaboration with the child welfare system shall seek, 1791 at a minimum, to provide effective and timely services to 1792 parents and caregivers involved in the child welfare system. 1793 (6) NETWORK ACCREDITATION AND SYSTEMS COORDINATION 1794 AGREEMENTS.— 1795 (a)1. The department shall identify acceptable 1796 accreditations which address coordination within a network and, 1797 if possible, between the network and major systems and programs 1798 with which the network interacts, such as the child welfare 1799 system, the courts system, and the Medicaid program. In 1800 identifying acceptable accreditations, the department shall 1801 consider whether the accreditation facilitates integrated 1802 strategic planning, resource coordination, technology 1803 integration, performance measurement, and increased value to 1804 consumers through choice of and access to services, improved 1805 coordination of services, and effectiveness and efficiency of 1806 service delivery. 1807 2. All managing entities under contract with the state by 1808 July 1, 2016, shall earn accreditation deemed acceptable by the 1809 department pursuant to subparagraph 1. by June 30, 2019. 1810 Managing entities whose initial contract with the state is 1811 executed after July 1, 2016, shall earn network accreditation 1812 within 3 years after the contract execution date. Pursuant to 1813 paragraph (4)(j), the department may continue the contract of a 1814 managing entity under contract as of July 1, 2016, that earns 1815 the network accreditation within the required timeframe and 1816 maintains it throughout the contract term. 1817 (b) If no accreditations are available or deemed acceptable 1818 pursuant to paragraph (a) which address coordination between the 1819 provider network and major systems and programs with which the 1820 provider network interacts, each managing entity shall enter 1821 into memoranda of understanding which details mechanisms for 1822 communication and coordination. The managing entity shall enter 1823 into such memoranda with any community-based care lead agencies, 1824 circuit courts, county courts, sheriffs’ offices, offices of the 1825 public defender, offices of criminal conflict and civil regional 1826 counsel, Medicaid managed medical assistance plans, and homeless 1827 coalitions in its service area. Each managing entity under 1828 contract on July 1, 2016, shall enter into such memoranda by 1829 June 30, 2017, and each managing entity under contract after 1830 July 1, 2016, shall enter into such memoranda within 1 year 1831 after its contract execution date. 1832 (7) PERFORMANCE MEASUREMENT AND ACCOUNTABILITY.-Managing 1833 entities shall collect and submit data to the department 1834 regarding persons served, outcomes of persons served, costs of 1835 services provided through the department’s contract, and other 1836 data as required by the department. The department shall 1837 evaluate managing entity performance and the overall progress 1838 made by the managing entity, together with other systems, in 1839 meeting the community’s behavioral health needs, based on 1840 consumer-centered outcome measures that reflect national 1841 standards, if possible, that can be accurately measured. The 1842 department shall work with managing entities to establish 1843 performance standards, including, but not limited to: 1844 (a) The extent to which individuals in the community 1845 receive services, including, but not limited to, parents or 1846 caregivers involved in the child welfare system who need 1847 behavioral health services. 1848 (b) The improvement in the overall behavioral health of a 1849 community. 1850 (c) The improvement in functioning or progress in the 1851 recovery of individuals served by the managing entity, as 1852 determined using person-centered measures tailored to the 1853 population. 1854 (d) The success of strategies to: 1855 1. Divert admissions from acute levels of care, jails, 1856 prisons, and forensic facilities as measured by, at a minimum, 1857 the total number and percentage of clients who, during a 1858 specified period, experience multiple admissions to acute levels 1859 of care, jails, prisons, or forensic facilities; 1860 2. Integrate behavioral health services with the child 1861 welfare system; and 1862 3. Address the housing needs of individuals being released 1863 from public receiving facilities who are homeless. 1864 (e) Consumer and family satisfaction. 1865 (f) The level of engagement of key community 1866 constituencies, such as law enforcement agencies, community 1867 based care lead agencies, juvenile justice agencies, the courts, 1868 school districts, local government entities, hospitals, and 1869 other organizations, as appropriate, for the geographical 1870 service area of the managing entity. 1871 (8) ENHANCEMENT PLANS.—By September 1 of each year, 1872 beginning in 2017, each managing entity shall develop and submit 1873 to the department a description of strategies for enhancing 1874 services and addressing three to five priority needs in the 1875 service area. The planning process sponsored by the managing 1876 entity shall include consumers and their families, community 1877 based care lead agencies, local governments, law enforcement 1878 agencies, service providers, community partners and other 1879 stakeholders. Each strategy must be described in detail and 1880 accompanied by an implementation plan that specifies action 1881 steps, identifies responsible parties, and delineates specific 1882 services that would be purchased, projected costs, the projected 1883 number of individuals that would be served, and the estimated 1884 benefits of the services. All or parts of these enhancement 1885 plans may be included in the department’s annual budget requests 1886 submitted to the Legislature. 1887 (9) FUNDING FOR MANAGING ENTITIES.— 1888 (a) A contract established between the department and a 1889 managing entity under this section shall be funded by general 1890 revenue, other applicable state funds, or applicable federal 1891 funding sources. A managing entity may carry forward documented 1892 unexpended state funds from one fiscal year to the next, but the 1893 cumulative amount carried forward may not exceed 8 percent of 1894 the annual amount of the contract. Any unexpended state funds in 1895 excess of that percentage shall be returned to the department. 1896 The funds carried forward may not be used in a way that would 1897 increase future recurring obligations or for any program or 1898 service that was not authorized under the existing contract with 1899 the department. Expenditures of funds carried forward shall be 1900 separately reported to the department. Any unexpended funds that 1901 remain at the end of the contract period shall be returned to 1902 the department. Funds carried forward may be retained through 1903 contract renewals and new contract procurements as long as the 1904 same managing entity is retained by the department. 1905 (b) The method of payment for a fixed-price contract with a 1906 managing entity shall provide for a 2-month advance payment at 1907 the beginning of each fiscal year and equal monthly payments 1908 thereafter. 1909 (10) ACUTE CARE SERVICES UTILIZATION DATABASE.—The 1910 department shall develop, implement, and maintain standards 1911 under which a managing entity shall collect utilization data 1912 from all public receiving facilities situated within its 1913 geographical service area and all detoxification and addictions 1914 receiving facilities under contract with the managing entity. As 1915 used in this subsection, the term “public receiving facility” 1916 means an entity that meets the licensure requirements of, and is 1917 designated by, the department to operate as a public receiving 1918 facility under s. 394.875 and that is operating as a licensed 1919 crisis stabilization unit. 1920 (a) The department shall develop standards and protocols to 1921 be used for data collection, storage, transmittal, and analysis. 1922 The standards and protocols shall allow for compatibility of 1923 data and data transmittal between public receiving facilities, 1924 detoxification facilities, addictions receiving facilities, 1925 managing entities, and the department for the implementation, 1926 and to meet the requirements, of this subsection. 1927 (b) A managing entity shall require providers specified in 1928 paragraph (a) to submit data, in real time or at least daily, to 1929 the managing entity for: 1930 1. All admissions and discharges of clients receiving 1931 public receiving facility services who qualify as indigent, as 1932 defined in s. 394.4787. 1933 2. All admissions and discharges of clients receiving 1934 substance abuse services in an addictions receiving facility or 1935 detoxification facility pursuant to parts IV and V of chapter 1936 397 who qualify as indigent. 1937 3. The current active census of total licensed and utilized 1938 beds, the number of beds purchased by the department, the number 1939 of clients qualifying as indigent who occupy any of those beds, 1940 the total number of unoccupied licensed beds, regardless of 1941 funding, and the number in excess of licensed capacity. Crisis 1942 units licensed for both adult and child use will report as a 1943 single unit. 1944 (c) A managing entity shall require providers specified in 1945 paragraph (a) to submit data, on a monthly basis, to the 1946 managing entity which aggregates the daily data submitted under 1947 paragraph (b). The managing entity shall reconcile the data in 1948 the monthly submission to the data received by the managing 1949 entity under paragraph (b) to check for consistency. If the 1950 monthly aggregate data submitted by a provider under this 1951 paragraph are inconsistent with the daily data submitted under 1952 paragraph (b), the managing entity shall consult with the 1953 provider to make corrections necessary to ensure accurate data. 1954 (d) A managing entity shall require providers specified in 1955 paragraph (a) within its provider network to submit data, on an 1956 annual basis, to the managing entity which aggregates the data 1957 submitted and reconciled under paragraph (c). The managing 1958 entity shall reconcile the data in the annual submission to the 1959 data received and reconciled by the managing entity under 1960 paragraph (c) to check for consistency. If the annual aggregate 1961 data submitted by a provider under this paragraph are 1962 inconsistent with the data received and reconciled under 1963 paragraph (c), the managing entity shall consult with the 1964 provider to make corrections necessary to ensure accurate data. 1965 (e) After ensuring the accuracy of data pursuant to 1966 paragraphs (c) and (d), the managing entity shall submit the 1967 data to the department on a monthly and an annual basis. The 1968 department shall create a statewide database for the data 1969 described under paragraph (b) and submitted under this paragraph 1970 for the purpose of analyzing the use of publicly funded crisis 1971 stabilization services and detoxification and addictions 1972 receiving services provided on a statewide and an individual 1973 provider basis. 1974 Section 20. Subsections (4) through (9) of section 397.305, 1975 Florida Statutes, are renumbered as subsections (6) though (11), 1976 respectively, and new subsections (4) and (5) are added to that 1977 section, to read: 1978 397.305 Legislative findings, intent, and purpose.— 1979 (4) It is the intent of the Legislature that licensed, 1980 qualified health professionals be authorized to practice to the 1981 full extent of their education and training in the performance 1982 of professional functions necessary to carry out the intent of 1983 this chapter. 1984 (5) It is the intent of the Legislature to establish 1985 expectations that services provided to persons in this state use 1986 the coordination-of-care principles characteristic of recovery 1987 oriented services and include social support services, such as 1988 housing support, life skills and vocational training, and 1989 employment assistance necessary for persons who have substance 1990 use disorders or co-occurring substance use and mental health 1991 disorders to live successfully in their communities. 1992 Section 21. Present subsection (19) of section 391.311, 1993 Florida Statutes, is redesignated as subsection (20), present 1994 subsections (20) through (45) of that section are redesignated 1995 as subsections (23) through (48), respectively, new subsections 1996 (19), (21), and (22) are added to that section, and present 1997 subsections (30) and (38) of that section are amended, to read: 1998 397.311 Definitions.—As used in this chapter, except part 1999 VIII, the term: 2000 (19) “Incompetent to consent to treatment” means a state in 2001 which a person’s judgment is so affected by a substance abuse 2002 impairment that he or she lacks the capacity to make a well 2003 reasoned, willful, and knowing decision concerning his or her 2004 medical health, mental health, or substance abuse treatment. 2005 (21) “Informed consent” means consent voluntarily given in 2006 writing by a competent person after sufficient explanation and 2007 disclosure of the subject matter involved to enable the person 2008 to make a knowing and willful decision without any element of 2009 force, fraud, deceit, duress, or other form of constraint or 2010 coercion. 2011 (22) “Involuntary services” means an array of behavioral 2012 health services that may be ordered by the court for persons 2013 with substance abuse impairment or co-occurring substance abuse 2014 impairment and mental health disorders. 2015 (33)(30)“Qualified professional” means a physician or a 2016 physician assistant licensed under chapter 458 or chapter 459; a 2017 professional licensed under chapter 490 or chapter 491; an 2018 advanced registered nurse practitionerhaving a specialty in2019psychiatrylicensed under part I of chapter 464; or a person who 2020 is certified through a department-recognized certification 2021 process for substance abuse treatment services and who holds, at 2022 a minimum, a bachelor’s degree. A person who is certified in 2023 substance abuse treatment services by a state-recognized 2024 certification process in another state at the time of employment 2025 with a licensed substance abuse provider in this state may 2026 perform the functions of a qualified professional as defined in 2027 this chapter but must meet certification requirements contained 2028 in this subsection no later than 1 year after his or her date of 2029 employment. 2030 (41)(38)“Service component” or “component” means a 2031 discrete operational entity within a service provider which is 2032 subject to licensing as defined by rule. Service components 2033 include prevention, intervention, and clinical treatment 2034 described in subsection (25)(22). 2035 Section 22. Subsections (16) through (20) of section 2036 397.321, Florida Statutes, are renumbered as subsections (15) 2037 through (19), respectively, present subsection (15) is amended, 2038 and a new subsection (20) is added to that section, to read: 2039 397.321 Duties of the department.—The department shall: 2040(15)Appoint a substance abuse impairment coordinator to2041represent the department in efforts initiated by the statewide2042substance abuse impairment prevention and treatment coordinator2043established in s. 397.801 and to assist the statewide2044coordinator in fulfilling the responsibilities of that position.2045 (20) Develop and prominently display on its website all 2046 forms necessary for the implementation and administration of 2047 parts IV and V of this chapter. These forms shall include, but 2048 are not limited to, a petition for involuntary admission form 2049 and all related pleading forms, and a form to be used by law 2050 enforcement agencies pursuant to s. 397.6772. The department 2051 shall notify law enforcement agencies, the courts, and other 2052 state agencies of the existence and availability of such forms. 2053 Section 23. Section 397.675, Florida Statutes, is amended 2054 to read: 2055 397.675 Criteria for involuntary admissions, including 2056 protective custody, emergency admission, and other involuntary 2057 assessment, involuntary treatment, and alternative involuntary 2058 assessment for minors, for purposes of assessment and 2059 stabilization, and for involuntary treatment.—A person meets the 2060 criteria for involuntary admission if there is good faith reason 2061 to believe that the person is substance abuse impaired or has a 2062 co-occurring mental health disorder and, because of such 2063 impairment or disorder: 2064 (1) Has lost the power of self-control with respect to 2065 substance abuseuse; andeither2066 (2)(a)Has inflicted, or threatened or attempted to2067inflict, or unless admitted is likely to inflict, physical harm2068on himself or herself or another; or2069(b)Is in need of substance abuse services and, by reason 2070 of substance abuse impairment, his or her judgment has been so 2071 impaired that he or shethe personis incapable of appreciating 2072 his or her need for such services and of making a rational 2073 decision in that regard, althoughthereto; however,mere refusal 2074 to receive such services does not constitute evidence of lack of 2075 judgment with respect to his or her need for such services; or 2076 (b) Without care or treatment, is likely to suffer from 2077 neglect or refuse to care for himself or herself; that such 2078 neglect or refusal poses a real and present threat of 2079 substantial harm to his or her well-being; and that it is not 2080 apparent that such harm may be avoided through the help of 2081 willing family members or friends or the provision of other 2082 services, or there is substantial likelihood that the person has 2083 inflicted, or threatened to or attempted to inflict, or, unless 2084 admitted, is likely to inflict, physical harm on himself, 2085 herself, or another. 2086 Section 24. Subsection (1) of section 397.6772, Florida 2087 Statutes, is amended to read: 2088 397.6772 Protective custody without consent.— 2089 (1) If a person in circumstances which justify protective 2090 custody as described in s. 397.677 fails or refuses to consent 2091 to assistance and a law enforcement officer has determined that 2092 a hospital or a licensed detoxification or addictions receiving 2093 facility is the most appropriate place for the person, the 2094 officer may, after giving due consideration to the expressed 2095 wishes of the person: 2096 (a) Take the person to a hospital or to a licensed 2097 detoxification or addictions receiving facility against the 2098 person’s will but without using unreasonable force. The officer 2099 shall use the standard form developed by the department pursuant 2100 to s. 397.321 to execute a written report detailing the 2101 circumstances under which the person was taken into custody. The 2102 written report shall be included in the patient’s clinical 2103 record; or 2104 (b) In the case of an adult, detain the person for his or 2105 her own protection in any municipal or county jail or other 2106 appropriate detention facility. 2107 2108 Such detention is not to be considered an arrest for any 2109 purpose, and no entry or other record may be made to indicate 2110 that the person has been detained or charged with any crime. The 2111 officer in charge of the detention facility must notify the 2112 nearest appropriate licensed service provider within the first 8 2113 hours after detention that the person has been detained. It is 2114 the duty of the detention facility to arrange, as necessary, for 2115 transportation of the person to an appropriate licensed service 2116 provider with an available bed. Persons taken into protective 2117 custody must be assessed by the attending physician within the 2118 72-hour period and without unnecessary delay, to determine the 2119 need for further services. 2120 Section 25. Paragraph (a) of subsection (1) of section 2121 397.6773, Florida Statutes, is amended to read: 2122 397.6773 Dispositional alternatives after protective 2123 custody.— 2124 (1) An individual who is in protective custody must be 2125 released by a qualified professional when: 2126 (a) The individual no longer meets the involuntary 2127 admission criteria in s. 397.675397.675(1); 2128 Section 26. Section 397.679, Florida Statutes, is amended 2129 to read: 2130 397.679 Emergency admission; circumstances justifying.—A 2131 person who meets the criteria for involuntary admission in s. 2132 397.675 may be admitted to a hospital or to a licensed 2133 detoxification facility or addictions receiving facility for 2134 emergency assessment and stabilization, or to a less intensive 2135 component of a licensed service provider for assessment only, 2136 upon receipt by the facility of athe physician’scertificate by 2137 a physician, an advanced registered nurse practitioner, a 2138 psychiatric nurse, a clinical psychologist, a clinical social 2139 worker, a marriage and family therapist, a mental health 2140 counselor, a physician assistant working under the scope of 2141 practice of the supervising physician, or a master’s-level 2142 certified addictions professional for substance abuse services, 2143 if the certificate is specific to substance abuse impairment, 2144 and the completion of an application for emergency admission. 2145 Section 27. Section 397.6791, Florida Statutes, is amended 2146 to read: 2147 397.6791 Emergency admission; persons who may initiate.—The 2148 following persons may request a certificate foranemergency 2149 assessment or admission: 2150 (1) In the case of an adult, any professional who may issue 2151 a professional certificate pursuant to s. 397.6793the2152certifying physician, the person’s spouse or legal guardian, any 2153 relative of the person, or any other responsible adult who has 2154 personal knowledge of the person’s substance abuse impairment. 2155 (2) In the case of a minor, the minor’s parent, legal 2156 guardian, or legal custodian. 2157 Section 28. Section 397.6793, Florida Statutes, is amended 2158 to read: 2159 397.6793 Professional’sPhysician’scertificate for 2160 emergency admission.— 2161 (1) A physician, a clinical psychologist, a physician 2162 assistant working under the scope of practice of the supervising 2163 physician, a psychiatric nurse, an advanced registered nurse 2164 practitioner, a mental health counselor, a marriage and family 2165 therapist, a master’s-level-certified addictions professional 2166 for substance abuse services, or a clinical social worker may 2167 execute a professional’s certificate for emergency admission. 2168 The professional’sphysician’scertificate must include the name 2169 of the person to be admitted, the relationship between the 2170 person and the professional executing the certificatephysician, 2171 the relationship between the applicant and the professional 2172physician, any relationship between the professionalphysician2173 and the licensed service provider,anda statement that the 2174 person has been examined and assessed within the preceding 5 2175 days afterofthe application date, andmust includefactual 2176 allegations with respect to the need for emergency admission, 2177 including: 2178 (a) The reason for thephysician’sbelief that the person 2179 is substance abuse impaired;and2180 (b) The reason for thephysician’sbelief that because of 2181 such impairment the person has lost the power of self-control 2182 with respect to substance abuse; andeither2183 (c)1. The reason for the beliefphysician believesthat, 2184 without care or treatment, the person is likely to suffer from 2185 neglect or refuse to care for himself or herself; that such 2186 neglect or refusal poses a real and present threat of 2187 substantial harm to his or her well-being; and that it is not 2188 apparent that such harm may be avoided through the help of 2189 willing family members or friends or the provision of other 2190 services, or there is substantial likelihood that the person has 2191 inflicted or, unless admitted, is likely to inflict, physical 2192 harm on himself,orherself, or anotherothers unless admitted; 2193 or 2194 2. The reason for the beliefphysician believesthat the 2195 person’s refusal to voluntarily receive care is based on 2196 judgment so impaired by reason of substance abuse that the 2197 person is incapable of appreciating his or her need for care and 2198 of making a rational decision regarding his or her need for 2199 care. 2200 (2) The professional’sphysician’scertificate must 2201 recommend the least restrictive type of service that is 2202 appropriate for the person. The certificate must be signed by 2203 the professionalphysician. If other less restrictive means are 2204 not available, such as voluntary appearance for outpatient 2205 evaluation, a law enforcement officer shall take the person 2206 named in the certificate into custody and deliver him or her to 2207 the appropriate facility for involuntary assessment and 2208 stabilization. 2209 (3) A signed copy of the professional’sphysician’s2210 certificate shall accompany the person,and shall be made a part 2211 of the person’s clinical record, together with a signed copy of 2212 the application. The application and the professional’s 2213physician’scertificate authorize the involuntary admission of 2214 the person pursuant to, and subject to the provisions of, ss. 2215 397.679-397.6797. 2216 (4) The professional’s certificate is valid for 7 days 2217 after issuance. 2218 (5) The professional’sphysician’scertificate must 2219 indicate whether the person requires transportation assistance 2220 for delivery for emergency admission and specify, pursuant to s. 2221 397.6795, the type of transportation assistance necessary. 2222 Section 29. Section 397.6795, Florida Statutes, is amended 2223 to read: 2224 397.6795 Transportation-assisted delivery of persons for 2225 emergency assessment.—An applicant for a person’s emergency 2226 admission,orthe person’s spouse or guardian, or a law 2227 enforcement officer, or a health officermay deliver a person 2228 named in the professional’sphysician’scertificate for 2229 emergency admission to a hospital or a licensed detoxification 2230 facility or addictions receiving facility for emergency 2231 assessment and stabilization. 2232 Section 30. Subsection (1) of section 397.681, Florida 2233 Statutes, is amended to read: 2234 397.681 Involuntary petitions; general provisions; court 2235 jurisdiction and right to counsel.— 2236 (1) JURISDICTION.—The courts have jurisdiction of 2237 involuntary assessment and stabilization petitions and 2238 involuntary treatment petitions for substance abuse impaired 2239 persons, and such petitions must be filed with the clerk of the 2240 court in the county where the person is located. The clerk of 2241 the court may not charge a fee for the filing of a petition 2242 under this section. The chief judge may appoint a general or 2243 special magistrate to preside over all or part of the 2244 proceedings. The alleged impaired person is named as the 2245 respondent. 2246 Section 31. Subsection (1) of section 397.6811, Florida 2247 Statutes, is amended to read: 2248 397.6811 Involuntary assessment and stabilization.—A person 2249 determined by the court to appear to meet the criteria for 2250 involuntary admission under s. 397.675 may be admitted for a 2251 period of 5 days to a hospital or to a licensed detoxification 2252 facility or addictions receiving facility, for involuntary 2253 assessment and stabilization or to a less restrictive component 2254 of a licensed service provider for assessment only upon entry of 2255 a court order or upon receipt by the licensed service provider 2256 of a petition. Involuntary assessment and stabilization may be 2257 initiated by the submission of a petition to the court. 2258 (1) If the person upon whose behalf the petition is being 2259 filed is an adult, a petition for involuntary assessment and 2260 stabilization may be filed by the respondent’s spouse or legal 2261 guardian, any relative, a private practitioner, the director of 2262 a licensed service provider or the director’s designee, or an 2263 adultany three adultswho has directhavepersonal knowledge of 2264 the respondent’s substance abuse impairment. 2265 Section 32. Section 397.6814, Florida Statutes, is amended 2266 to read: 2267 397.6814 Involuntary assessment and stabilization; contents 2268 of petition.—A petition for involuntary assessment and 2269 stabilization must contain the name of the respondent,;the name 2270 of the applicant or applicants,;the relationship between the 2271 respondent and the applicant, and;the name of the respondent’s 2272 attorney, if known,and a statement of the respondent’s ability2273to afford an attorney;and must state facts to support the need 2274 for involuntary assessment and stabilization, including: 2275 (1) The reason for the petitioner’s belief that the 2276 respondent is substance abuse impaired;and2277 (2) The reason for the petitioner’s belief that because of 2278 such impairment the respondent has lost the power of self 2279 control with respect to substance abuse; andeither2280 (3)(a) The reason the petitioner believes that the 2281 respondent has inflicted or is likely to inflict physical harm 2282 on himself or herself or others unless admitted; or 2283 (b) The reason the petitioner believes that the 2284 respondent’s refusal to voluntarily receive care is based on 2285 judgment so impaired by reason of substance abuse that the 2286 respondent is incapable of appreciating his or her need for care 2287 and of making a rational decision regarding that need for care. 2288 If the respondent has refused to submit to an assessment, such 2289 refusal must be alleged in the petition. 2290 2291 A fee may not be charged for the filing of a petition pursuant 2292 to this section. 2293 Section 33. Subsection (4) is added to section 397.6818, 2294 Florida Statutes, to read: 2295 397.6818 Court determination.—At the hearing initiated in 2296 accordance with s. 397.6811(1), the court shall hear all 2297 relevant testimony. The respondent must be present unless the 2298 court has reason to believe that his or her presence is likely 2299 to be injurious to him or her, in which event the court shall 2300 appoint a guardian advocate to represent the respondent. The 2301 respondent has the right to examination by a court-appointed 2302 qualified professional. After hearing all the evidence, the 2303 court shall determine whether there is a reasonable basis to 2304 believe the respondent meets the involuntary admission criteria 2305 of s. 397.675. 2306 (4) The order is valid only for the period specified in the 2307 order or, if a period is not specified, for 7 days after the 2308 order is signed. 2309 Section 34. Section 397.6819, Florida Statutes, is amended 2310 to read: 2311 397.6819 Involuntary assessment and stabilization; 2312 responsibility of licensed service provider.—A licensed service 2313 provider may admit an individual for involuntary assessment and 2314 stabilization for a period not to exceed 5 days unless a 2315 petition for involuntary services has been initiated and the 2316 individual is being retained pursuant to s. 397.6822(3) or a 2317 request for an extension of time has been filed with the court 2318 pursuant to s. 397.6821. The assessment of the individual must 2319 occur within 72 hoursbe assessedwithout unnecessary delayby a 2320 qualified professional. If an assessment is performed by a 2321 qualified professional who is not a physician, the assessment 2322 must be reviewed by a physician before the end of the assessment 2323 period. 2324 Section 35. Section 397.695, Florida Statutes, is amended 2325 to read: 2326 397.695 Involuntary servicestreatment; persons who may 2327 petition.— 2328 (1) If the respondent is an adult, a petition for 2329 involuntary servicestreatmentmay be filed by the respondent’s 2330 spouse or legal guardian, any relative, a service provider, or 2331 an adultany three adultswho has directhavepersonal knowledge 2332 of the respondent’s substance abuse impairment and his or her 2333 prior course of assessment and treatment. 2334 (2) If the respondent is a minor, a petition for 2335 involuntary treatment may be filed by a parent, legal guardian, 2336 or service provider. 2337 Section 36. Section 397.6951, Florida Statutes, is amended 2338 to read: 2339 397.6951 Contents of petition for involuntary services 2340treatment.—A petition for involuntary servicestreatmentmust 2341 contain the name of the respondentto be admitted; the name of 2342 the petitioner or petitioners; the relationship between the 2343 respondent and the petitioner; the name of the respondent’s 2344 attorney, if known, and a statement of the petitioner’s2345knowledge of the respondent’s ability to afford an attorney; the 2346 findings and recommendations of the assessment performed by the 2347 qualified professional; and the factual allegations presented by 2348 the petitioner establishing the need for involuntary outpatient 2349 services. The factual allegations must demonstratetreatment,2350including: 2351 (1) The reason for the petitioner’s belief that the 2352 respondent is substance abuse impaired;and2353 (2) The reason for the petitioner’s belief that because of 2354 such impairment the respondent has lost the power of self 2355 control with respect to substance abuse; andeither2356 (3)(a) The reason the petitioner believes that the 2357 respondent has inflicted or is likely to inflict physical harm 2358 on himself or herself or others unless the court orders the 2359 involuntary servicesadmitted; or 2360 (b) The reason the petitioner believes that the 2361 respondent’s refusal to voluntarily receive care is based on 2362 judgment so impaired by reason of substance abuse that the 2363 respondent is incapable of appreciating his or her need for care 2364 and of making a rational decision regarding that need for care. 2365 Section 37. Section 397.6955, Florida Statutes, is amended 2366 to read: 2367 397.6955 Duties of court upon filing of petition for 2368 involuntary servicestreatment.— 2369 (1) Upon the filing of a petition fortheinvoluntary 2370 services fortreatment ofa substance abuse impaired person with 2371 the clerk of the court, the court shall immediately determine 2372 whether the respondent is represented by an attorney or whether 2373 the appointment of counsel for the respondent is appropriate. If 2374 the court appoints counsel for the person, the clerk of the 2375 court shall immediately notify the office of criminal conflict 2376 and civil regional counsel, created pursuant to s. 27.511, of 2377 the appointment. The office of criminal conflict and civil 2378 regional counsel shall represent the person until the petition 2379 is dismissed, the court order expires, or the person is 2380 discharged from involuntary services. An attorney that 2381 represents the person named in the petition shall have access to 2382 the person, witnesses, and records relevant to the presentation 2383 of the person’s case and shall represent the interests of the 2384 person, regardless of the source of payment to the attorney. 2385 (2) The court shall schedule a hearing to be held on the 2386 petition within 510days unless a continuance is granted. The 2387 court may appoint a magistrate to preside at the hearing. 2388 (3) A copy of the petition and notice of the hearing must 2389 be provided to the respondent; the respondent’s parent, 2390 guardian, or legal custodian, in the case of a minor; the 2391 respondent’s attorney, if known; the petitioner; the 2392 respondent’s spouse or guardian, if applicable; and such other 2393 persons as the court may direct. If the respondent is a minor, a 2394 copy of the petition and notice of the hearing must beand have2395such petition and orderpersonally delivered to the respondent 2396if he or she is a minor. The court shall also issue a summons to 2397 the person whose admission is sought. 2398 Section 38. Section 397.6957, Florida Statutes, is amended 2399 to read: 2400 397.6957 Hearing on petition for involuntary services 2401treatment.— 2402 (1) At a hearing on a petition for involuntary services 2403treatment, the court shall hear and review all relevant 2404 evidence, including the review of results of the assessment 2405 completed by the qualified professional in connection with the 2406 respondent’s protective custody, emergency admission, 2407 involuntary assessment, or alternative involuntary admission. 2408 The respondent must be present unless the court finds that his 2409 or her presence is likely to be injurious to himself or herself 2410 or others, in which event the court must appoint a guardian 2411 advocate to act in behalf of the respondent throughout the 2412 proceedings. 2413 (2) The petitioner has the burden of proving by clear and 2414 convincing evidence that: 2415 (a) The respondent is substance abuse impaired and has a 2416 history of lack of compliance with treatment for substance 2417 abuse;,and 2418 (b) Because of such impairment the respondent is unlikely 2419 to voluntarily participate in the recommended services or is 2420 unable to determine for himself or herself whether services are 2421 necessarythe respondent has lost the power of self-control with2422respect to substance abuse;and:either2423 1. Without services, the respondent is likely to suffer 2424 from neglect or refuse to care for himself or herself; that such 2425 neglect or refusal poses a real and present threat of 2426 substantial harm to his or her well-being; and that there is a 2427 substantial likelihood that without services the respondent will 2428 cause serious bodily harm to himself, herself, or another in the 2429 near future, as evidenced by recent behaviorThe respondent has2430inflicted or is likely to inflict physical harm on himself or2431herself or others unless admitted; or 2432 2. The respondent’s refusal to voluntarily receive care is 2433 based on judgment so impaired by reason of substance abuse that 2434 the respondent is incapable of appreciating his or her need for 2435 care and of making a rational decision regarding that need for 2436 care. 2437 (3) One of the qualified professionals who executed the 2438 involuntary services certificate must be a witness. The court 2439 shall allow testimony from individuals, including family 2440 members, deemed by the court to be relevant under state law, 2441 regarding the respondent’s prior history and how that prior 2442 history relates to the person’s current condition. The testimony 2443 in the hearing must be under oath, and the proceedings must be 2444 recorded. The patient may refuse to testify at the hearing. 2445 (4)(3)At the conclusion of the hearing the court shall 2446eitherdismiss the petition or order the respondent to receive 2447undergoinvoluntary services from his or hersubstance abuse2448treatment, with the respondent’schosen licensed service 2449 provider ifto deliver the involuntary substance abuse treatment2450wherepossible and appropriate. 2451 Section 39. Section 397.697, Florida Statutes, is amended 2452 to read: 2453 397.697 Court determination; effect of court order for 2454 involuntary servicessubstance abuse treatment.— 2455 (1) When the court finds that the conditions for 2456 involuntary servicessubstance abuse treatmenthave been proved 2457 by clear and convincing evidence, it may order the respondent to 2458 receiveundergoinvoluntary services fromtreatment bya 2459 publicly funded licensed service provider for a period not to 2460 exceed 9060days. The court may also order a respondent to 2461 undergo treatment through a privately funded licensed service 2462 provider if the respondent has the ability to pay for the 2463 treatment, or if any person on the respondent’s behalf 2464 voluntarily demonstrates a willingness and an ability to pay for 2465 the treatment. If the court finds it necessary, it may direct 2466 the sheriff to take the respondent into custody and deliver him 2467 or her to the licensed service provider specified in the court 2468 order, or to the nearest appropriate licensed service provider, 2469 for involuntary servicestreatment. When the conditions 2470 justifying involuntary servicestreatmentno longer exist, the 2471 individual must be released as provided in s. 397.6971. When the 2472 conditions justifying involuntary servicestreatmentare 2473 expected to exist after 9060days of servicestreatment, a 2474 renewal of the involuntary servicestreatmentorder may be 2475 requested pursuant to s. 397.6975 beforeprior tothe end of the 2476 90-day60-dayperiod. 2477 (2) In all cases resulting in an order for involuntary 2478 servicessubstance abuse treatment, the court shall retain 2479 jurisdiction over the case and the parties for the entry of such 2480 further orders as the circumstances may require. The court’s 2481 requirements for notification of proposed release must be 2482 included in the originaltreatmentorder. 2483 (3) An involuntary servicestreatmentorder authorizes the 2484 licensed service provider to require the individual to receive 2485 services thatundergo such treatment aswill benefit him or her, 2486 including servicestreatmentat any licensable service component 2487 of a licensed service provider. 2488 (4) If the court orders involuntary services, a copy of the 2489 order must be sent to the managing entity within 1 working day 2490 after it is received from the court. Documents may be submitted 2491 electronically though existing data systems, if applicable. 2492 Section 40. Section 397.6971, Florida Statutes, is amended 2493 to read: 2494 397.6971 Early release from involuntary servicessubstance2495abuse treatment.— 2496 (1) At any time beforeprior tothe end of the 90-day602497dayinvoluntary servicestreatmentperiod, or beforeprior to2498 the end of any extension granted pursuant to s. 397.6975, an 2499 individual receivingadmitted forinvoluntary servicestreatment2500 may be determined eligible for discharge to the most appropriate 2501 referral or disposition for the individual when any of the 2502 following apply: 2503 (a) The individual no longer meets the criteria for 2504 involuntary admission and has given his or her informed consent 2505 to be transferred to voluntary treatment status.;2506 (b) If the individual was admitted on the grounds of 2507 likelihood of infliction of physical harm upon himself or 2508 herself or others, such likelihood no longer exists.; or2509 (c) If the individual was admitted on the grounds of need 2510 for assessment and stabilization or treatment, accompanied by 2511 inability to make a determination respecting such need, either: 2512 1. Such inability no longer exists; or 2513 2. It is evident that further treatment will not bring 2514 about further significant improvements in the individual’s 2515 condition.;2516 (d) The individual is no longer in need of services.; or2517 (e) The director of the service provider determines that 2518 the individual is beyond the safe management capabilities of the 2519 provider. 2520 (2) Whenever a qualified professional determines that an 2521 individual admitted for involuntary services qualifiestreatment2522is readyfor early release underfor any of the reasons listed2523insubsection (1), the service provider shall immediately 2524 discharge the individual,and must notify all persons specified 2525 by the court in the original treatment order. 2526 Section 41. Section 397.6975, Florida Statutes, is amended 2527 to read: 2528 397.6975 Extension of involuntary servicessubstance abuse2529treatmentperiod.— 2530 (1) Whenever a service provider believes that an individual 2531 who is nearing the scheduled date of his or her release from 2532 involuntary servicestreatmentcontinues to meet the criteria 2533 for involuntary servicestreatmentin s. 397.693, a petition for 2534 renewal of the involuntary servicestreatmentorder may be filed 2535 with the court at least 10 days before the expiration of the 2536 court-ordered servicestreatmentperiod. The court shall 2537 immediately schedule a hearing to be held not more than 15 days 2538 after filing of the petition. The court shall provide the copy 2539 of the petition for renewal and the notice of the hearing to all 2540 parties to the proceeding. The hearing is conducted pursuant to 2541 s. 397.6957. 2542 (2) If the court finds that the petition for renewal of the 2543 involuntary servicestreatmentorder should be granted, it may 2544 order the respondent to receiveundergoinvoluntary services 2545treatmentfor a period not to exceed an additional 90 days. When 2546 the conditions justifying involuntary servicestreatmentno 2547 longer exist, the individual must be released as provided in s. 2548 397.6971. When the conditions justifying involuntary services 2549treatmentcontinue to exist after an additional 90 days of 2550 serviceadditional treatment, a new petition requesting renewal 2551 of the involuntary servicestreatmentorder may be filed 2552 pursuant to this section. 2553 (3) Within 1 court working day after the filing of a 2554 petition for continued involuntary services, the court shall 2555 appoint the office of criminal conflict and civil regional 2556 counsel to represent the respondent, unless the respondent is 2557 otherwise represented by counsel. The clerk of the court shall 2558 immediately notify the office of criminal conflict and civil 2559 regional counsel of such appointment. The office of criminal 2560 conflict and civil regional counsel shall represent the 2561 respondent until the petition is dismissed or the court order 2562 expires or the respondent is discharged from involuntary 2563 services. Any attorney representing the respondent shall have 2564 access to the respondent, witnesses, and records relevant to the 2565 presentation of the respondent’s case and shall represent the 2566 interests of the respondent, regardless of the source of payment 2567 to the attorney. 2568 (4) Hearings on petitions for continued involuntary 2569 services shall be before the circuit court. The court may 2570 appoint a magistrate to preside at the hearing. The procedures 2571 for obtaining an order pursuant to this section shall be in 2572 accordance with s. 397.697. 2573 (5) Notice of hearing shall be provided to the respondent 2574 or his or her counsel. The respondent and the respondent’s 2575 counsel may agree to a period of continued involuntary services 2576 without a court hearing. 2577 (6) The same procedure shall be repeated before the 2578 expiration of each additional period of involuntary services. 2579 (7) If the respondent has previously been found incompetent 2580 to consent to treatment, the court shall consider testimony and 2581 evidence regarding the respondent’s competence. 2582 Section 42. Section 397.6977, Florida Statutes, is amended 2583 to read: 2584 397.6977 Disposition of individual upon completion of 2585 involuntary servicessubstance abuse treatment.—At the 2586 conclusion of the 90-day60-dayperiod of court-ordered 2587 involuntary servicestreatment, the respondentindividualis 2588 automatically discharged unless a motion for renewal of the 2589 involuntary servicestreatmentorder has been filed with the 2590 court pursuant to s. 397.6975. 2591 Section 43. Section 397.6978, Florida Statutes, is created 2592 to read: 2593 397.6978 Guardian advocate; patient incompetent to consent; 2594 substance abuse disorder.— 2595 (1) The administrator of a receiving facility or an 2596 addictions receiving facility may petition the court for the 2597 appointment of a guardian advocate based upon the opinion of a 2598 qualified professional that the patient is incompetent to 2599 consent to treatment. If the court finds that a patient is 2600 incompetent to consent to treatment and has not been adjudicated 2601 incapacitated and that a guardian with the authority to consent 2602 to substance abuse treatment has not been appointed, it may 2603 appoint a guardian advocate. The patient has the right to have 2604 an attorney represent him or her at the hearing. If the person 2605 is indigent, the court shall appoint the office of criminal 2606 conflict and civil regional counsel to represent him or her at 2607 the hearing. The patient has the right to testify, cross-examine 2608 witnesses, and present witnesses. The proceeding shall be 2609 recorded electronically or stenographically, and testimony must 2610 be provided under oath. One of the qualified professionals 2611 authorized to give an opinion in support of a petition for 2612 involuntary services, as described in s. 397.693, must testify. 2613 A guardian advocate must meet the qualifications of a guardian 2614 contained in part IV of chapter 744. The person who is appointed 2615 as a guardian advocate must agree to the appointment. 2616 (2) The following persons are prohibited from appointment 2617 as a patient’s guardian advocate: 2618 (a) A professional providing clinical services to the 2619 individual under this part. 2620 (b) The qualified professional who initiated the 2621 involuntary examination of the individual, if the examination 2622 was initiated by a qualified professional’s certificate. 2623 (c) An employee, an administrator, or a board member of the 2624 facility providing the examination of the individual. 2625 (d) An employee, an administrator, or a board member of the 2626 treatment facility providing treatment of the individual. 2627 (e) A person providing any substantial professional 2628 services, excluding public guardians or professional guardians, 2629 to the individual, including clinical services. 2630 (f) A creditor of the individual. 2631 (g) A person subject to an injunction for protection 2632 against domestic violence under s. 741.30, whether the order of 2633 injunction is temporary or final, and for which the individual 2634 was the petitioner. 2635 (h) A person subject to an injunction for protection 2636 against repeat violence, stalking, sexual violence, or dating 2637 violence under s. 784.046, whether the order of injunction is 2638 temporary or final, and for which the individual was the 2639 petitioner. 2640 (3) A facility requesting appointment of a guardian 2641 advocate must, before the appointment, provide the prospective 2642 guardian advocate with information about the duties and 2643 responsibilities of guardian advocates, including information 2644 about the ethics of medical decisionmaking. Before asking a 2645 guardian advocate to give consent to treatment for a patient, 2646 the facility must provide to the guardian advocate sufficient 2647 information so that the guardian advocate can decide whether to 2648 give express and informed consent to the treatment. Such 2649 information must include information that demonstrates that the 2650 treatment is essential to the care of the patient and does not 2651 present an unreasonable risk of serious, hazardous, or 2652 irreversible side effects. If possible, before giving consent to 2653 treatment, the guardian advocate must personally meet and talk 2654 with the patient and the patient’s physician. If that is not 2655 possible, the discussion may be conducted by telephone. The 2656 decision of the guardian advocate may be reviewed by the court, 2657 upon petition of the patient’s attorney, the patient’s family, 2658 or the facility administrator. 2659 (4) In lieu of the training required for guardians 2660 appointed pursuant to chapter 744, a guardian advocate shall 2661 attend at least a 4-hour training course approved by the court 2662 before exercising his or her authority. At a minimum, the 2663 training course must include information about patient rights, 2664 the diagnosis of substance abuse disorders, the ethics of 2665 medical decisionmaking, and the duties of guardian advocates. 2666 (5) The required training course and the information to be 2667 supplied to prospective guardian advocates before their 2668 appointment must be developed by the department, approved by the 2669 chief judge of the circuit court, and taught by a court-approved 2670 organization, which may include, but need not be limited to, a 2671 community college, a guardianship organization, a local bar 2672 association, or The Florida Bar. The training course may be web 2673 based, provided in video format, or provided in other electronic 2674 means but must be capable of ensuring the identity and 2675 participation of the prospective guardian advocate. The court 2676 may waive some or all of the training requirements for guardian 2677 advocates or impose additional requirements. The court shall 2678 make its decision on a case-by-case basis and, in making its 2679 decision, shall consider the experience and education of the 2680 guardian advocate, the duties assigned to the guardian advocate, 2681 and the needs of the patient. 2682 (6) In selecting a guardian advocate, the court shall give 2683 preference to the patient’s health care surrogate, if one has 2684 already been designated by the patient. If the patient has not 2685 previously designated a health care surrogate, the selection 2686 shall be made, except for good cause documented in the court 2687 record, from among the following persons, listed in order of 2688 priority: 2689 (a) The spouse of the patient. 2690 (b) An adult child of the patient. 2691 (c) A parent of the patient. 2692 (d) The adult next of kin of the patient. 2693 (e) An adult friend of the patient. 2694 (f) An adult trained and willing to serve as the guardian 2695 advocate for the patient. 2696 (7) If a guardian with the authority to consent to medical 2697 treatment has not already been appointed, or if the patient has 2698 not already designated a health care surrogate, the court may 2699 authorize the guardian advocate to consent to medical treatment 2700 as well as substance abuse disorder treatment. Unless otherwise 2701 limited by the court, a guardian advocate with authority to 2702 consent to medical treatment has the same authority to make 2703 health care decisions and is subject to the same restrictions as 2704 a proxy appointed under part IV of chapter 765. Unless the 2705 guardian advocate has sought and received express court approval 2706 in a proceeding separate from the proceeding to determine the 2707 competence of the patient to consent to medical treatment, the 2708 guardian advocate may not consent to: 2709 (a) Abortion. 2710 (b) Sterilization. 2711 (c) Electroshock therapy. 2712 (d) Psychosurgery. 2713 (e) Experimental treatments that have not been approved by 2714 a federally approved institutional review board in accordance 2715 with 45 C.F.R. part 46 or 21 C.F.R. part 56. 2716 2717 The court must base its authorization on evidence that the 2718 treatment or procedure is essential to the care of the patient 2719 and that the treatment does not present an unreasonable risk of 2720 serious, hazardous, or irreversible side effects. In complying 2721 with this subsection, the court shall follow the procedures set 2722 forth in subsection (1). 2723 (8) The guardian advocate shall be discharged when the 2724 patient is discharged from an order for involuntary services or 2725 when the patient is transferred from involuntary to voluntary 2726 status. The court or a hearing officer shall consider the 2727 competence of the patient as provided in subsection (1) and may 2728 consider an involuntarily placed patient’s competence to consent 2729 to services at any hearing. Upon sufficient evidence, the court 2730 may restore, or the magistrate may recommend that the court 2731 restore, the patient’s competence. A copy of the order restoring 2732 competence or the certificate of discharge containing the 2733 restoration of competence shall be provided to the patient and 2734 the guardian advocate. 2735 Section 44. Paragraphs (d) through (m) of subsection (2) of 2736 section 409.967, Florida Statutes, are redesignated as 2737 paragraphs (e) through (n), respectively, and a new paragraph 2738 (d) is added to that subsection, to read: 2739 409.967 Managed care plan accountability.— 2740 (2) The agency shall establish such contract requirements 2741 as are necessary for the operation of the statewide managed care 2742 program. In addition to any other provisions the agency may deem 2743 necessary, the contract must require: 2744 (d) Quality care.—Managed care plans shall provide, or 2745 contract for the provision of, care coordination to facilitate 2746 the appropriate delivery of behavioral health care services in 2747 the least restrictive setting with treatment and recovery 2748 capabilities that address the needs of the patient. Services 2749 shall be provided in a manner that integrates behavioral health 2750 services and primary care. Plans shall be required to achieve 2751 specific behavioral health outcome standards, established by the 2752 agency in consultation with the department. 2753 Section 45. Subsection (5) is added to section 409.973, 2754 Florida Statutes, to read: 2755 409.973 Benefits.— 2756 (5) INTEGRATED BEHAVIORAL HEALTH INITIATIVE.—Each plan 2757 operating in the managed medical assistance program shall work 2758 with the managing entity in its service area to establish 2759 specific organizational supports and protocols that enhance the 2760 integration and coordination of primary care and behavioral 2761 health services for Medicaid recipients. Progress in this 2762 initiative shall be measured using the integration framework and 2763 core measures developed by the Agency for Healthcare Research 2764 and Quality. 2765 Section 46. Notwithstanding the amendment made to s. 2766 409.975(6), Florida Statutes, by HB 5101, 1st Eng., 2016 Regular 2767 Session, subsection (6) of section 409.975, Florida Statutes, is 2768 reenacted to read: 2769 409.975 Managed care plan accountability.—In addition to 2770 the requirements of s. 409.967, plans and providers 2771 participating in the managed medical assistance program shall 2772 comply with the requirements of this section. 2773 (6) PROVIDER PAYMENT.—Managed care plans and hospitals 2774 shall negotiate mutually acceptable rates, methods, and terms of 2775 payment. For rates, methods, and terms of payment negotiated 2776 after the contract between the agency and the plan is executed, 2777 plans shall pay hospitals, at a minimum, the rate the agency 2778 would have paid on the first day of the contract between the 2779 provider and the plan. Such payments to hospitals may not exceed 2780 120 percent of the rate the agency would have paid on the first 2781 day of the contract between the provider and the plan, unless 2782 specifically approved by the agency. Payment rates may be 2783 updated periodically. 2784 Section 47. It is the intent of the Legislature that the 2785 reenactment of s. 409.975(6), Florida Statutes, shall control 2786 over the amendment to that subsection made by HB 5101, 1st Eng., 2787 2016 Regular Session, regardless of the order in which they are 2788 enacted. 2789 Section 48. Section 491.0045, Florida Statutes, is amended 2790 to read: 2791 491.0045 Intern registration; requirements.— 2792 (1)Effective January 1, 1998,An individual who has not 2793 satisfiedintends to practice in Florida to satisfythe 2794 postgraduate or post-master’s level experience requirements, as 2795 specified in s. 491.005(1)(c), (3)(c), or (4)(c), must register 2796 as an intern in the profession for which he or she is seeking 2797 licensure beforeprior tocommencing the post-master’s 2798 experience requirement or an individual who intends to satisfy 2799 part of the required graduate-level practicum, internship, or 2800 field experience, outside the academic arena for any profession, 2801 must register as an intern in the profession for which he or she 2802 is seeking licensure beforeprior tocommencing the practicum, 2803 internship, or field experience. 2804 (2) The department shall register as a clinical social 2805 worker intern, marriage and family therapist intern, or mental 2806 health counselor intern each applicant who the board certifies 2807 has: 2808 (a) Completed the application form and remitted a 2809 nonrefundable application fee not to exceed $200, as set by 2810 board rule; 2811 (b)1. Completed the education requirements as specified in 2812 s. 491.005(1)(c), (3)(c), or (4)(c) for the profession for which 2813 he or she is applying for licensure, if needed; and 2814 2. Submitted an acceptable supervision plan, as determined 2815 by the board, for meeting the practicum, internship, or field 2816 work required for licensure that was not satisfied in his or her 2817 graduate program. 2818 (c) Identified a qualified supervisor. 2819 (3) An individual registered under this section must remain 2820 under supervision while practicing under registered intern 2821 statusuntil he or she is in receipt of a license or a letter2822from the department stating that he or she is licensed to2823practice the profession for which he or she applied. 2824(4)An individual who has applied for intern registration2825on or before December 31, 2001, and has satisfied the education2826requirements of s. 491.005 that are in effect through December282731, 2000, will have met the educational requirements for2828licensure for the profession for which he or she has applied.2829 (4)(5)An individual who failsIndividuals who have2830commenced the experience requirement as specified in s.2831491.005(1)(c), (3)(c), or (4)(c) but failed to register as2832required by subsection (1) shall register with the department2833before January 1, 2000. Individuals who failto comply with this 2834 section maysubsection shallnot be granted a license under this 2835 chapter, and any time spent by the individual completing the 2836 experience requirement as specified in s. 491.005(1)(c), (3)(c), 2837 or (4)(c) beforeprior toregistering as an intern doesshall2838 not count toward completion of thesuchrequirement. 2839 (5) An intern registration is valid for 5 years. 2840 (6) A registration issued on or before March 31, 2017, 2841 expires March 31, 2022, and may not be renewed or reissued. Any 2842 registration issued after March 31, 2017, expires 60 months 2843 after the date it is issued. A subsequent intern registration 2844 may not be issued unless the candidate has passed the theory and 2845 practice examination described in s. 491.005(1)(d), (3)(d), and 2846 (4)(d). 2847 (7) An individual who has held a provisional license issued 2848 by the board may not apply for an intern registration in the 2849 same profession. 2850 Section 49. Section 394.4674, Florida Statutes, is 2851 repealed. 2852 Section 50. Section 394.4985, Florida Statutes, is 2853 repealed. 2854 Section 51. Section 394.745, Florida Statutes, is repealed. 2855 Section 52. Section 397.331, Florida Statutes, is repealed. 2856 Section 53. Section 397.801, Florida Statutes, is repealed. 2857 Section 54. Section 397.811, Florida Statutes, is repealed. 2858 Section 55. Section 397.821, Florida Statutes, is repealed. 2859 Section 56. Section 397.901, Florida Statutes, is repealed. 2860 Section 57. Section 397.93, Florida Statutes, is repealed. 2861 Section 58. Section 397.94, Florida Statutes, is repealed. 2862 Section 59. Section 397.951, Florida Statutes, is repealed. 2863 Section 60. Section 397.97, Florida Statutes, is repealed. 2864 Section 61. Section 397.98, Florida Statutes, is repealed. 2865 Section 62. Paragraph (a) of subsection (3) of section 2866 39.407, Florida Statutes, is amended to read: 2867 39.407 Medical, psychiatric, and psychological examination 2868 and treatment of child; physical, mental, or substance abuse 2869 examination of person with or requesting child custody.— 2870 (3)(a)1. Except as otherwise provided in subparagraph (b)1. 2871 or paragraph (e), before the department provides psychotropic 2872 medications to a child in its custody, the prescribing physician 2873 shall attempt to obtain express and informed consent, as defined 2874 in s. 394.455(15)s. 394.455(9)and as described in s. 2875 394.459(3)(a), from the child’s parent or legal guardian. The 2876 department must take steps necessary to facilitate the inclusion 2877 of the parent in the child’s consultation with the physician. 2878 However, if the parental rights of the parent have been 2879 terminated, the parent’s location or identity is unknown or 2880 cannot reasonably be ascertained, or the parent declines to give 2881 express and informed consent, the department may, after 2882 consultation with the prescribing physician, seek court 2883 authorization to provide the psychotropic medications to the 2884 child. Unless parental rights have been terminated and if it is 2885 possible to do so, the department shall continue to involve the 2886 parent in the decisionmaking process regarding the provision of 2887 psychotropic medications. If, at any time, a parent whose 2888 parental rights have not been terminated provides express and 2889 informed consent to the provision of a psychotropic medication, 2890 the requirements of this section that the department seek court 2891 authorization do not apply to that medication until such time as 2892 the parent no longer consents. 2893 2. Any time the department seeks a medical evaluation to 2894 determine the need to initiate or continue a psychotropic 2895 medication for a child, the department must provide to the 2896 evaluating physician all pertinent medical information known to 2897 the department concerning that child. 2898 Section 63. Subsection (1) of section 39.524, Florida 2899 Statutes, is amended to read: 2900 39.524 Safe-harbor placement.— 2901 (1) Except as provided in s. 39.407 or s. 985.801, a 2902 dependent child 6 years of age or older who has been found to be 2903 a victim of sexual exploitation as defined in s. 39.01(70)(g)s.290439.01(69)(g)must be assessed for placement in a safe house or 2905 safe foster home as provided in s. 409.1678 using the initial 2906 screening and assessment instruments provided in s. 409.1754(1). 2907 If such placement is determined to be appropriate for the child 2908 as a result of this assessment, the child may be placed in a 2909 safe house or safe foster home, if one is available. However, 2910 the child may be placed in another setting, if the other setting 2911 is more appropriate to the child’s needs or if a safe house or 2912 safe foster home is unavailable, as long as the child’s 2913 behaviors are managed so as not to endanger other children 2914 served in that setting. 2915 Section 64. Paragraph (e) of subsection (5) of section 2916 212.055, Florida Statutes, is amended to read: 2917 212.055 Discretionary sales surtaxes; legislative intent; 2918 authorization and use of proceeds.—It is the legislative intent 2919 that any authorization for imposition of a discretionary sales 2920 surtax shall be published in the Florida Statutes as a 2921 subsection of this section, irrespective of the duration of the 2922 levy. Each enactment shall specify the types of counties 2923 authorized to levy; the rate or rates which may be imposed; the 2924 maximum length of time the surtax may be imposed, if any; the 2925 procedure which must be followed to secure voter approval, if 2926 required; the purpose for which the proceeds may be expended; 2927 and such other requirements as the Legislature may provide. 2928 Taxable transactions and administrative procedures shall be as 2929 provided in s. 212.054. 2930 (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in 2931 s. 125.011(1) may levy the surtax authorized in this subsection 2932 pursuant to an ordinance either approved by extraordinary vote 2933 of the county commission or conditioned to take effect only upon 2934 approval by a majority vote of the electors of the county voting 2935 in a referendum. In a county as defined in s. 125.011(1), for 2936 the purposes of this subsection, “county public general 2937 hospital” means a general hospital as defined in s. 395.002 2938 which is owned, operated, maintained, or governed by the county 2939 or its agency, authority, or public health trust. 2940 (e) A governing board, agency, or authority shall be 2941 chartered by the county commission upon this act becoming law. 2942 The governing board, agency, or authority shall adopt and 2943 implement a health care plan for indigent health care services. 2944 The governing board, agency, or authority shall consist of no 2945 more than seven and no fewer than five members appointed by the 2946 county commission. The members of the governing board, agency, 2947 or authority shall be at least 18 years of age and residents of 2948 the county. No member may be employed by or affiliated with a 2949 health care provider or the public health trust, agency, or 2950 authority responsible for the county public general hospital. 2951 The following community organizations shall each appoint a 2952 representative to a nominating committee: the South Florida 2953 Hospital and Healthcare Association, the Miami-Dade County 2954 Public Health Trust, the Dade County Medical Association, the 2955 Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade 2956 County. This committee shall nominate between 10 and 14 county 2957 citizens for the governing board, agency, or authority. The 2958 slate shall be presented to the county commission and the county 2959 commission shall confirm the top five to seven nominees, 2960 depending on the size of the governing board. Until such time as 2961 the governing board, agency, or authority is created, the funds 2962 provided for in subparagraph (d)2. shall be placed in a 2963 restricted account set aside from other county funds and not 2964 disbursed by the county for any other purpose. 2965 1. The plan shall divide the county into a minimum of four 2966 and maximum of six service areas, with no more than one 2967 participant hospital per service area. The county public general 2968 hospital shall be designated as the provider for one of the 2969 service areas. Services shall be provided through participants’ 2970 primary acute care facilities. 2971 2. The plan and subsequent amendments to it shall fund a 2972 defined range of health care services for both indigent persons 2973 and the medically poor, including primary care, preventive care, 2974 hospital emergency room care, and hospital care necessary to 2975 stabilize the patient. For the purposes of this section, 2976 “stabilization” means stabilization as defined in s. 397.311(44) 2977s. 397.311(41). Where consistent with these objectives, the plan 2978 may include services rendered by physicians, clinics, community 2979 hospitals, and alternative delivery sites, as well as at least 2980 one regional referral hospital per service area. The plan shall 2981 provide that agreements negotiated between the governing board, 2982 agency, or authority and providers shall recognize hospitals 2983 that render a disproportionate share of indigent care, provide 2984 other incentives to promote the delivery of charity care to draw 2985 down federal funds where appropriate, and require cost 2986 containment, including, but not limited to, case management. 2987 From the funds specified in subparagraphs (d)1. and 2. for 2988 indigent health care services, service providers shall receive 2989 reimbursement at a Medicaid rate to be determined by the 2990 governing board, agency, or authority created pursuant to this 2991 paragraph for the initial emergency room visit, and a per-member 2992 per-month fee or capitation for those members enrolled in their 2993 service area, as compensation for the services rendered 2994 following the initial emergency visit. Except for provisions of 2995 emergency services, upon determination of eligibility, 2996 enrollment shall be deemed to have occurred at the time services 2997 were rendered. The provisions for specific reimbursement of 2998 emergency services shall be repealed on July 1, 2001, unless 2999 otherwise reenacted by the Legislature. The capitation amount or 3000 rate shall be determined beforeprior toprogram implementation 3001 by an independent actuarial consultant. In no event shall such 3002 reimbursement rates exceed the Medicaid rate. The plan must also 3003 provide that any hospitals owned and operated by government 3004 entities on or after the effective date of this act must, as a 3005 condition of receiving funds under this subsection, afford 3006 public access equal to that provided under s. 286.011 as to any 3007 meeting of the governing board, agency, or authority the subject 3008 of which is budgeting resources for the retention of charity 3009 care, as that term is defined in the rules of the Agency for 3010 Health Care Administration. The plan shall also include 3011 innovative health care programs that provide cost-effective 3012 alternatives to traditional methods of service and delivery 3013 funding. 3014 3. The plan’s benefits shall be made available to all 3015 county residents currently eligible to receive health care 3016 services as indigents or medically poor as defined in paragraph 3017 (4)(d). 3018 4. Eligible residents who participate in the health care 3019 plan shall receive coverage for a period of 12 months or the 3020 period extending from the time of enrollment to the end of the 3021 current fiscal year, per enrollment period, whichever is less. 3022 5. At the end of each fiscal year, the governing board, 3023 agency, or authority shall prepare an audit that reviews the 3024 budget of the plan, delivery of services, and quality of 3025 services, and makes recommendations to increase the plan’s 3026 efficiency. The audit shall take into account participant 3027 hospital satisfaction with the plan and assess the amount of 3028 poststabilization patient transfers requested, and accepted or 3029 denied, by the county public general hospital. 3030 Section 65. Paragraph (c) of subsection (2) of section 3031 394.4599, Florida Statutes, is amended to read: 3032 394.4599 Notice.— 3033 (2) INVOLUNTARY ADMISSION.— 3034 (c)1. A receiving facility shall give notice of the 3035 whereabouts of a minor who is being involuntarily held for 3036 examination pursuant to s. 394.463 to the minor’s parent, 3037 guardian, caregiver, or guardian advocate, in person or by 3038 telephone or other form of electronic communication, immediately 3039 after the minor’s arrival at the facility. The facility may 3040 delay notification for no more than 24 hours after the minor’s 3041 arrival if the facility has submitted a report to the central 3042 abuse hotline, pursuant to s. 39.201, based upon knowledge or 3043 suspicion of abuse, abandonment, or neglect and if the facility 3044 deems a delay in notification to be in the minor’s best 3045 interest. 3046 2. The receiving facility shall attempt to notify the 3047 minor’s parent, guardian, caregiver, or guardian advocate until 3048 the receiving facility receives confirmation from the parent, 3049 guardian, caregiver, or guardian advocate, verbally, by 3050 telephone or other form of electronic communication, or by 3051 recorded message, that notification has been received. Attempts 3052 to notify the parent, guardian, caregiver, or guardian advocate 3053 must be repeated at least once every hour during the first 12 3054 hours after the minor’s arrival and once every 24 hours 3055 thereafter and must continue until such confirmation is 3056 received, unless the minor is released at the end of the 72-hour 3057 examination period, or until a petition for involuntary services 3058placementis filed with the court pursuant to s. 394.463(2)(g) 3059s. 394.463(2)(i). The receiving facility may seek assistance 3060 from a law enforcement agency to notify the minor’s parent, 3061 guardian, caregiver, or guardian advocate if the facility has 3062 not received within the first 24 hours after the minor’s arrival 3063 a confirmation by the parent, guardian, caregiver, or guardian 3064 advocate that notification has been received. The receiving 3065 facility must document notification attempts in the minor’s 3066 clinical record. 3067 Section 66. Subsection (3) and paragraph (p) of subsection 3068 (4) of section 394.495, Florida Statutes, are amended to read: 3069 394.495 Child and adolescent mental health system of care; 3070 programs and services.— 3071 (3) Assessments must be performed by: 3072 (a) A professional as defined in s. 394.455(5), (7), (32), 3073 (35), or (36)s. 394.455(2), (4), (21), (23), or (24); 3074 (b) A professional licensed under chapter 491; or 3075 (c) A person who is under the direct supervision of a 3076 qualified professional as defined in s. 394.455(5), (7), (32), 3077 (35), or (36)s. 394.455(2), (4), (21), (23), or (24)or a 3078 professional licensed under chapter 491. 3079 (4) The array of services may include, but is not limited 3080 to: 3081 (p) Trauma-informed services for children who have suffered 3082 sexual exploitation as defined in s. 39.01(70)(g)s.308339.01(69)(g). 3084 Section 67. Subsection (5) of section 394.496, Florida 3085 Statutes, is amended to read: 3086 394.496 Service planning.— 3087 (5) A professional as defined in s. 394.455(5), (7), (32), 3088 (35), or (36)s. 394.455(2), (4), (21), (23), or (24)or a 3089 professional licensed under chapter 491 must be included among 3090 those persons developing the services plan. 3091 Section 68. Subsection (6) of section 394.9085, Florida 3092 Statutes, is amended to read: 3093 394.9085 Behavioral provider liability.— 3094 (6) For purposes of this section, the terms “detoxification 3095 services,” “addictions receiving facility,” and “receiving 3096 facility” have the same meanings as those provided in ss. 3097 397.311(25)(a)4., 397.311(25)(a)1., and 394.455(39)ss.3098397.311(22)(a)4., 397.311(22)(a)1., and 394.455(26), 3099 respectively. 3100 Section 69. Subsections (16) through (20) of section 3101 397.321, Florida Statutes, are renumbered as subsections (15) 3102 through (19), respectively, and present subsection (15) of that 3103 section is amended, to read: 3104 397.321 Duties of the department.—The department shall: 3105(15)Appoint a substance abuse impairment coordinator to3106represent the department in efforts initiated by the statewide3107substance abuse impairment prevention and treatment coordinator3108established in s. 397.801 and to assist the statewide3109coordinator in fulfilling the responsibilities of that position.3110 Section 70. Subsection (8) of section 397.405, Florida 3111 Statutes, is amended to read: 3112 397.405 Exemptions from licensure.—The following are exempt 3113 from the licensing provisions of this chapter: 3114 (8) A legally cognizable church or nonprofit religious 3115 organization or denomination providing substance abuse services, 3116 including prevention services, which are solely religious, 3117 spiritual, or ecclesiastical in nature. A church or nonprofit 3118 religious organization or denomination providing any of the 3119 licensed service components itemized under s. 397.311(25)s.3120397.311(22)is not exempt from substance abuse licensure but 3121 retains its exemption with respect to all services which are 3122 solely religious, spiritual, or ecclesiastical in nature. 3123 3124 The exemptions from licensure in this section do not apply to 3125 any service provider that receives an appropriation, grant, or 3126 contract from the state to operate as a service provider as 3127 defined in this chapter or to any substance abuse program 3128 regulated pursuant to s. 397.406. Furthermore, this chapter may 3129 not be construed to limit the practice of a physician or 3130 physician assistant licensed under chapter 458 or chapter 459, a 3131 psychologist licensed under chapter 490, a psychotherapist 3132 licensed under chapter 491, or an advanced registered nurse 3133 practitioner licensed under part I of chapter 464, who provides 3134 substance abuse treatment, so long as the physician, physician 3135 assistant, psychologist, psychotherapist, or advanced registered 3136 nurse practitioner does not represent to the public that he or 3137 she is a licensed service provider and does not provide services 3138 to individuals pursuant to part V of this chapter. Failure to 3139 comply with any requirement necessary to maintain an exempt 3140 status under this section is a misdemeanor of the first degree, 3141 punishable as provided in s. 775.082 or s. 775.083. 3142 Section 71. Subsections (1) and (5) of section 397.407, 3143 Florida Statutes, are amended to read: 3144 397.407 Licensure process; fees.— 3145 (1) The department shall establish the licensure process to 3146 include fees and categories of licenses and must prescribe a fee 3147 range that is based, at least in part, on the number and 3148 complexity of programs listed in s. 397.311(25)s. 397.311(22)3149 which are operated by a licensee. The fees from the licensure of 3150 service components are sufficient to cover at least 50 percent 3151 of the costs of regulating the service components. The 3152 department shall specify a fee range for public and privately 3153 funded licensed service providers. Fees for privately funded 3154 licensed service providers must exceed the fees for publicly 3155 funded licensed service providers. 3156 (5) The department may issue probationary, regular, and 3157 interim licenses. The department shall issue one license for 3158 each service component that is operated by a service provider 3159 and defined pursuant to s. 397.311(25)s. 397.311(22). The 3160 license is valid only for the specific service components listed 3161 for each specific location identified on the license. The 3162 licensed service provider shall apply for a new license at least 3163 60 days before the addition of any service components or 30 days 3164 before the relocation of any of its service sites. Provision of 3165 service components or delivery of services at a location not 3166 identified on the license may be considered an unlicensed 3167 operation that authorizes the department to seek an injunction 3168 against operation as provided in s. 397.401, in addition to 3169 other sanctions authorized by s. 397.415. Probationary and 3170 regular licenses may be issued only after all required 3171 information has been submitted. A license may not be 3172 transferred. As used in this subsection, the term “transfer” 3173 includes, but is not limited to, the transfer of a majority of 3174 the ownership interest in the licensed entity or transfer of 3175 responsibilities under the license to another entity by 3176 contractual arrangement. 3177 Section 72. Section 397.416, Florida Statutes, is amended 3178 to read: 3179 397.416 Substance abuse treatment services; qualified 3180 professional.—Notwithstanding any other provision of law, a 3181 person who was certified through a certification process 3182 recognized by the former Department of Health and Rehabilitative 3183 Services before January 1, 1995, may perform the duties of a 3184 qualified professional with respect to substance abuse treatment 3185 services as defined in this chapter, and need not meet the 3186 certification requirements contained in s. 397.311(33)s.3187397.311(30). 3188 Section 73. Subsection (2) of section 397.4871, Florida 3189 Statutes, is amended to read: 3190 397.4871 Recovery residence administrator certification.— 3191 (2) The department shall approve at least one credentialing 3192 entity by December 1, 2015, for the purpose of developing and 3193 administering a voluntary credentialing program for 3194 administrators. The department shall approve any credentialing 3195 entity that the department endorses pursuant to s. 397.321(15) 3196s. 397.321(16)if the credentialing entity also meets the 3197 requirements of this section. The approved credentialing entity 3198 shall: 3199 (a) Establish recovery residence administrator core 3200 competencies, certification requirements, testing instruments, 3201 and recertification requirements. 3202 (b) Establish a process to administer the certification 3203 application, award, and maintenance processes. 3204 (c) Develop and administer: 3205 1. A code of ethics and disciplinary process. 3206 2. Biennial continuing education requirements and annual 3207 certification renewal requirements. 3208 3. An education provider program to approve training 3209 entities that are qualified to provide precertification training 3210 to applicants and continuing education opportunities to 3211 certified persons. 3212 Section 74. Paragraph (c) of subsection (1) and paragraphs 3213 (a) and (b) of subsection (6) of section 409.1678, Florida 3214 Statutes, are amended to read: 3215 409.1678 Specialized residential options for children who 3216 are victims of sexual exploitation.— 3217 (1) DEFINITIONS.—As used in this section, the term: 3218 (c) “Sexually exploited child” means a child who has 3219 suffered sexual exploitation as defined in s. 39.01(70)(g)s.322039.01(69)(g)and is ineligible for relief and benefits under the 3221 federal Trafficking Victims Protection Act, 22 U.S.C. ss. 7101 3222 et seq. 3223 (6) LOCATION INFORMATION.— 3224 (a) Information about the location of a safe house, safe 3225 foster home, or other residential facility serving victims of 3226 sexual exploitation, as defined in s. 39.01(70)(g)s.322739.01(69)(g), which is held by an agency, as defined in s. 3228 119.011, is confidential and exempt from s. 119.07(1) and s. 3229 24(a), Art. I of the State Constitution. This exemption applies 3230 to such confidential and exempt information held by an agency 3231 before, on, or after the effective date of the exemption. 3232 (b) Information about the location of a safe house, safe 3233 foster home, or other residential facility serving victims of 3234 sexual exploitation, as defined in s. 39.01(70)(g)s.323539.01(69)(g), may be provided to an agency, as defined in s. 3236 119.011, as necessary to maintain health and safety standards 3237 and to address emergency situations in the safe house, safe 3238 foster home, or other residential facility. 3239 Section 75. Paragraph (e) of subsection (3) of section 3240 409.966, Florida Statutes, is amended to read: 3241 409.966 Eligible plans; selection.— 3242 (3) QUALITY SELECTION CRITERIA.— 3243 (e) To ensure managed care plan participation in Regions 1 3244 and 2, the agency shall award an additional contract to each 3245 plan with a contract award in Region 1 or Region 2. Such 3246 contract shall be in any other region in which the plan 3247 submitted a responsive bid and negotiates a rate acceptable to 3248 the agency. If a plan that is awarded an additional contract 3249 pursuant to this paragraph is subject to penalties pursuant to 3250 s. 409.967(2)(i)s. 409.967(2)(h)for activities in Region 1 or 3251 Region 2, the additional contract is automatically terminated 3252 180 days after the imposition of the penalties. The plan must 3253 reimburse the agency for the cost of enrollment changes and 3254 other transition activities. 3255 Section 76. Paragraph (b) of subsection (1) of section 3256 409.972, Florida Statutes, is amended to read: 3257 409.972 Mandatory and voluntary enrollment.— 3258 (1) The following Medicaid-eligible persons are exempt from 3259 mandatory managed care enrollment required by s. 409.965, and 3260 may voluntarily choose to participate in the managed medical 3261 assistance program: 3262 (b) Medicaid recipients residing in residential commitment 3263 facilities operated through the Department of Juvenile Justice 3264 or amental healthtreatment facilityfacilitiesas defined in 3265 s. 394.455(47)by s. 394.455(32). 3266 Section 77. Paragraphs (d) and (g) of subsection (1) of 3267 section 440.102, Florida Statutes, are amended to read: 3268 440.102 Drug-free workplace program requirements.—The 3269 following provisions apply to a drug-free workplace program 3270 implemented pursuant to law or to rules adopted by the Agency 3271 for Health Care Administration: 3272 (1) DEFINITIONS.—Except where the context otherwise 3273 requires, as used in this act: 3274 (d) “Drug rehabilitation program” means a service provider, 3275 established pursuant to s. 397.311(42)s. 397.311(39), that 3276 provides confidential, timely, and expert identification, 3277 assessment, and resolution of employee drug abuse. 3278 (g) “Employee assistance program” means an established 3279 program capable of providing expert assessment of employee 3280 personal concerns; confidential and timely identification 3281 services with regard to employee drug abuse; referrals of 3282 employees for appropriate diagnosis, treatment, and assistance; 3283 and followup services for employees who participate in the 3284 program or require monitoring after returning to work. If, in 3285 addition to the above activities, an employee assistance program 3286 provides diagnostic and treatment services, these services shall 3287 in all cases be provided by service providers pursuant to s. 3288 397.311(42)s. 397.311(39). 3289 Section 78. Subsection (7) of section 744.704, Florida 3290 Statutes, is amended to read: 3291 744.704 Powers and duties.— 3292 (7) A public guardian mayshallnot commit a ward to a 3293mental healthtreatment facility, as defined in s. 394.455(47) 3294s. 394.455(32), without an involuntary placement proceeding as 3295 provided by law. 3296 Section 79. Subsection (5) of section 960.065, Florida 3297 Statutes, is amended to read: 3298 960.065 Eligibility for awards.— 3299 (5) A person is not ineligible for an award pursuant to 3300 paragraph (2)(a), paragraph (2)(b), or paragraph (2)(c) if that 3301 person is a victim of sexual exploitation of a child as defined 3302 in s. 39.01(70)(g)s. 39.01(69)(g). 3303 Section 80. The Secretary of Children and Families shall 3304 appoint a workgroup to consider the feasibility of individuals 3305 using advance directives to express the treatment wishes for 3306 substance use disorders. The workgroup shall be composed of 3307 individuals with expertise in the treatment of substance use 3308 disorders. The workgroup must review the use of advance 3309 directives in mental health, the use of advance directives for 3310 substance use disorders in other states, and the use of similar 3311 legal instruments to express the treatment wishes of individuals 3312 suffering from substance use disorders. The workgroup shall 3313 provide a report to the Governor, the President of the Senate, 3314 and the Speaker of the House of Representatives by January 1, 3315 2017. The report must include recommendations on the feasibility 3316 of using advance directives for individuals with substance use 3317 disorders and recommendations for any revisions to state laws or 3318 agency rules. The members of the workgroup are not entitled to 3319 reimbursement from the Department of Children and Families for 3320 travel for workgroup meetings unless they are employees of the 3321 department. This section expires on May 6, 2017. 3322 Section 81. Paragraph (b) of subsection (2) of section 3323 61.13, Florida Statutes, is amended to read: 3324 61.13 Support of children; parenting and time-sharing; 3325 powers of court.— 3326 (2) 3327 (b) A parenting plan approved by the court must, at a 3328 minimum:,3329 1. Describe in adequate detail how the parents will share 3330 and be responsible for the daily tasks associated with the 3331 upbringing of the child; 3332 2. Include the time-sharing schedule arrangements that 3333 specify the time that the minor child will spend with each 3334 parent; 3335 3. Designatea designation ofwho will be responsible for: 3336 a. Any and all forms of health care. If the court orders 3337 shared parental responsibility over health care decisions, the 3338 parenting plan must provide that either parent may consent to 3339 mental health treatment for the child. 3340 b. School-related matters, including the address to be used 3341 for school-boundary determination and registration., and3342 c. Other activities; and 3343 4. Describe in adequate detail the methods and technologies 3344 that the parents will use to communicate with the child. 3345 Section 82. Subsection (6) of section 39.001, Florida 3346 Statutes, is amended to read: 3347 39.001 Purposes and intent; personnel standards and 3348 screening.— 3349 (6) MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES.— 3350 (a) The Legislature recognizes that early referral and 3351 comprehensive treatment can help combat mental illnesses and 3352 substance abuse disorders in families and that treatment is 3353 cost-effective. 3354 (b) The Legislature establishes the following goals for the 3355 state related to mental illness and substance abuse treatment 3356 services in the dependency process: 3357 1. To ensure the safety of children. 3358 2. To prevent and remediate the consequences of mental 3359 illnesses and substance abuse disorders on families involved in 3360 protective supervision or foster care and reduce the occurrences 3361 of mental illnesses and substance abuse disorders, including 3362 alcohol abuse or related disorders, for families who are at risk 3363 of being involved in protective supervision or foster care. 3364 3. To expedite permanency for children and reunify healthy, 3365 intact families, when appropriate. 3366 4. To support families in recovery. 3367 (c) The Legislature finds that children in the care of the 3368 state’s dependency system need appropriate health care services, 3369 that the impact of mental illnesses and substance abuse 3370 disorders on health indicates the need for health care services 3371 to include treatment for mental health and substance abuse 3372 disorders forservices tochildren and parents, where 3373 appropriate, and that it is in the state’s best interest that 3374 such children be provided the services they need to enable them 3375 to become and remain independent of state care. In order to 3376 provide these services, the state’s dependency system must have 3377 the ability to identify and provide appropriate intervention and 3378 treatment for children with personal or family-related mental 3379 illness and substance abuse problems. 3380 (d) It is the intent of the Legislature to encourage the 3381 use of the mental health court program model established under 3382 chapter 394 and the drug court program model established under 3383bys. 397.334 and authorize courts to assess children and 3384 persons who have custody or are requesting custody of children 3385 where good cause is shown to identify and address mental 3386 illnesses and substance abuse disordersproblemsas the court 3387 deems appropriate at every stage of the dependency process. 3388 Participation in treatment, including a mental health court 3389 program or a treatment-based drug court program, may be required 3390 by the court following adjudication. Participation in assessment 3391 and treatment beforeprior toadjudication isshall be3392 voluntary, except as provided in s. 39.407(16). 3393 (e) It is therefore the purpose of the Legislature to 3394 provide authority for the state to contract with mental health 3395 service providers and community substance abuse treatment 3396 providers for the development and operation of specialized 3397 support and overlay services for the dependency system, which 3398 will be fully implemented and used as resources permit. 3399 (f) Participation in a mental health court program or athe3400 treatment-based drug court program does not divest any public or 3401 private agency of its responsibility for a child or adult, but 3402 is intended to enable these agencies to better meet their needs 3403 through shared responsibility and resources. 3404 Section 83. Subsection (10) of section 39.507, Florida 3405 Statutes, is amended to read: 3406 39.507 Adjudicatory hearings; orders of adjudication.— 3407 (10) After an adjudication of dependency, or a finding of 3408 dependency in whichwhereadjudication is withheld, the court 3409 may order a person who has custody or is requesting custody of 3410 the child to submit to a mental health or substance abuse 3411 disorder assessment or evaluation. The order may be made only 3412 upon good cause shown and pursuant to notice and procedural 3413 requirements provided under the Florida Rules of Juvenile 3414 Procedure. The assessment or evaluation must be administered by 3415 an appropriateaqualified professional, as defined in s. 39.01 3416 or s. 397.311. The court may also require such person to 3417 participate in and comply with treatment and services identified 3418 as necessary, including, when appropriate and available, 3419 participation in and compliance with a mental health court 3420 program established under chapter 394 or a treatment-based drug 3421 court program established under s. 397.334. In addition to 3422 supervision by the department, the court, including the mental 3423 health court program or treatment-based drug court program, may 3424 oversee the progress and compliance with treatment by a person 3425 who has custody or is requesting custody of the child. The court 3426 may impose appropriate available sanctions for noncompliance 3427 upon a person who has custody or is requesting custody of the 3428 child or make a finding of noncompliance for consideration in 3429 determining whether an alternative placement of the child is in 3430 the child’s best interests. Any order entered under this 3431 subsection may be made only upon good cause shown. This 3432 subsection does not authorize placement of a child with a person 3433 seeking custody, other than the parent or legal custodian, who 3434 requires mental health or substance abuse disorder treatment. 3435 Section 84. Paragraph (b) of subsection (1) of section 3436 39.521, Florida Statutes, is amended to read: 3437 39.521 Disposition hearings; powers of disposition.— 3438 (1) A disposition hearing shall be conducted by the court, 3439 if the court finds that the facts alleged in the petition for 3440 dependency were proven in the adjudicatory hearing, or if the 3441 parents or legal custodians have consented to the finding of 3442 dependency or admitted the allegations in the petition, have 3443 failed to appear for the arraignment hearing after proper 3444 notice, or have not been located despite a diligent search 3445 having been conducted. 3446 (b) When any child is adjudicated by a court to be 3447 dependent, the court having jurisdiction of the child has the 3448 power by order to: 3449 1. Require the parent and, when appropriate, the legal 3450 custodian and the child to participate in treatment and services 3451 identified as necessary. The court may require the person who 3452 has custody or who is requesting custody of the child to submit 3453 to a mental health or substance abuse disorder assessment or 3454 evaluation. The order may be made only upon good cause shown and 3455 pursuant to notice and procedural requirements provided under 3456 the Florida Rules of Juvenile Procedure. The mental health 3457 assessment or evaluation must be administered by a qualified 3458 professional,as defined in s. 39.01, and the substance abuse 3459 assessment or evaluation must be administered by a qualified 3460 professional as defined in s. 397.311. The court may also 3461 require such person to participate in and comply with treatment 3462 and services identified as necessary, including, when 3463 appropriate and available, participation in and compliance with 3464 a mental health court program established under chapter 394 or a 3465 treatment-based drug court program established under s. 397.334. 3466 In addition to supervision by the department, the court, 3467 including the mental health court program or the treatment-based 3468 drug court program, may oversee the progress and compliance with 3469 treatment by a person who has custody or is requesting custody 3470 of the child. The court may impose appropriate available 3471 sanctions for noncompliance upon a person who has custody or is 3472 requesting custody of the child or make a finding of 3473 noncompliance for consideration in determining whether an 3474 alternative placement of the child is in the child’s best 3475 interests. Any order entered under this subparagraph may be made 3476 only upon good cause shown. This subparagraph does not authorize 3477 placement of a child with a person seeking custody of the child, 3478 other than the child’s parent or legal custodian, who requires 3479 mental health or substance abuse disorder treatment. 3480 2. Require, if the court deems necessary, the parties to 3481 participate in dependency mediation. 3482 3. Require placement of the child either under the 3483 protective supervision of an authorized agent of the department 3484 in the home of one or both of the child’s parents or in the home 3485 of a relative of the child or another adult approved by the 3486 court, or in the custody of the department. Protective 3487 supervision continues until the court terminates it or until the 3488 child reaches the age of 18, whichever date is first. Protective 3489 supervision shall be terminated by the court whenever the court 3490 determines that permanency has been achieved for the child, 3491 whether with a parent, another relative, or a legal custodian, 3492 and that protective supervision is no longer needed. The 3493 termination of supervision may be with or without retaining 3494 jurisdiction, at the court’s discretion, and shall in either 3495 case be considered a permanency option for the child. The order 3496 terminating supervision by the department mustshallset forth 3497 the powers of the custodian of the child andshallinclude the 3498 powers ordinarily granted to a guardian of the person of a minor 3499 unless otherwise specified. Upon the court’s termination of 3500 supervision by the department,nofurther judicial reviews are 3501 not required if, so long aspermanency has been established for 3502 the child. 3503 Section 85. Section 394.4655, Florida Statutes, is amended 3504 to read: 3505 394.4655 Involuntary outpatient servicesplacement.— 3506 (1) DEFINITIONS.—As used in this section, the term: 3507 (a) “Court” means a circuit court or a criminal county 3508 court. 3509 (b) “Criminal county court” means a county court exercising 3510 its original jurisdiction in a misdemeanor case under s. 34.01. 3511 (2)(1)CRITERIA FOR INVOLUNTARY OUTPATIENT SERVICES 3512PLACEMENT.—A person may be ordered to involuntary outpatient 3513 servicesplacementupon a finding of the court, by clear and 3514 convincing evidence, that the person meets all of the following 3515 criteriaby clear and convincing evidence: 3516 (a) The person is 18 years of age or older.;3517 (b) The person has a mental illness.;3518 (c) The person is unlikely to survive safely in the 3519 community without supervision, based on a clinical 3520 determination.;3521 (d) The person has a history of lack of compliance with 3522 treatment for mental illness.;3523 (e) The person has: 3524 1. At least twice within the immediately preceding 36 3525 months been involuntarily admitted to a receiving or treatment 3526 facility as defined in s. 394.455, or has received mental health 3527 services in a forensic or correctional facility. The 36-month 3528 period does not include any period during which the person was 3529 admitted or incarcerated; or 3530 2. Engaged in one or more acts of serious violent behavior 3531 toward self or others, or attempts at serious bodily harm to 3532 himself or herself or others, within the preceding 36 months.;3533 (f) The person is, as a result of his or her mental 3534 illness, unlikely to voluntarily participate in the recommended 3535 treatment plan andeither he or shehas refused voluntary 3536 servicesplacementfor treatment after sufficient and 3537 conscientious explanation and disclosure of why the services are 3538 necessarypurpose of placement for treatmentorhe or sheis 3539 unable to determine for himself or herself whether services are 3540placement isnecessary.;3541 (g) In view of the person’s treatment history and current 3542 behavior, the person is in need of involuntary outpatient 3543 servicesplacementin order to prevent a relapse or 3544 deterioration that would be likely to result in serious bodily 3545 harm to himself or herself or others, or a substantial harm to 3546 his or her well-being as set forth in s. 394.463(1).;3547 (h) It is likely that the person will benefit from 3548 involuntary outpatient services.placement; and3549 (i) All available, less restrictive alternatives that would 3550 offer an opportunity for improvement of his or her condition 3551 have been judged to be inappropriate or unavailable. 3552 (3)(2)INVOLUNTARY OUTPATIENT SERVICESPLACEMENT.— 3553 (a)1. A patient who is being recommended for involuntary 3554 outpatient servicesplacementby the administrator of the 3555receivingfacility where the patient has been examined may be 3556 retained by the facility after adherence to the notice 3557 procedures provided in s. 394.4599. The recommendation must be 3558 supported by the opinion of a psychiatrist and the second 3559 opinion of a clinical psychologist or another psychiatrist, both 3560 of whom have personally examined the patient within the 3561 preceding 72 hours, that the criteria for involuntary outpatient 3562 servicesplacementare met. However,in a county having a3563population of fewer than 50,000,if the administrator certifies 3564 that a psychiatrist or clinical psychologist is not available to 3565 provide the second opinion, the second opinion may be provided 3566 by a licensed physician who has postgraduate training and 3567 experience in diagnosis and treatment of mental illness, a 3568 physician assistant who has at least 3 years’ experience and is 3569 supervised by such licensed physician or a psychiatrist, a 3570 clinical social worker,and nervous disordersor by a 3571 psychiatric nurse. Any second opinion authorized in this 3572 subparagraph may be conducted through a face-to-face 3573 examination, in person or by electronic means. Such 3574 recommendation must be entered on an involuntary outpatient 3575 servicesplacementcertificate that authorizes thereceiving3576 facility to retain the patient pending completion of a hearing. 3577 The certificate mustshallbe made a part of the patient’s 3578 clinical record. 3579 2. If the patient has been stabilized and no longer meets 3580 the criteria for involuntary examination pursuant to s. 3581 394.463(1), the patient must be released from thereceiving3582 facility while awaiting the hearing for involuntary outpatient 3583 servicesplacement. Before filing a petition for involuntary 3584 outpatient servicestreatment, the administrator of thea3585receivingfacility or a designated department representative 3586 must identify the service provider that will have primary 3587 responsibility for service provision under an order for 3588 involuntary outpatient servicesplacement, unless the person is 3589 otherwise participating in outpatient psychiatric treatment and 3590 is not in need of public financing for that treatment, in which 3591 case the individual, if eligible, may be ordered to involuntary 3592 treatment pursuant to the existing psychiatric treatment 3593 relationship. 3594 3. The service provider shall prepare a written proposed 3595 treatment plan in consultation with the patient or the patient’s 3596 guardian advocate, if appointed, for the court’s consideration 3597 for inclusion in the involuntary outpatient servicesplacement3598 order that addresses the nature and extent of the mental illness 3599 and any co-occurring substance use disorder that necessitate 3600 involuntary outpatient services. The treatment plan must specify 3601 the likely level of care, including the use of medication, and 3602 anticipated discharge criteria for terminating involuntary 3603 outpatient services.The service provider shall also provide a3604copy of the proposed treatment plan to the patient and the3605administrator of the receiving facility. The treatment plan must3606specify the nature and extent of the patient’s mental illness,3607address the reduction of symptoms that necessitate involuntary3608outpatient placement, and include measurable goals and3609objectives for the services and treatment that are provided to3610treat the person’s mental illness and assist the person in3611living and functioning in the community or to prevent a relapse3612or deterioration.Service providers may select and supervise 3613 other individuals to implement specific aspects of the treatment 3614 plan. The services in thetreatmentplan must be deemed 3615 clinically appropriate by a physician, clinical psychologist, 3616 psychiatric nurse, mental health counselor, marriage and family 3617 therapist, or clinical social worker who consults with, or is 3618 employed or contracted by, the service provider. The service 3619 provider must certify to the court in the proposedtreatment3620 plan whether sufficient services for improvement and 3621 stabilization are currently available and whether the service 3622 provider agrees to provide those services. If the service 3623 provider certifies that the services in the proposed treatment 3624 plan are not available, the petitioner may not file the 3625 petition. The service provider must notify the managing entity 3626 if the requested services are not available. The managing entity 3627 must document such efforts to obtain the requested services. 3628 (b) If a patient in involuntary inpatient placement meets 3629 the criteria for involuntary outpatient servicesplacement, the 3630 administrator of thetreatmentfacility may, before the 3631 expiration of the period during which thetreatmentfacility is 3632 authorized to retain the patient, recommend involuntary 3633 outpatient servicesplacement. The recommendation must be 3634 supported by the opinion of a psychiatrist and the second 3635 opinion of a clinical psychologist or another psychiatrist, both 3636 of whom have personally examined the patient within the 3637 preceding 72 hours, that the criteria for involuntary outpatient 3638 servicesplacementare met. However,in a county having a3639population of fewer than 50,000,if the administrator certifies 3640 that a psychiatrist or clinical psychologist is not available to 3641 provide the second opinion, the second opinion may be provided 3642 by a licensed physician who has postgraduate training and 3643 experience in diagnosis and treatment of mental illness, a 3644 physician assistant who has at least three years’ experience and 3645 is supervised by such licensed physician or a psychiatrist, a 3646 clinical social worker,and nervous disordersor by a 3647 psychiatric nurse. Any second opinion authorized in this 3648 subparagraph may be conducted through a face-to-face 3649 examination, in person or by electronic means. Such 3650 recommendation must be entered on an involuntary outpatient 3651 servicesplacementcertificate, and the certificate must be made 3652 a part of the patient’s clinical record. 3653 (c)1. The administrator of the treatment facility shall 3654 provide a copy of the involuntary outpatient servicesplacement3655 certificate and a copy of the state mental health discharge form 3656 to the managing entitya department representativein the county 3657 where the patient will be residing. For persons who are leaving 3658 a state mental health treatment facility, the petition for 3659 involuntary outpatient servicesplacementmust be filed in the 3660 county where the patient will be residing. 3661 2. The service provider that will have primary 3662 responsibility for service provision shall be identified by the 3663 designated department representative beforeprior tothe order 3664 for involuntary outpatient servicesplacementand must, before 3665prior tofiling a petition for involuntary outpatient services 3666placement, certify to the court whether the services recommended 3667 in the patient’s discharge plan are availablein the local3668communityand whether the service provider agrees to provide 3669 those services. The service provider must develop with the 3670 patient, or the patient’s guardian advocate, if appointed, a 3671 treatment or service plan that addresses the needs identified in 3672 the discharge plan. The plan must be deemed to be clinically 3673 appropriate by a physician, clinical psychologist, psychiatric 3674 nurse, mental health counselor, marriage and family therapist, 3675 or clinical social worker, as defined in this chapter, who 3676 consults with, or is employed or contracted by, the service 3677 provider. 3678 3. If the service provider certifies that the services in 3679 the proposed treatment or service plan are not available, the 3680 petitioner may not file the petition. The service provider must 3681 notify the managing entity if the requested services are not 3682 available. The managing entity must document such efforts to 3683 obtain the requested services. 3684 (4)(3)PETITION FOR INVOLUNTARY OUTPATIENT SERVICES 3685PLACEMENT.— 3686 (a) A petition for involuntary outpatient services 3687placementmay be filed by: 3688 1. The administrator of a receiving facility; or 3689 2. The administrator of a treatment facility. 3690 (b) Each required criterion for involuntary outpatient 3691 servicesplacementmust be alleged and substantiated in the 3692 petition for involuntary outpatient servicesplacement. A copy 3693 of the certificate recommending involuntary outpatient services 3694placementcompleted by a qualified professional specified in 3695 subsection (3)(2)must be attached to the petition. A copy of 3696 the proposed treatment plan must be attached to the petition. 3697 Before the petition is filed, the service provider shall certify 3698 that the services in the proposedtreatmentplan are available. 3699 If the necessary services are not availablein the patient’s3700local community to respond to the person’s individual needs, the 3701 petition may not be filed. The service provider must notify the 3702 managing entity if the requested services are not available. The 3703 managing entity must document such efforts to obtain the 3704 requested services. 3705 (c) The petition for involuntary outpatient services 3706placementmust be filed in the county where the patient is 3707 located, unless the patient is being placed from a state 3708 treatment facility, in which case the petition must be filed in 3709 the county where the patient will reside. When the petition has 3710 been filed, the clerk of the court shall provide copies of the 3711 petition and the proposed treatment plan to the department, the 3712 managing entity, the patient, the patient’s guardian or 3713 representative, the state attorney, and the public defender or 3714 the patient’s private counsel. A fee may not be charged for 3715 filing a petition under this subsection. 3716 (5)(4)APPOINTMENT OF COUNSEL.—Within 1 court working day 3717 after the filing of a petition for involuntary outpatient 3718 servicesplacement, the court shall appoint the public defender 3719 to represent the person who is the subject of the petition, 3720 unless the person is otherwise represented by counsel. The clerk 3721 of the court shall immediately notify the public defender of the 3722 appointment. The public defender shall represent the person 3723 until the petition is dismissed, the court order expires, or the 3724 patient is discharged from involuntary outpatient services 3725placement. An attorney who represents the patient must be 3726 providedshall haveaccess to the patient, witnesses, and 3727 records relevant to the presentation of the patient’s case and 3728 shall represent the interests of the patient, regardless of the 3729 source of payment to the attorney. 3730 (6)(5)CONTINUANCE OF HEARING.—The patient is entitled, 3731 with the concurrence of the patient’s counsel, to at least one 3732 continuance of the hearing. The continuance shall be for a 3733 period of up to 4 weeks. 3734 (7)(6)HEARING ON INVOLUNTARY OUTPATIENT SERVICES 3735PLACEMENT.— 3736 (a)1. The court shall hold the hearing on involuntary 3737 outpatient servicesplacementwithin 5 working days after the 3738 filing of the petition, unless a continuance is granted. The 3739 hearing mustshallbe held in the county where the petition is 3740 filed, mustshallbe as convenient to the patient as is 3741 consistent with orderly procedure, and mustshallbe conducted 3742 in physical settings not likely to be injurious to the patient’s 3743 condition. If the court finds that the patient’s attendance at 3744 the hearing is not consistent with the best interests of the 3745 patient and if the patient’s counsel does not object, the court 3746 may waive the presence of the patient from all or any portion of 3747 the hearing. The state attorney for the circuit in which the 3748 patient is located shall represent the state, rather than the 3749 petitioner, as the real party in interest in the proceeding. 3750 2. The court may appoint a magistratemasterto preside at 3751 the hearing. One of the professionals who executed the 3752 involuntary outpatient servicesplacementcertificate shall be a 3753 witness. The patient and the patient’s guardian or 3754 representative shall be informed by the court of the right to an 3755 independent expert examination. If the patient cannot afford 3756 such an examination, the court shall ensure that one is 3757 provided, as otherwise provided by lawprovide for one. The 3758 independent expert’s report isshall beconfidential and not 3759 discoverable, unless the expert is to be called as a witness for 3760 the patient at the hearing. The court shall allow testimony from 3761 individuals, including family members, deemed by the court to be 3762 relevant under state law, regarding the person’s prior history 3763 and how that prior history relates to the person’s current 3764 condition. The testimony in the hearing must be given under 3765 oath, and the proceedings must be recorded. The patient may 3766 refuse to testify at the hearing. 3767 (b)1. If the court concludes that the patient meets the 3768 criteria for involuntary outpatient servicesplacementpursuant 3769 to subsection (2)(1), the court shall issue an order for 3770 involuntary outpatient servicesplacement. The court order shall 3771 be for a period of up to 90 days6 months. The order must 3772 specify the nature and extent of the patient’s mental illness. 3773 The order of the court and the treatment plan mustshallbe made 3774 part of the patient’s clinical record. The service provider 3775 shall discharge a patient from involuntary outpatient services 3776placementwhen the order expires or any time the patient no 3777 longer meets the criteria for involuntary placement. Upon 3778 discharge, the service provider shall send a certificate of 3779 discharge to the court. 3780 2. The court may not order the department or the service 3781 provider to provide services if the program or service is not 3782 available in the patient’s local community, if there is no space 3783 available in the program or service for the patient, or if 3784 funding is not available for the program or service. The service 3785 provider must notify the managing entity if the requested 3786 services are not available. The managing entity must document 3787 such efforts to obtain the requested services. A copy of the 3788 order must be sent to the managing entityAgency for Health Care3789Administrationby the service provider within 1 working day 3790 after it is received from the court. The order may be submitted 3791 electronically through existing data systems. After the 3792placementorder for involuntary services is issued, the service 3793 provider and the patient may modifyprovisions ofthe treatment 3794 plan. For any material modification of the treatment plan to 3795 which the patient or, if one is appointed, the patient’s 3796 guardian advocate agrees, if appointed, does agree, the service 3797 provider shall send notice of the modification to the court. Any 3798 material modifications of the treatment plan which are contested 3799 by the patient or the patient’s guardian advocate, if applicable 3800appointed, must be approved or disapproved by the court 3801 consistent with subsection (3)(2). 3802 3. If, in the clinical judgment of a physician, the patient 3803 has failed or has refused to comply with the treatment ordered 3804 by the court, and, in the clinical judgment of the physician, 3805 efforts were made to solicit compliance and the patient may meet 3806 the criteria for involuntary examination, a person may be 3807 brought to a receiving facility pursuant to s. 394.463. If, 3808 after examination, the patient does not meet the criteria for 3809 involuntary inpatient placement pursuant to s. 394.467, the 3810 patient must be discharged from thereceivingfacility. The 3811 involuntary outpatient servicesplacementorder shall remain in 3812 effect unless the service provider determines that the patient 3813 no longer meets the criteria for involuntary outpatient services 3814placementor until the order expires. The service provider must 3815 determine whether modifications should be made to the existing 3816 treatment plan and must attempt to continue to engage the 3817 patient in treatment. For any material modification of the 3818 treatment plan to which the patient or the patient’s guardian 3819 advocate, if applicableappointed, agreesdoes agree, the 3820 service provider shall send notice of the modification to the 3821 court. Any material modifications of the treatment plan which 3822 are contested by the patient or the patient’s guardian advocate, 3823 if applicableappointed, must be approved or disapproved by the 3824 court consistent with subsection (3)(2). 3825 (c) If, at any time before the conclusion of the initial 3826 hearing on involuntary outpatient servicesplacement, it appears 3827 to the court that the person does not meet the criteria for 3828 involuntary outpatient servicesplacementunder this section 3829 but, instead, meets the criteria for involuntary inpatient 3830 placement, the court may order the person admitted for 3831 involuntary inpatient examination under s. 394.463. If the 3832 person instead meets the criteria for involuntary assessment, 3833 protective custody, or involuntary admission pursuant to s. 3834 397.675, the court may order the person to be admitted for 3835 involuntary assessment for a period of 5 days pursuant to s. 3836 397.6811. Thereafter, all proceedings areshall begoverned by 3837 chapter 397. 3838 (d) At the hearing on involuntary outpatient services 3839placement, the court shall consider testimony and evidence 3840 regarding the patient’s competence to consent to services 3841treatment. If the court finds that the patient is incompetent to 3842 consent to treatment, it shall appoint a guardian advocate as 3843 provided in s. 394.4598. The guardian advocate shall be 3844 appointed or discharged in accordance with s. 394.4598. 3845 (e) The administrator of the receiving facility or the 3846 designated department representative shall provide a copy of the 3847 court order and adequate documentation of a patient’s mental 3848 illness to the service provider for involuntary outpatient 3849 servicesplacement. Such documentation must include any advance 3850 directives made by the patient, a psychiatric evaluation of the 3851 patient, and any evaluations of the patient performed by a 3852clinicalpsychologist or a clinical social worker. 3853 (8)(7)PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT 3854 SERVICESPLACEMENT.— 3855 (a)1. If the person continues to meet the criteria for 3856 involuntary outpatient servicesplacement, the service provider 3857 shall, at least 10 days before the expiration of the period 3858 during which the treatment is ordered for the person, file in 3859 thecircuitcourt that issued the order for involuntary 3860 outpatient services a petition for continued involuntary 3861 outpatient servicesplacement. The court shall immediately 3862 schedule a hearing on the petition to be held within 15 days 3863 after the petition is filed. 3864 2. The existing involuntary outpatient servicesplacement3865 order remains in effect until disposition on the petition for 3866 continued involuntary outpatient servicesplacement. 3867 3. A certificate shall be attached to the petition which 3868 includes a statement from the person’s physician or clinical 3869 psychologist justifying the request, a brief description of the 3870 patient’s treatment during the time he or she was receiving 3871 involuntary servicesinvoluntarily placed, and an individualized 3872 plan of continued treatment. 3873 4. The service provider shall develop the individualized 3874 plan of continued treatment in consultation with the patient or 3875 the patient’s guardian advocate, if applicableappointed. When 3876 the petition has been filed, the clerk of the court shall 3877 provide copies of the certificate and the individualized plan of 3878 continued servicestreatmentto the department, the patient, the 3879 patient’s guardian advocate, the state attorney, and the 3880 patient’s private counsel or the public defender. 3881 (b) Within 1 court working day after the filing of a 3882 petition for continued involuntary outpatient services 3883placement, the court shall appoint the public defender to 3884 represent the person who is the subject of the petition, unless 3885 the person is otherwise represented by counsel. The clerk of the 3886 court shall immediately notify the public defender of such 3887 appointment. The public defender shall represent the person 3888 until the petition is dismissed or the court order expires or 3889 the patient is discharged from involuntary outpatient services 3890placement. Any attorney representing the patient shall have 3891 access to the patient, witnesses, and records relevant to the 3892 presentation of the patient’s case and shall represent the 3893 interests of the patient, regardless of the source of payment to 3894 the attorney. 3895 (c) Hearings on petitions for continued involuntary 3896 outpatient services mustplacement shallbe before thecircuit3897 court that issued the order for involuntary outpatient services. 3898 The court may appoint a magistratemasterto preside at the 3899 hearing. The procedures for obtaining an order pursuant to this 3900 paragraph must meet the requirements ofshall be in accordance3901withsubsection (7)(6), except that the time period included in 3902 paragraph (2)(e)(1)(e)is not applicable in determining the 3903 appropriateness of additional periods of involuntary outpatient 3904 placement. 3905 (d) Notice of the hearing mustshallbe provided as set 3906 forth in s. 394.4599. The patient and the patient’s attorney may 3907 agree to a period of continued outpatient servicesplacement3908 without a court hearing. 3909 (e) The same procedure mustshallbe repeated before the 3910 expiration of each additional period the patient is placed in 3911 treatment. 3912 (f) If the patient has previously been found incompetent to 3913 consent to treatment, the court shall consider testimony and 3914 evidence regarding the patient’s competence. Section 394.4598 3915 governs the discharge of the guardian advocate if the patient’s 3916 competency to consent to treatment has been restored. 3917 Section 86. Paragraphs (c) and (d) of subsection (2) of 3918 section 394.4599, Florida Statutes, are amended to read: 3919 394.4599 Notice.— 3920 (2) INVOLUNTARY ADMISSION.— 3921 (c)1. A receiving facility shall give notice of the 3922 whereabouts of a minor who is being involuntarily held for 3923 examination pursuant to s. 394.463 to the minor’s parent, 3924 guardian, caregiver, or guardian advocate, in person or by 3925 telephone or other form of electronic communication, immediately 3926 after the minor’s arrival at the facility. The facility may 3927 delay notification for no more than 24 hours after the minor’s 3928 arrival if the facility has submitted a report to the central 3929 abuse hotline, pursuant to s. 39.201, based upon knowledge or 3930 suspicion of abuse, abandonment, or neglect and if the facility 3931 deems a delay in notification to be in the minor’s best 3932 interest. 3933 2. The receiving facility shall attempt to notify the 3934 minor’s parent, guardian, caregiver, or guardian advocate until 3935 the receiving facility receives confirmation from the parent, 3936 guardian, caregiver, or guardian advocate, verbally, by 3937 telephone or other form of electronic communication, or by 3938 recorded message, that notification has been received. Attempts 3939 to notify the parent, guardian, caregiver, or guardian advocate 3940 must be repeated at least once every hour during the first 12 3941 hours after the minor’s arrival and once every 24 hours 3942 thereafter and must continue until such confirmation is 3943 received, unless the minor is released at the end of the 72-hour 3944 examination period, or until a petition for involuntary services 3945placementis filed with the court pursuant to s. 394.463(2)(g) 3946s. 394.463(2)(i). The receiving facility may seek assistance 3947 from a law enforcement agency to notify the minor’s parent, 3948 guardian, caregiver, or guardian advocate if the facility has 3949 not received within the first 24 hours after the minor’s arrival 3950 a confirmation by the parent, guardian, caregiver, or guardian 3951 advocate that notification has been received. The receiving 3952 facility must document notification attempts in the minor’s 3953 clinical record. 3954 (d) The written notice of the filing of the petition for 3955 involuntary services forplacement ofan individual being held 3956 must contain the following: 3957 1. Notice that the petition for: 3958 a. Involuntary inpatient treatment pursuant to s. 394.467 3959 has been filed with the circuit court in the county in which the 3960 individual is hospitalized and the address of such court; or 3961 b. Involuntary outpatient services pursuant to s. 394.4655 3962 has been filed with the criminal county court, as defined in s. 3963 394.4655(1), or the circuit court, as applicable, in the county 3964 in which the individual is hospitalized and the address of such 3965 court. 3966 2. Notice that the office of the public defender has been 3967 appointed to represent the individual in the proceeding, if the 3968 individual is not otherwise represented by counsel. 3969 3. The date, time, and place of the hearing and the name of 3970 each examining expert and every other person expected to testify 3971 in support of continued detention. 3972 4. Notice that the individual, the individual’s guardian, 3973 guardian advocate, health care surrogate or proxy, or 3974 representative, or the administrator may apply for a change of 3975 venue for the convenience of the parties or witnesses or because 3976 of the condition of the individual. 3977 5. Notice that the individual is entitled to an independent 3978 expert examination and, if the individual cannot afford such an 3979 examination, that the court will provide for one. 3980 Section 87. Section 394.455, Florida Statutes, is amended 3981 to read: 3982 394.455 Definitions.—As used in this part,unless the3983context clearly requires otherwise,the term: 3984 (1) “Access center” means a facility that has medical, 3985 mental health, and substance abuse professionals to provide 3986 emergency screening and evaluation for mental health or 3987 substance abuse disorders and may provide transportation to an 3988 appropriate facility if an individual is in need of more 3989 intensive services. 3990 (2) “Addictions receiving facility” is a secure, acute care 3991 facility that, at a minimum, provides emergency screening, 3992 evaluation, detoxification, and stabilization services; is 3993 operated 24 hours per day, 7 days per week; and is designated by 3994 the department to serve individuals found to have substance 3995 abuse impairment who qualify for services under this part. 3996 (3)(1)“Administrator” means the chief administrative 3997 officer of a receiving or treatment facility or his or her 3998 designee. 3999 (4) “Adult” means an individual who is 18 years of age or 4000 older or who has had the disability of nonage removed under 4001 chapter 743. 4002 (5)(2)“Clinical psychologist” means a psychologist as 4003 defined in s. 490.003(7) with 3 years of postdoctoral experience 4004 in the practice of clinical psychology, inclusive of the 4005 experience required for licensure, or a psychologist employed by 4006 a facility operated by the United States Department of Veterans 4007 Affairs that qualifies as a receiving or treatment facility 4008 under this part. 4009 (6)(3)“Clinical record” means all parts of the record 4010 required to be maintained and includes all medical records, 4011 progress notes, charts, and admission and discharge data, and 4012 all other information recorded byafacility staff which 4013 pertains to the patient’s hospitalization or treatment. 4014 (7)(4)“Clinical social worker” means a person licensed as 4015 a clinical social worker under s. 491.005 or s. 491.006chapter4016491. 4017 (8)(5)“Community facility” means aanycommunity service 4018 provider that contractscontractingwith the department to 4019 furnish substance abuse or mental health services under part IV 4020 of this chapter. 4021 (9)(6)“Community mental health center or clinic” means a 4022 publicly funded, not-for-profit center thatwhichcontracts with 4023 the department for the provision of inpatient, outpatient, day 4024 treatment, or emergency services. 4025 (10)(7)“Court,” unless otherwise specified, means the 4026 circuit court. 4027 (11)(8)“Department” means the Department of Children and 4028 Families. 4029 (12) “Designated receiving facility” means a facility 4030 approved by the department which may be a public or private 4031 hospital, crisis stabilization unit, or addictions receiving 4032 facility; which provides, at a minimum, emergency screening, 4033 evaluation, and short-term stabilization for mental health or 4034 substance abuse disorders; and which may have an agreement with 4035 a corresponding facility for transportation and services. 4036 (13) “Detoxification facility” means a facility licensed to 4037 provide detoxification services under chapter 397. 4038 (14) “Electronic means” means a form of telecommunication 4039 which requires all parties to maintain visual as well as audio 4040 communication when being used to conduct an examination by a 4041 qualified professional. 4042 (15)(9)“Express and informed consent” means consent 4043 voluntarily given in writing, by a competent person, after 4044 sufficient explanation and disclosure of the subject matter 4045 involved to enable the person to make a knowing and willful 4046 decision without any element of force, fraud, deceit, duress, or 4047 other form of constraint or coercion. 4048 (16)(10)“Facility” means any hospital, community facility, 4049 public or private facility, or receiving or treatment facility 4050 providing for the evaluation, diagnosis, care, treatment, 4051 training, or hospitalization of persons who appear to havea4052mental illnessor who have been diagnosed as having a mental 4053 illness or substance abuse impairment. The term“Facility”does 4054 not include aanyprogram or an entity licensed underpursuant4055tochapter 400 or chapter 429. 4056 (17)(11)“Guardian” means the natural guardian of a minor, 4057 or a person appointed by a court to act on behalf of a ward’s 4058 person if the ward is a minor or has been adjudicated 4059 incapacitated. 4060 (18)(12)“Guardian advocate” means a person appointed by a 4061 court to make decisions regarding mental health treatment on 4062 behalf of a patient who has been found incompetent to consent to 4063 treatment pursuant to this part.The guardian advocate may be4064granted specific additional powers by written order of the4065court, as provided in this part.4066 (19)(13)“Hospital” means a hospitalfacility as defined in4067s. 395.002 andlicensed under chapter 395 and part II of chapter 4068 408. 4069 (20)(14)“Incapacitated” means that a person has been 4070 adjudicated incapacitated pursuant to part V of chapter 744 and 4071 a guardian of the person has been appointed. 4072 (21)(15)“Incompetent to consent to treatment” means a 4073 state in whichthata person’s judgment is so affected by ahis4074or hermental illness or a substance abuse impairment that he or 4075 shethe personlacks the capacity to make a well-reasoned, 4076 willful, and knowing decision concerning his or her medical,or4077 mental health, or substance abuse treatment. 4078 (22) “Involuntary examination” means an examination 4079 performed under s. 394.463, s. 397.6772, s. 397.679, s. 4080 397.6798, or s. 397.6811 to determine whether a person qualifies 4081 for involuntary services. 4082 (23) “Involuntary services” means court-ordered outpatient 4083 services or inpatient placement for mental health treatment 4084 pursuant to s. 394.4655 or s. 394.467. 4085 (24)(16)“Law enforcement officer” has the same meaning as 4086 providedmeans a law enforcement officer as definedin s. 4087 943.10. 4088 (25) “Marriage and family therapist” means a person 4089 licensed to practice marriage and family therapy under s. 4090 491.005 or s. 491.006. 4091 (26) “Mental health counselor” means a person licensed to 4092 practice mental health counseling under s. 491.005 or s. 4093 491.006. 4094 (27)(17)“Mental health overlay program” means a mobile 4095 service thatwhichprovides an independent examination for 4096 voluntary admissionadmissionsand a range of supplemental 4097 onsite services to persons with a mental illness in a 4098 residential setting such as a nursing home, an assisted living 4099 facility, or an adult family-care home,or a nonresidential 4100 setting such as an adult day care center. Independent 4101 examinations providedpursuant to this partthrough a mental 4102 health overlay program must only be provided under contract with 4103 the departmentfor this serviceor be attached to a public 4104 receiving facility that is also a community mental health 4105 center. 4106 (28)(18)“Mental illness” means an impairment of the mental 4107 or emotional processes that exercise conscious control of one’s 4108 actions or of the ability to perceive or understand reality, 4109 which impairment substantially interferes with the person’s 4110 ability to meet the ordinary demands of living. For the purposes 4111 of this part, the term does not include a developmental 4112 disability as defined in chapter 393, intoxication, or 4113 conditions manifested only by antisocial behavior or substance 4114 abuseimpairment. 4115 (29) “Minor” means an individual who is 17 years of age or 4116 younger and who has not had the disability of nonage removed 4117 pursuant to s. 743.01 or s. 743.015. 4118 (30)(19)“Mobile crisis response service” means a 4119 nonresidential crisis serviceattached to a public receiving4120facility andavailable 24 hours peraday, 7 days peraweek,4121throughwhich provides immediate intensive assessments and 4122 interventions, including screening for admission into a mental 4123 health receiving facility, an addictions receiving facility, or 4124 a detoxification facility,take placefor the purpose of 4125 identifying appropriate treatment services. 4126 (31)(20)“Patient” means any person, with or without a co 4127 occurring substance abuse disorder, who is held or accepted for 4128 mental health treatment. 4129 (32)(21)“Physician” means a medical practitioner licensed 4130 under chapter 458 or chapter 459 who has experience in the 4131 diagnosis and treatment of mental illnessand nervous disorders4132 or a physician employed by a facility operated by the United 4133 States Department of Veterans Affairs or the United States 4134 Department of Defensewhich qualifies as a receiving or4135treatment facility under this part. 4136 (33) “Physician assistant” means a person licensed under 4137 chapter 458 or chapter 459 who has experience in the diagnosis 4138 and treatment of mental disorders. 4139 (34)(22)“Private facility” means aanyhospital or 4140 facility operated by a for-profit or not-for-profit corporation 4141 or association whichthatprovides mental health or substance 4142 abuse services and is not a public facility. 4143 (35)(23)“Psychiatric nurse” means an advanced registered 4144 nurse practitioner certified under s. 464.012 who has a master’s 4145 or doctoral degree in psychiatric nursing, holds a national 4146 advanced practice certification as a psychiatric mental health 4147 advanced practice nurse, and has 2 years of post-master’s 4148 clinical experience under the supervision of a physician. 4149 (36)(24)“Psychiatrist” means a medical practitioner 4150 licensed under chapter 458 or chapter 459who has primarily4151diagnosed and treated mental and nervous disordersfor at least 4152a period of not less than3 years, inclusive of psychiatric 4153 residency. 4154 (37)(25)“Public facility” means aanyfacility that has 4155 contracted with the department to provide mental health services 4156 to all persons, regardless oftheirability to pay, and is 4157 receiving state funds for such purpose. 4158 (38) “Qualified professional” means a physician or a 4159 physician assistant licensed under chapter 458 or chapter 459; a 4160 psychiatrist licensed under chapter 458 or chapter 459; a 4161 psychologist as defined in s. 490.003(7); or a psychiatric nurse 4162 as defined in s. 394.455. 4163 (39)(26)“Receiving facility” means aanypublic or private 4164 facility or hospital designated by the department to receive and 4165 hold or refer, as appropriate, involuntary patients under 4166 emergency conditionsorfor mental health or substance abuse 4167psychiatricevaluation and to provideshort-termtreatment or 4168 transportation to the appropriate service provider. The term 4169 does not include a county jail. 4170 (40)(27)“Representative” means a person selected to 4171 receive notice of proceedings during the time a patient is held 4172 in or admitted to a receiving or treatment facility. 4173 (41)(28)(a)“Restraint” means:a physical device, method,4174or drug used to control behavior.4175 (a) A physical restraint, includingisany manual method or 4176 physical or mechanical device, material, or equipment attached 4177 or adjacent to antheindividual’s body so that he or she cannot 4178 easily remove the restraint and which restricts freedom of 4179 movement or normal access to one’s body. “Physical restraint” 4180 includes the physical holding of a person during a procedure to 4181 forcibly administer psychotropic medication. “Physical 4182 restraint” does not include physical devices such as 4183 orthopedically prescribed appliances, surgical dressings and 4184 bandages, supportive body bands, or other physical holding when 4185 necessary for routine physical examinations and tests or for 4186 purposes of orthopedic, surgical, or other similar medical 4187 treatment when used to provide support for the achievement of 4188 functional body position or proper balance or when used to 4189 protect a person from falling out of bed. 4190 (b) A drug orused as a restraint is amedication used to 4191 control atheperson’s behavior or to restrict his or her 4192 freedom of movement whichandis not part of the standard 4193 treatment regimen of a person with a diagnosed mental illness 4194who is a client of the department. Physically holding a person4195during a procedure to forcibly administer psychotropic4196medication is a physical restraint. 4197(c)Restraint does not include physical devices, such as4198orthopedically prescribed appliances, surgical dressings and4199bandages, supportive body bands, or other physical holding when4200necessary for routine physical examinations and tests; or for4201purposes of orthopedic, surgical, or other similar medical4202treatment; when used to provide support for the achievement of4203functional body position or proper balance; or when used to4204protect a person from falling out of bed.4205 (42)(29)“Seclusion” means the physical segregationof a4206person in any fashionor involuntary isolation of a person in a 4207 room or area from which the person is prevented from leaving. 4208 The prevention may be by physical barrier or by a staff member 4209 who is acting in a manner, or who is physically situated, so as 4210 to prevent the person from leaving the room or area. For 4211 purposes of this partchapter, the term does not mean isolation 4212 due to a person’s medical condition or symptoms. 4213 (43)(30)“Secretary” means the Secretary of Children and 4214 Families. 4215 (44) “Service provider” means a receiving facility, a 4216 facility licensed under chapter 397, a treatment facility, an 4217 entity under contract with the department to provide mental 4218 health or substance abuse services, a community mental health 4219 center or clinic, a psychologist, a clinical social worker, a 4220 marriage and family therapist, a mental health counselor, a 4221 physician, a psychiatrist, an advanced registered nurse 4222 practitioner, a psychiatric nurse, or a qualified professional 4223 as defined in s. 39.01. 4224 (45) “Substance abuse impairment” means a condition 4225 involving the use of alcoholic beverages or any psychoactive or 4226 mood-altering substance in such a manner that a person has lost 4227 the power of self-control and has inflicted or is likely to 4228 inflict physical harm on himself, herself, or another. 4229 (46)(31)“Transfer evaluation” means the process by which,4230as approved by the appropriate district office of the4231department, wherebya person who is being considered for 4232 placement in a state treatment facility isfirstevaluated for 4233 appropriateness of admission to suchthefacilityby a4234community-based public receiving facility or by a community4235mental health center or clinic if the public receiving facility4236is not a community mental health center or clinic. 4237 (47)(32)“Treatment facility” means aanystate-owned, 4238 state-operated, or state-supported hospital, center, or clinic 4239 designated by the department for extended treatment and 4240 hospitalization, beyond that provided for by a receiving 4241 facility, of persons who have a mental illness, including 4242 facilities of the United States Government, and any private 4243 facility designated by the department when rendering such 4244 services to a person pursuant to the provisions of this part. 4245 Patients treated in facilities of the United States Government 4246 shall be solely those whose care is the responsibility of the 4247 United States Department of Veterans Affairs. 4248 (48) “Triage center” means a facility that has medical, 4249 mental health, and substance abuse professionals present or on 4250 call to provide emergency screening and evaluation for mental 4251 health or substance abuse disorders for individuals transported 4252 to the center by a law enforcement officer. 4253(33)“Service provider” means any public or private4254receiving facility, an entity under contract with the Department4255of Children and Families to provide mental health services, a4256clinical psychologist, a clinical social worker, a marriage and4257family therapist, a mental health counselor, a physician, a4258psychiatric nurse as defined in subsection (23), or a community4259mental health center or clinic as defined in this part.4260(34)“Involuntary examination” means an examination4261performed under s. 394.463 to determine if an individual4262qualifies for involuntary inpatient treatment under s.4263394.467(1) or involuntary outpatient treatment under s.4264394.4655(1).4265(35)“Involuntary placement” means either involuntary4266outpatient treatment pursuant to s. 394.4655 or involuntary4267inpatient treatment pursuant to s. 394.467.4268(36)“Marriage and family therapist” means a person4269licensed as a marriage and family therapist under chapter 491.4270(37)“Mental health counselor” means a person licensed as a4271mental health counselor under chapter 491.4272(38)“Electronic means” means a form of telecommunication4273that requires all parties to maintain visual as well as audio4274communication.4275 Section 88. Subsection (2) of section 394.463, Florida 4276 Statutes, is amended to read: 4277 394.463 Involuntary examination.— 4278 (2) INVOLUNTARY EXAMINATION.— 4279 (a) An involuntary examination may be initiated by any one 4280 of the following means: 4281 1. A circuit or county court may enter an ex parte order 4282 stating that a person appears to meet the criteria for 4283 involuntary examination and specifying, givingthe findings on 4284 which that conclusion is based. The ex parte order for 4285 involuntary examination must be based on written or oral sworn 4286 testimony that includes specific facts that support the 4287 findings, written or oral. If other less restrictive means are 4288 not available, such as voluntary appearance for outpatient 4289 evaluation, a law enforcement officer, or other designated agent 4290 of the court, shall take the person into custody and deliver him 4291 or her to an appropriate, or the nearest,receivingfacility 4292 within the designated receiving system pursuant to s. 394.462 4293 for involuntary examination. The order of the court shall be 4294 made a part of the patient’s clinical record. ANofee may not 4295shallbe charged for the filing of an order under this 4296 subsection. AAny receivingfacility accepting the patient based 4297 on this order must send a copy of the order to the department 4298Agency for Health Care Administration onthe next working day. 4299 The order may be submitted electronically through existing data 4300 systems, if available. The order shall be valid only until the 4301 person is delivered to the facility orexecuted or, if not4302executed,for the period specified in the order itself, 4303 whichever comes first. If no time limit is specified in the 4304 order, the order shall be valid for 7 days after the date that 4305 the order was signed. 4306 2. A law enforcement officer shall take a person who 4307 appears to meet the criteria for involuntary examination into 4308 custody and deliver the person or have him or her delivered to 4309 an appropriate, or the nearest,receivingfacility within the 4310 designated receiving system pursuant to s. 394.462 for 4311 examination. The officer shall execute a written report 4312 detailing the circumstances under which the person was taken 4313 into custody, which mustand the report shallbe made a part of 4314 the patient’s clinical record. Anyreceivingfacility accepting 4315 the patient based on this report must send a copy of the report 4316 to the departmentAgency for Health Care Administration onthe 4317 next working day. 4318 3. A physician, clinical psychologist, psychiatric nurse, 4319 mental health counselor, marriage and family therapist, or 4320 clinical social worker may execute a certificate stating that he 4321 or she has examined a person within the preceding 48 hours and 4322 finds that the person appears to meet the criteria for 4323 involuntary examination and stating the observations upon which 4324 that conclusion is based. If other less restrictive means, such 4325 as voluntary appearance for outpatient evaluation, are not 4326 available,such as voluntary appearance for outpatient4327evaluation,a law enforcement officer shall take into custody 4328 the person named in the certificateinto custodyand deliver him 4329 or her to the appropriate, or nearest,receivingfacility within 4330 the designated receiving system pursuant to s. 394.462 for 4331 involuntary examination. The law enforcement officer shall 4332 execute a written report detailing the circumstances under which 4333 the person was taken into custody. The report and certificate 4334 shall be made a part of the patient’s clinical record. Any 4335receivingfacility accepting the patient based on this 4336 certificate must send a copy of the certificate to the 4337 departmentAgency for Health Care Administration onthe next 4338 working day. The document may be submitted electronically 4339 through existing data systems, if applicable. 4340 (b) A person mayshallnot be removed from any program or 4341 residential placement licensed under chapter 400 or chapter 429 4342 and transported to a receiving facility for involuntary 4343 examination unless an ex parte order, a professional 4344 certificate, or a law enforcement officer’s report is first 4345 prepared. If the condition of the person is such that 4346 preparation of a law enforcement officer’s report is not 4347 practicable before removal, the report shall be completed as 4348 soon as possible after removal, but in any case before the 4349 person is transported to a receiving facility. Areceiving4350 facility admitting a person for involuntary examination who is 4351 not accompanied by the required ex parte order, professional 4352 certificate, or law enforcement officer’s report shall notify 4353 the departmentAgency for Health Care Administrationof such 4354 admission by certified mail or by e-mail, if available, byno4355later thanthe next working day. The provisions of this 4356 paragraph do not apply when transportation is provided by the 4357 patient’s family or guardian. 4358 (c) A law enforcement officer acting in accordance with an 4359 ex parte order issued pursuant to this subsection may serve and 4360 execute such order on any day of the week, at any time of the 4361 day or night. 4362 (d) A law enforcement officer acting in accordance with an 4363 ex parte order issued pursuant to this subsection may use such 4364 reasonable physical force as is necessary to gain entry to the 4365 premises, and any dwellings, buildings, or other structures 4366 located on the premises, and to take custody of the person who 4367 is the subject of the ex parte order. 4368 (e) The departmentAgency for Health Care Administration4369 shall receive and maintain the copies of ex parte orders, 4370 involuntary outpatient servicesplacementorders issued pursuant 4371 to s. 394.4655, involuntary inpatient placement orders issued 4372 pursuant to s. 394.467, professional certificates, and law 4373 enforcement officers’ reports. These documents shall be 4374 considered part of the clinical record, governed by the 4375 provisions of s. 394.4615. These documents shall be used toThe4376agency shallprepare annual reports analyzing the data obtained 4377 from these documents, without information identifying patients, 4378 and shall provide copies of reports to the department, the 4379 President of the Senate, the Speaker of the House of 4380 Representatives, and the minority leaders of the Senate and the 4381 House of Representatives. 4382 (f) A patient shall be examined by a physician or,a 4383 clinical psychologist, or by a psychiatric nurse performing 4384 within the framework of an established protocol with a 4385 psychiatrist at areceivingfacility without unnecessary delay 4386 to determine if the criteria for involuntary services are met. 4387 Emergency treatment may be providedand may,upon the order of a 4388 physician if the physician determines, be given emergency4389treatment if it is determinedthat such treatment is necessary 4390 for the safety of the patient or others. The patient may not be 4391 released by the receiving facility or its contractor without the 4392 documented approval of a psychiatrist or a clinical psychologist 4393 or, if the receiving facility is owned or operated by a hospital 4394 or health system, the release may also be approved by a 4395 psychiatric nurse performing within the framework of an 4396 established protocol with a psychiatrist, or an attending 4397 emergency department physician with experience in the diagnosis 4398 and treatment of mental illnessand nervous disorders andafter 4399 completion of an involuntary examination pursuant to this 4400 subsection. A psychiatric nurse may not approve the release of a 4401 patient if the involuntary examination was initiated by a 4402 psychiatrist unless the release is approved by the initiating 4403 psychiatrist.However, a patient may not be held in a receiving4404facility for involuntary examination longer than 72 hours.4405 (g) Within the 72-hour examination period or, if the 72 4406 hours ends on a weekend or holiday, no later than the next 4407 working day thereafter, one of the following actions must be 4408 taken, based on the individual needs of the patient: 4409 1. The patient shall be released, unless he or she is 4410 charged with a crime, in which case the patient shall be 4411 returned to the custody of a law enforcement officer; 4412 2. The patient shall be released, subject to the provisions 4413 of subparagraph 1., for voluntary outpatient treatment; 4414 3. The patient, unless he or she is charged with a crime, 4415 shall be asked to give express and informed consent to placement 4416 as a voluntary patient and, if such consent is given, the 4417 patient shall be admitted as a voluntary patient; or 4418 4. A petition for involuntary services shall be filed in 4419 the circuit court if inpatient treatment is deemed necessary or 4420 with the criminal county court, as defined in s. 394.4655(1), as 4421 applicable. When inpatient treatment is deemed necessary, the 4422 least restrictive treatment consistent with the optimum 4423 improvement of the patient’s condition shall be made available. 4424 When a petition is to be filed for involuntary outpatient 4425 placement, it shall be filed by one of the petitioners specified 4426 in s. 394.4655(4)(a). A petition for involuntary inpatient 4427 placement shall be filed by the facility administrator. 4428 (h)(g)A person for whom an involuntary examination has 4429 been initiated who is being evaluated or treated at a hospital 4430 for an emergency medical condition specified in s. 395.002 must 4431 be examined by areceivingfacility within 72 hours. The 72-hour 4432 period begins when the patient arrives at the hospital and 4433 ceases when the attending physician documents that the patient 4434 has an emergency medical condition. If the patient is examined 4435 at a hospital providing emergency medical services by a 4436 professional qualified to perform an involuntary examination and 4437 is found as a result of that examination not to meet the 4438 criteria for involuntary outpatient servicesplacementpursuant 4439 to s. 394.4655(2)394.4655(1)or involuntary inpatient placement 4440 pursuant to s. 394.467(1), the patient may be offered voluntary 4441 services or placement, if appropriate, or released directly from 4442 the hospital providing emergency medical services. The finding 4443 by the professional that the patient has been examined and does 4444 not meet the criteria for involuntary inpatient services 4445placementor involuntary outpatient placement must be entered 4446 into the patient’s clinical record.Nothing inThis paragraph is 4447 not intended to prevent a hospital providing emergency medical 4448 services from appropriately transferring a patient to another 4449 hospital beforeprior tostabilization if, providedthe 4450 requirements of s. 395.1041(3)(c) have been met. 4451 (i)(h)One of the following must occur within 12 hours 4452 after the patient’s attending physician documents that the 4453 patient’s medical condition has stabilized or that an emergency 4454 medical condition does not exist: 4455 1. The patient must be examined by adesignated receiving4456 facility and released; or 4457 2. The patient must be transferred to a designated 4458receivingfacility in which appropriate medical treatment is 4459 available. However, thereceivingfacility must be notified of 4460 the transfer within 2 hours after the patient’s condition has 4461 been stabilized or after determination that an emergency medical 4462 condition does not exist. 4463(i)Within the 72-hour examination period or, if the 724464hours ends on a weekend or holiday, no later than the next4465working day thereafter, one of the following actions must be4466taken, based on the individual needs of the patient:44671.The patient shall be released, unless he or she is4468charged with a crime, in which case the patient shall be4469returned to the custody of a law enforcement officer;44702.The patient shall be released, subject to the provisions4471of subparagraph 1., for voluntary outpatient treatment;44723.The patient, unless he or she is charged with a crime,4473shall be asked to give express and informed consent to placement4474as a voluntary patient, and, if such consent is given, the4475patient shall be admitted as a voluntary patient; or44764.A petition for involuntary placement shall be filed in4477the circuit court when outpatient or inpatient treatment is4478deemed necessary. When inpatient treatment is deemed necessary,4479the least restrictive treatment consistent with the optimum4480improvement of the patient’s condition shall be made available.4481When a petition is to be filed for involuntary outpatient4482placement, it shall be filed by one of the petitioners specified4483in s. 394.4655(3)(a). A petition for involuntary inpatient4484placement shall be filed by the facility administrator.4485 Section 89. Subsection (3) of section 394.4615, Florida 4486 Statutes, is amended to read: 4487 394.4615 Clinical records; confidentiality.— 4488 (3) Information from the clinical record may be released in 4489 the following circumstances: 4490 (a) When a patient has declared an intention to harm other 4491 persons. When such declaration has been made, the administrator 4492 may authorize the release of sufficient information to provide 4493 adequate warning to the person threatened with harm by the 4494 patient. 4495 (b) When the administrator of the facility or secretary of 4496 the department deems release to a qualified researcher as 4497 defined in administrative rule, an aftercare treatment provider, 4498 or an employee or agent of the department is necessary for 4499 treatment of the patient, maintenance of adequate records, 4500 compilation of treatment data, aftercare planning, or evaluation 4501 of programs. 4502 4503 For the purpose of determining whether a person meets the 4504 criteria for involuntary outpatient placement or for preparing 4505 the proposed treatment plan pursuant to s. 394.4655, the 4506 clinical record may be released to the state attorney, the 4507 public defender or the patient’s private legal counsel, the 4508 court, and to the appropriate mental health professionals, 4509 including the service provider identified in s. 394.4655(7)(b)2. 4510394.4655(6)(b)2., in accordance with state and federal law. 4511 Section 90. For the 2016-2017 fiscal year, the sum of 4512 $400,000 in nonrecurring funds is appropriated from the 4513 Operations and Maintenance Trust Fund to the Department of 4514 Children and Families for the purpose of modifying the existing 4515 crisis stabilization database to collect and analyze data and 4516 information pursuant to s. 397.321, Florida Statutes, as amended 4517 by this act. 4518 Section 91. This act shall take effect July 1, 2016.