September 18, 2019
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_h1213__
HB 1213

1
A bill to be entitled
2An act relating to mental health; revising part I of ch.
3394, F.S., relating to the Florida Mental Health Act, to
4substitute the term "individual" for the terms "person,"
5"patient," or "client"; amending s. 394.453, F.S.;
6conforming terms; amending s. 394.455, F.S.; redefining
7terms, defining new terms, and deleting terms; amending s.
8394.457, F.S.; conforming terms; amending s. 394.4572,
9F.S.; conforming terms; deleting certain background
10screening requirements and exemptions for certain mental
11health professionals; amending s. 394.4573, F.S.;
12conforming terms; deleting a report requirement relating
13to the implementation of staffing standards in state
14treatment facilities; amending ss. 394.4574 and 394.458,
15F.S.; conforming terms; amending s. 394.459, F.S.;
16conforming terms; revising requirements for a physical
17examination and psychiatric evaluation and requiring the
18examination to be documented in the clinical record;
19requiring facilities to provide procedures for reporting
20events that place individuals receiving services at risk
21of harm; requiring facilities to provide information and
22assist individuals with advance directives; amending ss.
23394.4593 and 394.4595, F.S.; conforming terms; amending s.
24394.4597, F.S.; conforming terms; adding a health care
25surrogate to list of persons to be noted in the clinical
26record; specifying the rights, authority, and
27responsibilities of a representative; amending s.
28394.4598, F.S.; conforming terms; requiring a guardian
29advocate to make every effort to make the decision the
30individual would have made; amending s. 394.4599, F.S.;
31conforming terms; adding the health care surrogate or
32proxy to list of persons to receive notice of involuntary
33admission; repealing s. 394.460, F.S., relating to the
34rights of professionals; amending s. 394.461, F.S.;
35conforming terms; specifying that only governmental
36facilities and other facilities designated by the
37Department of Children and Family Services may serve as
38receiving and treatment facilities; revising facility data
39that must be submitted to the Agency for Health Care
40Administration; amending s. 394.4615, F.S.; conforming
41terms; adding a health care surrogate or proxy to list of
42persons that may waive confidentiality of a clinical
43record; providing additional grounds for releasing a
44clinical record; amending s. 394.462, F.S.; conforming
45terms; providing that a law enforcement officer acting in
46good faith may not be held liable for false imprisonment;
47specifying when a county or law enforcement agency may be
48reimbursed for transportation expenses; authorizing the
49Department of Corrections to transport an individual under
50certain circumstances; amending s. 394.4625, F.S.;
51conforming terms; requiring a minor's assent to voluntary
52admission; requiring an individual who has been
53voluntarily admitted and charged with a crime to be
54returned to the custody of a law enforcement agency after
55discharge; amending s. 394.463, F.S.; conforming terms;
56requiring an ex parte order for involuntary examination to
57be based on specific facts and have occurred within the
58last 14 days; providing that a certificate for involuntary
59examination is valid only until the individual is
60delivered to a receiving facility or for 7 days after the
61certificate is executed; providing notification
62requirements to guardians of minors who are involuntarily
63examined; revising the procedures for holding a person for
64involuntary examination and for emergency situations;
65requiring an individual charged with a crime who has been
66voluntarily or involuntarily admitted to be returned to
67the custody of a law enforcement agency after discharge;
68amending s. 394.4655, F.S.; conforming terms; revising
69criteria for requesting a continuance for a hearing on
70involuntary outpatient placement; amending s. 394.467,
71F.S.; conforming terms; requiring a facility to send a
72copy of the petition for involuntary inpatient placement
73to the Agency for Health Care Administration; requiring an
74attorney representing an individual in involuntary
75placement to represent the individual's expressed desires
76and be present at all hearings; requiring the state
77attorney to participate in all hearings on involuntary
78placement; prohibiting continuance requests from parties
79other than the individual; requiring the court to also
80conduct a hearing on capacity to consent to treatment;
81providing for the appointment of a guardian advocate if an
82individual is found incompetent; requiring the court to
83determine that an individual has knowingly waived his or
84her attendance at the hearing; requiring the court to
85allow certain testimony at hearings on involuntary
86placement if a continuance is granted; requiring the
87Division of Administrative Hearings to inform an
88individual of his or her right to an independent expert
89examination; amending ss. 394.46715 and 394.4672, F.S.;
90conforming terms; repealing s. 394.4674, F.S., relating to
91a plan and report on the deinstitutionalization of
92patients in treatment facilities; amending s. 394.4685,
93F.S.; conforming terms; authorizing a public facility to
94request the transfer of an individual to a private
95facility; amending s. 394.469, F.S.; conforming terms;
96requiring a discharged individual who is charged with a
97crime to be returned to the custody of a law enforcement
98agency; amending ss. 394.473, 394.475, 394.4785, 394.4786,
99394.47865, 394.4787, 394.4788, and 394.4789, F.S.;
100conforming terms; amending ss. 39.407, 394.495, 394.496,
101394.9085, 419.001, and 744.704, F.S.; conforming cross-
102references; providing an effective date.
103
104Be It Enacted by the Legislature of the State of Florida:
105
106     Section 1.  Section 394.453, Florida Statutes, is amended
107to read:
108     394.453  Legislative intent.-It is the intent of the
109Legislature to authorize and direct the Department of Children
110and Family Services to evaluate, research, plan, and recommend
111to the Governor and the Legislature programs designed to reduce
112the occurrence, severity, duration, and disabling aspects of
113mental, emotional, and behavioral disorders. It is the intent of
114the Legislature that treatment programs for such disorders shall
115include, but not be limited to, comprehensive health, social,
116educational, and rehabilitative services for individuals to
117persons requiring intensive short-term and continued treatment
118in order to encourage them to assume responsibility for their
119treatment and recovery. It is intended that such individuals
120persons be provided with emergency service and temporary
121detention for evaluation if when required; that they be admitted
122to treatment facilities if on a voluntary basis when extended or
123continuing care is needed and unavailable in the community; that
124involuntary placement be provided only if when expert evaluation
125determines that it is necessary; that any involuntary treatment
126or examination be accomplished in a setting that which is
127clinically appropriate and most likely to facilitate the
128individual's person's return to the community as soon as
129possible; and that individual dignity and human rights be
130guaranteed to all individuals persons who are admitted to mental
131health facilities or who are being held under s. 394.463. It is
132the further intent of the Legislature that the least restrictive
133means of intervention be employed based on the individual's
134individual needs of each person, within the scope of available
135services. It is the policy of this state that the use of
136restraint and seclusion on clients is justified only as an
137emergency safety measure to be used in response to imminent
138danger to the individual client or others. It is, therefore, the
139intent of the Legislature to achieve an ongoing reduction in the
140use of restraint and seclusion in programs and facilities
141serving individuals who have persons with mental illness.
142     Section 2.  Section 394.455, Florida Statutes, is amended
143to read:
144     394.455  Definitions.-As used in this part, unless the
145context clearly requires otherwise, the term:
146     (1)  "Administrator" means the chief administrative officer
147of a receiving or treatment facility or his or her designee.
148     (2)  "Adult" means an individual who is 18 years of age or
149older or who has had the disability of nonage removed pursuant
150to s. 743.01 or s. 743.015.
151     (3)  "Advance directive" has the same meaning as in s.
152765.101.
153     (4)(2)  "Clinical psychologist" means a psychologist as
154defined in s. 490.003 490.003(7) with 3 years of postdoctoral
155experience in the practice of clinical psychology, inclusive of
156the experience required for licensure, or a psychologist
157employed by a facility operated by the United States Department
158of Veterans Affairs or the United States Department of Defense
159that qualifies as a receiving or treatment facility under this
160part.
161     (5)(3)  "Clinical record" means all parts of the record
162required to be maintained and includes all medical records,
163progress notes, charts, and admission and discharge data, and
164all other information recorded by a facility staff which
165pertains to an individual's the patient's hospitalization or
166treatment.
167     (6)(4)  "Clinical social worker" has the same meaning as in
168s. 491.003 means a person licensed as a clinical social worker
169under chapter 491.
170     (7)(5)  "Community facility" means a any community service
171provider contracting with the department to furnish substance
172abuse or mental health services under part IV of this chapter.
173     (8)(6)  "Community mental health center or clinic" means a
174publicly funded, not-for-profit center that which contracts with
175the department for the provision of inpatient, outpatient, day
176treatment, or emergency services.
177     (9)(7)  "Court," unless otherwise specified, means the
178circuit court.
179     (10)(8)  "Department" means the Department of Children and
180Family Services.
181     (11)  "Electronic means" means a form of telecommunication
182that requires all parties to maintain visual as well as audio
183communication.
184     (12)(9)  "Express and informed consent" means consent
185voluntarily given in writing, by a competent individual person,
186after sufficient explanation and disclosure of the subject
187matter involved to enable the individual person to make a
188knowing and willful decision without any element of force,
189fraud, deceit, duress, or other form of constraint or coercion.
190     (13)(10)  "Facility" means a any hospital, community
191facility, public or private facility, or receiving or treatment
192facility providing for the evaluation, diagnosis, care,
193treatment, training, or hospitalization of individuals persons
194who appear to have a mental illness or who have been diagnosed
195as having a mental illness. The term "Facility" does not include
196a any program or entity licensed under pursuant to chapter 400
197or chapter 429.
198     (14)  "Government facility" means a facility owned,
199operated, or administered by the Department of Corrections or
200the United States Department of Veterans Affairs.
201     (15)(11)  "Guardian" means the natural guardian of a minor,
202or a person appointed by a court to act on behalf of a ward's
203person if the ward is a minor or has been adjudicated
204incapacitated.
205     (16)(12)  "Guardian advocate" means a person appointed by a
206court to make decisions regarding mental health treatment on
207behalf of an individual a patient who has been found incompetent
208to consent to treatment pursuant to this part. The guardian
209advocate may be granted specific additional powers by written
210order of the court, as provided in this part.
211     (17)(13)  "Hospital" means a hospital facility as defined
212in s. 395.002 and licensed under chapter 395 and part II of
213chapter 408.
214     (18)(14)  "Incapacitated" means that an individual a person
215has been adjudicated incapacitated pursuant to part V of chapter
216744 and a guardian of the person has been appointed.
217     (19)(15)  "Incompetent to consent to treatment" means that
218an individual's a person's judgment is so affected by his or her
219mental illness that he or she the person lacks the capacity to
220make a well-reasoned, willful, and knowing decision concerning
221his or her medical or mental health treatment.
222     (20)  "Involuntary examination" means an examination
223performed under s. 394.463 to determine if an individual
224qualifies for involuntary inpatient treatment under s. 394.467
225or involuntary outpatient treatment under s. 394.4655.
226     (21)  "Involuntary placement" means involuntary outpatient
227treatment pursuant to s. 394.4655 or involuntary inpatient
228treatment pursuant to s. 394.467.
229     (22)(16)  "Law enforcement officer" has the same meaning as
230means a law enforcement officer as defined in s. 943.10.
231     (23)  "Marriage and family therapist" has the same meaning
232as in s. 491.003.
233     (24)  "Mental health counselor" has the same meaning as in
234s. 491.003.
235     (25)(17)  "Mental health overlay program" means a mobile
236service that which provides an independent examination for
237voluntary admission admissions and a range of supplemental
238onsite services to an individual who has persons with a mental
239illness in a residential setting such as a nursing home,
240assisted living facility, adult family-care home, or a
241nonresidential setting such as an adult day care center.
242Independent examinations provided pursuant to this part through
243a mental health overlay program must only be provided only under
244contract with the department for this service or be attached to
245a public receiving facility that is also a community mental
246health center.
247     (26)(18)  "Mental illness" means an impairment of the
248mental or emotional processes that exercise conscious control of
249one's actions or of the ability to perceive or understand
250reality, which impairment substantially interferes with the a
251person's ability to meet the ordinary demands of living,
252regardless of etiology. For the purposes of this part, the term
253does not include a retardation or developmental disability as
254defined in chapter 393, intoxication, brain injury, dementia, or
255conditions manifested only by antisocial behavior or substance
256abuse impairment.
257     (27)  "Minor" means an individual who is 17 years of age or
258younger and who has not had the disabilities of nonage removed
259pursuant to s. 743.01 or s. 743.015.
260     (28)(19)  "Mobile crisis response service" means a
261nonresidential crisis service attached to a public receiving
262facility and available 24 hours a day, 7 days a week, through
263which provides immediate intensive assessments and
264interventions, including screening for admission into a
265receiving facility, take place for the purpose of identifying
266appropriate treatment services.
267     (20)  "Patient" means any person who is held or accepted
268for mental health treatment.
269     (29)(21)  "Physician" means a medical practitioner licensed
270under chapter 458 or chapter 459 who has experience in the
271diagnosis and treatment of mental and nervous disorders or a
272physician employed by a facility operated by the United States
273Department of Veterans Affairs or the United States Department
274of Defense which qualifies as a receiving or treatment facility
275under this part.
276     (30)  "Physician assistant" means a person licensed as a
277physician assistant under chapter 458 or chapter 459.
278     (31)(22)  "Private facility" means any hospital or facility
279operated by a for-profit or not-for-profit corporation or
280association that provides mental health services and is not a
281public facility.
282     (32)(23)  "Psychiatric nurse" means an advanced a
283registered nurse practitioner licensed under part I of chapter
284464 who has a national advanced practice certification from an
285approved nursing specialty board and a collaborative practice
286agreement with a psychiatrist on file with the Board of Nursing
287master's degree or a doctorate in psychiatric nursing and 2
288years of post-master's clinical experience under the supervision
289of a physician.
290     (33)(24)  "Psychiatrist" means a medical practitioner
291licensed under chapter 458 or chapter 459 who has primarily
292diagnosed and treated mental and nervous disorders for at least
293a period of not less than 3 years, inclusive of psychiatric
294residency.
295     (34)(25)  "Public facility" means any facility that has
296contracted with the department to provide mental health services
297to all individuals persons, regardless of their ability to pay,
298and is receiving state funds for such purpose.
299     (35)(26)  "Receiving facility" means any public or private
300facility expressly designated by the department to receive and
301hold individuals involuntarily involuntary patients under
302emergency conditions or for psychiatric evaluation and to
303provide short-term treatment. The term does not include a county
304jail.
305     (36)(27)  "Representative" means a person selected pursuant
306to s. 394.4597(2) to receive notice of proceedings during the
307time a patient is held in or admitted to a receiving or
308treatment facility.
309     (37)(28)(a)  "Restraint" means a physical device, method,
310or drug used to control behavior.
311     (a)  A physical restraint is any manual method or physical
312or mechanical device, material, or equipment attached or
313adjacent to an the individual's body so that he or she cannot
314easily remove the restraint and which restricts freedom of
315movement or normal access to one's body.
316     (b)  A drug used as a restraint is a medication used to
317control an individual's the person's behavior or to restrict his
318or her freedom of movement and is not part of the standard
319treatment regimen for an individual having of a person with a
320diagnosed mental illness who is a client of the department.
321Physically holding an individual a person during a procedure to
322forcibly administer psychotropic medication is a physical
323restraint.
324     (c)  Restraint does not include physical devices, such as
325orthopedically prescribed appliances, surgical dressings and
326bandages, supportive body bands, or other physical holding when
327necessary for routine physical examinations and tests; or for
328purposes of orthopedic, surgical, or other similar medical
329treatment; when used to provide support for the achievement of
330functional body position or proper balance; or when used to
331protect an individual a person from falling out of bed.
332     (38)(29)  "Seclusion" means the physical segregation of a
333person in any fashion or involuntary isolation of an individual
334a person in a room or area from which the individual person is
335prevented from leaving. The prevention may be by physical
336barrier or by a staff member who is acting in a manner, or who
337is physically situated, so as to prevent the individual person
338from leaving the room or area. For purposes of this chapter, the
339term does not mean isolation due to an individual's a person's
340medical condition or symptoms.
341     (39)(30)  "Secretary" means the Secretary of Children and
342Family Services.
343     (40)  "Service provider" means a public or private
344receiving facility, an entity under contract with the department
345to provide mental health services, a community mental health
346center or clinic, a clinical psychologist, a clinical social
347worker, a marriage and family therapist, a mental health
348counselor, a physician, or a psychiatric nurse.
349     (41)(31)  "Transfer evaluation" means the process, as
350approved by the appropriate district office of the department,
351during which an individual whereby a person who is being
352considered for placement in a state treatment facility is first
353evaluated for appropriateness of admission to a state treatment
354the facility by a community-based public receiving facility or
355by a community mental health center or clinic if the public
356receiving facility is not a community mental health center or
357clinic.
358     (42)(32)  "Treatment facility" means a any state-owned,
359state-operated, or state-supported hospital, or a community
360mental health center, or clinic, designated by the department
361for extended treatment and hospitalization of individuals who
362have a mental illness, beyond that provided for by a receiving
363facility or a, of persons who have a mental illness, including
364facilities of the United States Government, and any private
365facility designated by the department when rendering such
366services to a person pursuant to the provisions of this part.
367Patients treated in facilities of the United States Government
368shall be solely those whose care is the responsibility of the
369United States Department of Veterans Affairs.
370     (33)  "Service provider" means any public or private
371receiving facility, an entity under contract with the department
372of Children and Family Services to provide mental health
373services, a clinical psychologist, a clinical social worker, a
374marriage and family therapist, a mental health counselor, a
375physician, a psychiatric nurse as defined in subsection (23), or
376a community mental health center or clinic as defined in this
377part.
378     (34)  "Involuntary examination" means an examination
379performed under s. 394.463 to determine if an individual
380qualifies for involuntary inpatient treatment under s.
381394.467(1) or involuntary outpatient treatment under s.
382394.4655(1).
383     (35)  "Involuntary placement" means either involuntary
384outpatient treatment pursuant to s. 394.4655 or involuntary
385inpatient treatment pursuant to s. 394.467.
386     (36)  "Marriage and family therapist" means a person
387licensed as a marriage and family therapist under chapter 491.
388     (37)  "Mental health counselor" means a person licensed as
389a mental health counselor under chapter 491.
390     (38)  "Electronic means" means a form of telecommunication
391that requires all parties to maintain visual as well as audio
392communication.
393     Section 3.  Section 394.457, Florida Statutes, is amended
394to read:
395     394.457  Operation and administration.-
396     (1)  ADMINISTRATION.-The Department of Children and Family
397Services is designated the "Mental Health Authority" of Florida.
398The department and the Agency for Health Care Administration
399shall exercise executive and administrative supervision over all
400mental health facilities, programs, and services.
401     (2)  RESPONSIBILITIES OF THE DEPARTMENT.-The department is
402responsible for:
403     (a)  The planning, evaluation, and implementation of a
404complete and comprehensive statewide program of mental health,
405including community services, receiving and treatment
406facilities, child services, research, and training as authorized
407and approved by the Legislature, based on the annual program
408budget of the department. The department is also responsible for
409the coordination of efforts with other departments and divisions
410of the state government, county and municipal governments, and
411private agencies concerned with and providing mental health
412services. It is responsible for establishing standards,
413providing technical assistance, and supervising exercising
414supervision of mental health programs of, and the treatment of
415individuals patients at, community facilities, other facilities
416serving individuals for persons who have a mental illness, and
417any agency or facility providing services under to patients
418pursuant to this part.
419     (b)  The publication and distribution of an information
420handbook to facilitate the understanding of this part, the
421policies and procedures involved in the implementation of this
422part, and the responsibilities of the various service providers
423of services under this part. The department It shall stimulate
424research by public and private agencies, institutions of higher
425learning, and hospitals in the interest of the elimination and
426amelioration of mental illness.
427     (3)  POWER TO CONTRACT.-The department may contract to
428provide, and be provided with, services and facilities in order
429to carry out its responsibilities under this part with respect
430to the following agencies: public and private hospitals;
431receiving and treatment facilities; clinics; laboratories;
432departments, divisions, and other units of state government; the
433state colleges and universities; the community colleges; private
434colleges and universities; counties, municipalities, and any
435other political subdivisions governmental unit, including
436facilities of the United States Government; and any other public
437or private entity that which provides or needs facilities or
438services. Baker Act funds for community inpatient, crisis
439stabilization, short-term residential treatment, and screening
440services under this part must be allocated to each county
441pursuant to the department's funding allocation methodology.
442Notwithstanding the provisions of s. 287.057(5)(f), contracts
443for community-based Baker Act services for inpatient, crisis
444stabilization, short-term residential treatment, and screening
445provided under this part, other than those with other units of
446government, to be provided for the department must be awarded
447using competitive solicitation if sealed bids when the county
448commission of the county receiving the services makes a request
449to the department's circuit district office by January 15 of the
450contracting year. The office may district shall not enter into a
451competitively bid contract under this provision if such action
452will result in increases of state or local expenditures for
453Baker Act services within the circuit district. Contracts for
454these Baker Act services using competitive solicitation are
455sealed bids will be effective for 3 years. The department shall
456adopt rules establishing minimum standards for such contracted
457services and facilities and shall make periodic audits and
458inspections to assure that the contracted services are provided
459and meet the standards of the department.
460     (4)  APPLICATION FOR AND ACCEPTANCE OF GIFTS AND GRANTS.-
461The department may apply for and accept any funds, grants,
462gifts, or services made available to it by any agency or
463department of the Federal Government or any other public or
464private agency or person individual in aid of mental health
465programs. All such moneys must shall be deposited in the State
466Treasury and shall be disbursed as provided by law.
467     (5)  RULES.-The department shall adopt rules:
468     (a)  The department shall adopt rules Establishing forms
469and procedures relating to the rights and privileges of
470individuals receiving patients seeking mental health examination
471or treatment from facilities under this part.
472     (b)  The department shall adopt rules Necessary for the
473implementation and administration of the provisions of this
474part., and A program subject to the provisions of this part may
475shall not be permitted to operate unless rules designed to
476ensure the protection of the health, safety, and welfare of the
477individuals examined and patients treated under through such
478program have been adopted. Such rules adopted under this
479subsection must include provisions governing the use of
480restraint and seclusion which are consistent with recognized
481best practices and professional judgment; prohibit inherently
482dangerous restraint or seclusion procedures; establish
483limitations on the use and duration of restraint and seclusion;
484establish measures to ensure the safety of program participants
485and staff during an incident of restraint or seclusion;
486establish procedures for staff to follow before, during, and
487after incidents of restraint or seclusion; establish
488professional qualifications of and training for staff who may
489order or be engaged in the use of restraint or seclusion; and
490establish mandatory reporting, data collection, and data
491dissemination procedures and requirements. Such rules adopted
492under this subsection must require that each instance of the use
493of restraint or seclusion be documented in the clinical record
494of the individual who has been restrained or secluded patient.
495     (c)  The department shall adopt rules Establishing minimum
496standards for services provided by a mental health overlay
497program or a mobile crisis response service.
498     (6)  PERSONNEL.-
499     (a)  The department shall, by rule, establish minimum
500standards of education and experience for professional and
501technical personnel employed in mental health programs,
502including members of a mobile crisis response service.
503     (b)  The department shall design and distribute appropriate
504materials for the orientation and training of persons actively
505engaged in implementing the provisions of this part relating to
506the involuntary examination and placement of individuals persons
507who are believed to have a mental illness.
508     (7)  PAYMENT FOR CARE OF PATIENTS.-Fees and fee collections
509for individuals receiving treatment or services patients in
510state-owned, state-operated, or state-supported treatment
511facilities must shall be in accordance with according to s.
512402.33.
513     Section 4.  Section 394.4572, Florida Statutes, is amended
514to read:
515     394.4572  Screening of mental health personnel.-
516     (1)(a)  The department and the Agency for Health Care
517Administration shall require employment screening for mental
518health personnel using the standards for level 2 screening
519standards provided in s. 435.04 set forth in chapter 435.
520"Mental health personnel" includes all program directors,
521professional clinicians, staff members, and volunteers working
522in public or private mental health programs and facilities who
523have direct contact with individuals held for examination or
524admitted for mental health treatment unmarried patients under
525the age of 18 years. For purposes of this chapter, employment
526screening of mental health personnel shall also include, but is
527not limited to, employment screening as provided under chapter
528435.
529     (a)(b)  Students in the health care professions who are
530interning in a mental health facility licensed under chapter
531395, where the primary purpose of the facility is not the
532treatment of minors, are exempt from the fingerprinting and
533screening requirements if, provided they are under direct
534supervision in the actual physical presence of a licensed health
535care professional.
536     (c)  Mental health personnel working in a facility licensed
537under chapter 395 who have less than 15 hours per week of direct
538contact with patients or who are health care professionals
539licensed by the Agency for Health Care Administration or a board
540thereunder are exempt from the fingerprinting and screening
541requirements, except for persons working in mental health
542facilities where the primary purpose of the facility is the
543treatment of minors.
544     (b)(d)  A volunteer who assists on an intermittent basis
545for less than 40 hours per month is exempt from the
546fingerprinting and screening requirements if, provided the
547volunteer is under direct and constant supervision by persons
548who meet the screening requirements of this section paragraph
549(a).
550     (2)  The department or the Agency for Health Care
551Administration may grant exemptions from disqualification as
552provided in s. 435.07 435.06.
553     (3)  Prospective mental health personnel who have
554previously been fingerprinted or screened pursuant to this
555chapter, chapter 393, chapter 397, chapter 402, or chapter 409,
556or teachers who have been fingerprinted pursuant to chapter
5571012, who have not been unemployed for more than 90 days
558thereafter, and who under the penalty of perjury attest to the
559completion of such fingerprinting or screening and to compliance
560with the provisions of this section and the standards for level
5611 screening under contained in chapter 435, are shall not be
562required to be refingerprinted or rescreened in order to comply
563with the any screening requirements of this part.
564     Section 5.  Section 394.4573, Florida Statutes, is amended
565to read:
566     394.4573  Continuity of care management system; measures of
567performance; reports.-
568     (1)  For the purposes of this section:
569     (a)  "Case management" means those activities aimed at
570assessing the client needs, planning services, linking the
571service system to a client, coordinating the various system
572components, monitoring service delivery, and evaluating the
573effect of service delivery for individuals eligible for publicly
574funded mental health services.
575     (b)  "Case manager" means a person an individual who works
576with individuals who are eligible for publicly funded mental
577health services clients, and their families and significant
578others, to provide case management.
579     (c)  "Client manager" means an employee of the department
580who is assigned to specific provider agencies and geographic
581areas to ensure that the full range of needed services is
582available to individuals who are eligible for publicly funded
583mental health services clients.
584     (d)  "Continuity of care management system" means a system
585that assures, within available resources, that individuals who
586are eligible for publicly funded mental health services clients
587have access to the full array of services within the mental
588health services delivery system.
589     (2)  The department shall is directed to implement a
590continuity of care management system for the provision of mental
591health care, through the provision of client and case
592management, including individuals clients referred from state
593treatment facilities to community mental health facilities. Such
594system must shall include a statewide network of client managers
595and case managers throughout the state designed to:
596     (a)  Reduce the possibility of an individual's a client's
597admission or readmission to a state treatment facility.
598     (b)  Provide for the creation or designation of an agency
599in each county to provide single intake services for each
600individual person seeking mental health services. Such agency
601shall provide information and referral services necessary to
602ensure that such individuals clients receive the most
603appropriate and least restrictive form of care, based on the
604individual's individual needs of the person seeking treatment.
605Such agency shall have a single telephone number, operating 24
606hours per day, 7 days per week, if where practicable, at a
607central location, where each individual receiving mental health
608services has client will have a client central record.
609     (c)  Advocate on behalf of the individual receiving mental
610health services client to ensure that all appropriate services
611are provided afforded to the client in a timely and dignified
612manner.
613     (d)  Require a that any public receiving facility
614initiating an individual's a patient transfer to a licensed
615hospital for acute care mental health services not accessible
616through the public receiving facility to shall notify the
617hospital of the such transfer and send all records relating to
618the emergency psychiatric or medical condition.
619     (3)  The department shall is directed to develop and
620include performance measures in contracts with service providers
621relating to measures of performance with regard to goals and
622objectives as specified in the state plan. Such measures shall
623use, To the extent practical, such measures must use existing
624data collection methods and reports and may shall not require,
625as a result of this subsection, additional reports on the part
626of service providers. The department shall plan monitoring
627visits of community mental health facilities with other state,
628federal, and local governmental and private agencies charged
629with monitoring such facilities.
630     (4)  The department is directed to submit a report to the
631Legislature, prior to April 1 of each year, outlining
632departmental progress towards the implementation of the minimum
633staffing patterns' standards in state mental health treatment
634facilities. The report shall contain, by treatment facility,
635information regarding goals and objectives and departmental
636performance toward meeting each such goal and objective.
637     Section 6.  Paragraph (a) of subsection (2) and subsection
638(3) of section 394.4574, Florida Statutes, are amended to read:
639     394.4574  Department responsibilities for a mental health
640resident who resides in an assisted living facility that holds a
641limited mental health license.-
642     (2)  The department must ensure that:
643     (a)  A mental health resident has been assessed by a
644psychiatrist, clinical psychologist, clinical social worker, or
645psychiatric nurse, or an individual who is supervised by one of
646these professionals, and determined to be appropriate to reside
647in an assisted living facility. The documentation must be
648provided to the administrator of the facility within 30 days
649after the mental health resident has been admitted to the
650facility. An evaluation completed upon discharge from a state
651mental health treatment facility hospital meets the requirements
652of this subsection related to appropriateness for placement as a
653mental health resident if it was completed within 90 days before
654prior to admission to the facility.
655     (3)  The secretary of Children and Family Services, in
656consultation with the Agency for Health Care Administration,
657shall annually require each circuit district administrator to
658develop, with community input, detailed plans that demonstrate
659how the circuit district will ensure the provision of state-
660funded mental health and substance abuse treatment services to
661residents of assisted living facilities that hold a limited
662mental health license. These plans must be consistent with the
663substance abuse and mental health circuit district plan
664developed pursuant to s. 394.75 and must address case management
665services; access to consumer-operated drop-in centers; access to
666services during evenings, weekends, and holidays; supervision of
667the clinical needs of the residents; and access to emergency
668psychiatric care.
669     Section 7.  Subsection (1) of section 394.458, Florida
670Statutes, is amended to read:
671     394.458  Introduction or removal of certain articles
672unlawful; penalty.-
673     (1)(a)  Except as authorized by law or as specifically
674authorized by the person in charge of a receiving or treatment
675facility each hospital providing mental health services under
676this part, it is unlawful to:
677     (a)  Introduce into or upon the grounds of such facility
678hospital, or to take or attempt to take or send from the
679facility therefrom, any of the following articles, which are
680hereby declared to be contraband for the purposes of this
681section:
682     1.  An Any intoxicating beverage or beverage that which
683causes or may cause an intoxicating effect;
684     2.  A Any controlled substance as defined in chapter 893;
685or
686     3.  A firearm Any firearms or deadly weapon.
687     (b)  It is unlawful to Transmit to, or attempt to transmit
688to, or cause or attempt to cause to be transmitted to, or
689received by, any individual receiving mental health services
690from a receiving or treatment facility patient of any hospital
691providing mental health services under this part any article or
692thing declared by this section to be contraband, at any place
693which is outside of the grounds of such facility hospital,
694except as authorized by law or as specifically authorized by the
695person in charge of such hospital.
696     Section 8.  Section 394.459, Florida Statutes, is amended
697to read:
698     394.459  Rights of individuals receiving treatment and
699services patients.-
700     (1)  RIGHT TO INDIVIDUAL DIGNITY.-It is the policy of this
701state that the individual dignity of all individuals held for
702examination or admitted for mental health treatment the patient
703shall be respected at all times and upon all occasions,
704including any occasion when the individual patient is taken into
705custody, held, or transported. Procedures, facilities, vehicles,
706and restraining devices used utilized for criminals or those
707accused of a crime may shall not be used in connection with
708individuals persons who have a mental illness, except for the
709protection of that individual the patient or others. Individuals
710Persons who have a mental illness but who are not charged with a
711criminal offense may shall not be detained or incarcerated in
712the jails of this state. An individual A person who is receiving
713treatment for mental illness may shall not be deprived of any
714constitutional rights. However, if such individual a person is
715adjudicated incapacitated, his or her rights may be limited to
716the same extent that the rights of any incapacitated person are
717limited by law.
718     (2)  RIGHT TO TREATMENT.-Each individual held for
719examination or admitted for mental health treatment:
720     (a)  May A person shall not be denied treatment for mental
721illness, and services may shall not be delayed at a receiving or
722treatment facility because of inability to pay. However, every
723reasonable effort to collect appropriate reimbursement for the
724cost of providing mental health services from individuals to
725persons able to pay for services, including insurance or third-
726party payers payments, shall be made by facilities providing
727services under pursuant to this part.
728     (b)  Shall be provided It is further the policy of the
729state that the least restrictive appropriate available
730treatment, be utilized based on the individual's individual
731needs and best interests, of the patient and consistent with the
732optimum improvement of the individual's patient's condition.
733     (c)  Each person who remains at a receiving or treatment
734facility for more than 12 hours Shall be given a physical
735examination and psychiatric evaluation by a health practitioners
736practitioner authorized by law to give such examinations, within
73724 hours after arrival at such facility if they have not been
738released or discharged pursuant to s. 394.463(2)(h) or s.
739394.469. The physical examination and psychiatric evaluation
740must be documented in the clinical record.
741     (d)  Every patient in a facility Shall be afforded the
742opportunity to participate in activities designed to enhance
743self-image and the beneficial effects of other treatments, as
744determined by the facility.
745     (e)  Not more than 5 days after admission to a facility,
746each patient Shall have and receive an individualized treatment
747plan in writing, which the individual patient has had an
748opportunity to assist in preparing and to review prior to its
749implementation, within 5 days after admission to a facility. The
750plan must shall include a space for the individual's patient's
751comments and signature.
752     (3)  RIGHT TO EXPRESS AND INFORMED PATIENT CONSENT.-
753     (a)1.  Each individual patient entering treatment shall be
754asked to give express and informed consent for admission or
755treatment.
756     1.  If the individual patient has been adjudicated
757incapacitated or found to be incompetent to consent to
758treatment, express and informed consent must to treatment shall
759be sought instead from his or her the patient's guardian or
760guardian advocate. If the individual patient is a minor, express
761and informed consent for admission or treatment must be obtained
762shall also be requested from the patient's guardian. Express and
763informed consent for admission or treatment of a patient under
76418 years of age shall be required from the minor's patient's
765guardian, unless the minor is seeking outpatient crisis
766intervention services under s. 394.4784. Express and informed
767consent for admission or treatment given by a patient who is
768under 18 years of age shall not be a condition of admission when
769the patient's guardian gives express and informed consent for
770the patient's admission pursuant to s. 394.463 or s. 394.467.
771     2.  Before giving express and informed consent, the
772following information shall be provided and explained in plain
773language to the individual patient, or to his or her the
774patient's guardian if the individual patient is an adult 18
775years of age or older and has been adjudicated incapacitated, or
776to his or her the patient's guardian advocate if the individual
777patient has been found to be incompetent to consent to
778treatment, or to both the individual patient and the guardian if
779the individual patient is a minor: the reason for admission or
780treatment; the proposed treatment; the purpose of the treatment
781to be provided; the common risks, benefits, and side effects
782thereof; the specific dosage range for the medication, when
783applicable; alternative treatment modalities; the approximate
784length of care; the potential effects of stopping treatment; how
785treatment will be monitored; and that any consent given for
786treatment may be revoked orally or in writing before or during
787the treatment period by the individual receiving the treatment
788patient or by a person who is legally authorized to make health
789care decisions on the individual's behalf of the patient.
790     (b)  Before performing a medical procedure In the case of
791medical procedures requiring the use of a general anesthetic or
792electroconvulsive treatment, and prior to performing the
793procedure, express and informed consent must shall be obtained
794from the individual subject to the procedure patient if the
795individual patient is legally competent, from the guardian of a
796minor patient, from the guardian of an individual a patient who
797has been adjudicated incapacitated, or from the individual's
798guardian advocate of the patient if the guardian advocate has
799been given express court authority to consent to medical
800procedures or electroconvulsive treatment as provided under s.
801394.4598.
802     (c)  If When the department is the legal guardian of a
803patient, or is the custodian of an individual a patient whose
804physician is unwilling to perform a medical procedure, including
805an electroconvulsive treatment, based solely on the individual's
806patient's consent and whose guardian or guardian advocate is
807unknown or unlocatable, the court shall hold a hearing to
808determine the medical necessity of the medical procedure. The
809individual subject to the procedure must patient shall be
810physically present, unless his or her the patient's medical
811condition precludes such presence, represented by counsel, and
812provided the right and opportunity to be confronted with, and to
813cross-examine, all witnesses alleging the medical necessity of
814such procedure. In such proceedings, the burden of proof by
815clear and convincing evidence is shall be on the party alleging
816the medical necessity of the procedure.
817     (d)  The administrator of a receiving or treatment facility
818may, upon the recommendation of an individual's the patient's
819attending physician, authorize emergency medical treatment,
820including a surgical procedure, if such treatment is deemed
821lifesaving, or if the situation threatens serious bodily harm to
822the individual patient, and the permission of the individual
823patient or his or her the patient's guardian or guardian
824advocate cannot be obtained.
825     (4)  QUALITY OF TREATMENT.-
826     (a)  Each individual held for examination or admitted for
827mental health treatment, or receiving involuntary outpatient
828treatment patient shall receive services, including, for a
829patient placed under s. 394.4655, shall receive those services
830that are included in the court order which are suited to his or
831her needs, and which shall be administered skillfully, safely,
832and humanely with full respect for the individual's patient's
833dignity and personal integrity. Each individual must patient
834shall receive such medical, vocational, social, educational, and
835rehabilitative services as his or her condition requires in
836order to live successfully in the community. In order to achieve
837this goal, the department shall is directed to coordinate its
838mental health programs with all other programs of the department
839and other state agencies.
840     (b)  Facilities shall develop and maintain, in a form
841accessible to and readily understandable by individuals held for
842examination or admitted for mental health treatment, patients
843and consistent with rules adopted by the department, the
844following:
845     1.  Criteria, procedures, and required staff training for
846the any use of close or elevated levels of supervision;, of
847restraint, seclusion, or isolation;, or of emergency treatment
848orders;, and for the use of bodily control and physical
849management techniques.
850     2.  Procedures for documenting, monitoring, and requiring
851clinical review of all uses of the procedures described in
852subparagraph 1. and for documenting and requiring review of any
853incidents resulting in injury to individuals receiving services
854patients.
855     3.  A system for investigating, tracking, managing, and
856responding to complaints by individuals persons receiving
857services or persons individuals acting on their behalf.
858     4.  Procedures for reporting events that place individuals
859receiving services at risk of harm. Such events must be reported
860to the department in accordance with department operating
861procedures after discovery and include, but are not limited to:
862     a.  An individual whose life terminates due to a natural,
863unnatural, expected, or unexpected cause while in the facility
864or within 72 hours after release.
865     b.  An injury sustained, or allegedly sustained, due to an
866accident, act of abuse, neglect, or suicide attempt requiring
867medical treatment by a licensed health care practitioner in an
868acute care medical facility.
869     c.  The unauthorized departure or absence of an individual
870from a facility in which he or she has been held for involuntary
871examination or involuntary placement.
872     d.  An unusual occurrence or circumstance precipitated by
873something uncommon, abnormal, or out of the ordinary, such as a
874tornado, kidnapping, riot, or hostage situation that jeopardizes
875the health, safety, or welfare of the individual.
876     e.  An allegation of sexual battery upon the individual.
877     (c)  A facility may not use seclusion or restraint for
878punishment, to compensate for inadequate staffing, or for the
879convenience of staff. Facilities shall ensure that all staff are
880made aware of these restrictions on the use of seclusion and
881restraint and shall make and maintain records that which
882demonstrate that this information has been conveyed to each
883individual staff member members.
884     (5)  COMMUNICATION, ABUSE REPORTING, AND VISITS.-
885     (a)  Each individual held for examination or admitted for
886mental health treatment person receiving services in a facility
887providing mental health services under this part has the right
888to communicate freely and privately with persons outside the
889facility unless it is determined that such communication is
890likely to be harmful to the individual person or others. Each
891facility shall make available as soon as reasonably possible to
892persons receiving services a telephone that allows for free
893local calls and access to a long-distance service available to
894the individual as soon as reasonably possible. A facility is not
895required to pay the costs of the individual's a patient's long-
896distance calls. The telephone must shall be readily accessible
897to the patient and shall be placed so that the individual
898patient may use it to communicate privately and confidentially.
899The facility may establish reasonable rules for the use of this
900telephone which, provided that the rules do not interfere with
901an individual's a patient's access to a telephone to report
902abuse pursuant to paragraph (e).
903     (b)  Each individual patient admitted to a facility under
904the provisions of this part shall be allowed to receive, send,
905and mail sealed, unopened correspondence; and the individual's
906no patient's incoming or outgoing correspondence may not shall
907be opened, delayed, held, or censored by the facility unless
908there is reason to believe that it contains items or substances
909that which may be harmful to the individual patient or others,
910in which case the administrator may direct reasonable
911examination of such mail and may regulate the disposition of
912such items or substances.
913     (c)  Each facility shall allow must permit immediate access
914to an individual held for examination or admitted for mental
915health treatment any patient, subject to the patient's right to
916deny or withdraw consent at any time, by the individual, or by
917the individual's patient's family members, guardian, guardian
918advocate, representative, Florida statewide or local advocacy
919council, or attorney, unless such access would be detrimental to
920the individual patient. If the a patient's right to communicate
921or to receive visitors is restricted by the facility, written
922notice of such restriction and the reasons for the restriction
923shall be served on the individual and patient, the individual's
924patient's attorney, and the patient's guardian, guardian
925advocate, or representative,; and such restriction, and the
926reasons for the restriction, must shall be recorded in on the
927patient's clinical record with the reasons therefor. The
928restriction must of a patient's right to communicate or to
929receive visitors shall be reviewed at least every 7 days. The
930right to communicate or receive visitors may shall not be
931restricted as a means of punishment. Nothing in This paragraph
932does not shall be construed to limit the provisions of paragraph
933(d).
934     (d)  Each facility shall establish reasonable rules
935governing visitors, visiting hours, and the use of telephones by
936individuals held for examination or admitted for mental health
937treatment patients in the least restrictive possible manner. An
938individual has Patients shall have the right to contact and to
939receive communication from his or her attorney their attorneys
940at any reasonable time.
941     (e)  Each individual held for examination or admitted for
942patient receiving mental health treatment in any facility shall
943have ready access to a telephone in order to report an alleged
944abuse. The facility staff shall orally and in writing inform
945each individual patient of the procedure for reporting abuse and
946shall make every reasonable effort to present the information in
947a language the individual patient understands. A written copy of
948that procedure, including the telephone number of the central
949abuse hotline and reporting forms, must shall be posted in plain
950view.
951     (f)  The department shall adopt rules providing a procedure
952for reporting abuse. Facility staff shall be required, as a
953condition of employment, must to become familiar with the
954requirements and procedures for the reporting of abuse.
955     (6)  CARE AND CUSTODY OF PERSONAL EFFECTS OF PATIENTS.-The
956rights of an individual held for examination or admitted for
957mental health treatment A patient's right to the possession of
958his or her clothing and personal effects shall be respected. The
959facility may take temporary custody of such effects if when
960required for medical and safety reasons. The A patient's
961clothing and personal effects shall be inventoried upon their
962removal into temporary custody. Copies of this inventory shall
963be given to the individual patient and to his or her the
964patient's guardian, guardian advocate, or representative and
965shall be recorded in the patient's clinical record. This
966inventory may be amended upon the request of the individual
967patient or his or her the patient's guardian, guardian advocate,
968or representative. The inventory and any amendments to it must
969be witnessed by two members of the facility staff and by the
970individual patient, if he or she is able. All of the a patient's
971clothing and personal effects held by the facility must shall be
972returned to the individual patient immediately upon his or her
973the discharge or transfer of the patient from the facility,
974unless such return would be detrimental to the individual
975patient. If personal effects are not returned to the patient,
976the reason must be documented in the clinical record along with
977the disposition of the clothing and personal effects, which may
978be given instead to the individual's patient's guardian,
979guardian advocate, or representative. As soon as practicable
980after an emergency transfer of a patient, the individual's
981patient's clothing and personal effects shall be transferred to
982the individual's patient's new location, together with a copy of
983the inventory and any amendments, unless an alternate plan is
984approved by the individual patient, if he or she is able, and by
985his or her the patient's guardian, guardian advocate, or
986representative.
987     (7)  VOTING IN PUBLIC ELECTIONS.-An individual held for
988examination or admitted for mental health treatment A patient
989who is eligible to vote according to the laws of the state has
990the right to vote in the primary and general elections. The
991department shall establish rules to enable such individuals
992patients to obtain voter registration forms, applications for
993absentee ballots, and absentee ballots.
994     (8)  HABEAS CORPUS.-
995     (a)  At any time, and without notice, an individual a
996person held for examination in a receiving or treatment
997facility, or a relative, friend, guardian, guardian advocate,
998representative, or attorney, or the department, on behalf of
999such individual person, may petition for a writ of habeas corpus
1000to question the cause and legality of such detention and request
1001that the court order a return to the writ in accordance with
1002chapter 79. Each individual patient held in a facility shall
1003receive a written notice of the right to petition for a writ of
1004habeas corpus.
1005     (b)  At any time, and without notice, an individual
1006admitted for mental health treatment a person who is a patient
1007in a receiving or treatment facility, or a relative, friend,
1008guardian, guardian advocate, representative, or attorney, or the
1009department, on behalf of such individual person, may file a
1010petition in the circuit court in the county where the individual
1011patient is being held alleging that he or she the patient is
1012being unjustly denied a right or privilege granted under this
1013section herein or that a procedure authorized under this section
1014herein is being abused. Upon the filing of such a petition, the
1015court may shall have the authority to conduct a judicial inquiry
1016and to issue an any order needed to correct an abuse of the
1017provisions of this part.
1018     (c)  The administrator of any receiving or treatment
1019facility receiving a petition under this subsection shall file
1020the petition with the clerk of the court on the next court
1021working day.
1022     (d)  A No fee may not shall be charged for the filing of a
1023petition under this subsection.
1024     (9)  VIOLATIONS.-The department shall report to the Agency
1025for Health Care Administration any violation of the rights or
1026privileges of individuals patients, or of any procedures
1027provided under this part, by any facility or professional
1028licensed or regulated by the agency. The agency may is
1029authorized to impose any sanction authorized for violation of
1030this part, based solely on the investigation and findings of the
1031department.
1032     (10)  LIABILITY FOR VIOLATIONS.-Any person who violates or
1033abuses the any rights or privileges of individuals held for
1034examination or admitted for mental health treatment patients
1035provided under by this part is liable for damages as determined
1036by law. Any person who acts reasonably, in good faith, and
1037without negligence in compliance with the provisions of this
1038part is immune from civil or criminal liability for his or her
1039actions in connection with the preparation or execution of
1040petitions, applications, certificates, reports, or other
1041documents initiating admission to a facility or the
1042apprehension, detention, transportation, examination, admission,
1043diagnosis, treatment, or discharge of an individual a patient to
1044or from a facility. However, this section does not relieve any
1045person from liability if such person commits negligence.
1046     (11)  RIGHT TO PARTICIPATE IN TREATMENT AND DISCHARGE
1047PLANNING.-An individual held for examination or admitted for
1048mental health treatment The patient shall have the opportunity
1049to participate in treatment and discharge planning and shall be
1050notified in writing of his or her right, upon discharge from the
1051facility, to seek treatment from the professional or agency of
1052the individual's patient's choice.
1053     (12)  ADVANCE DIRECTIVES.-All receiving and treatment
1054facilities and other service providers shall provide information
1055concerning advance directives and assist individuals who are
1056competent and willing to complete an advance directive. The
1057directive may include instructions regarding mental health care.
1058Receiving and treatment facilities and service providers must
1059honor the advance directive of an individual admitted to or
1060served by the facility or provider.
1061     (13)(12)  POSTING OF NOTICE OF RIGHTS OF PATIENTS.-Each
1062facility shall post a notice, which lists and describes in
1063listing and describing, in the language and terminology that the
1064individual persons to whom the notice is addressed can
1065understand, of the rights provided under in this section. This
1066notice must shall include a statement that provisions of the
1067federal Americans with Disabilities Act apply and the name and
1068telephone number of a person to contact for further information.
1069The This notice must shall be posted in a place readily
1070accessible to patients and in a format easily seen by the
1071individuals served patients. The This notice must shall include
1072the telephone numbers of the Florida local advocacy council and
1073Advocacy Center for Persons with Disabilities, Inc.
1074     Section 9.  Subsections (1), (2), (3), and (4) of section
1075394.4593, Florida Statutes, are amended to read:
1076     394.4593  Sexual misconduct prohibited; reporting required;
1077penalties.-
1078     (1)  As used in this section, the term:
1079     (a)  "Employee" includes any paid staff member, volunteer,
1080or intern of the department; any person under contract with the
1081department; and any person providing care or support to an
1082individual a client on behalf of the department or its service
1083providers.
1084     (b)  "Sexual activity" means:
1085     1.  Fondling the genital area, groin, inner thighs,
1086buttocks, or breasts of an individual a person.
1087     2.  The oral, anal, or vaginal penetration by or union with
1088the sexual organ of another or the anal or vaginal penetration
1089of another by any other object.
1090     3.  Intentionally touching in a lewd or lascivious manner
1091the breasts, genitals, the genital area, or buttocks, or the
1092clothing covering them, of an individual a person, or forcing or
1093enticing an individual a person to touch the perpetrator.
1094     4.  Intentionally masturbating in the presence of another
1095person.
1096     5.  Intentionally exposing the genitals in a lewd or
1097lascivious manner in the presence of another individual person.
1098     6.  Intentionally committing any other sexual act that does
1099not involve actual physical or sexual contact with another
1100individual the victim, including, but not limited to,
1101sadomasochistic abuse, sexual bestiality, or the simulation of
1102any act involving sexual activity in the presence of the
1103individual a victim.
1104     (c)  "Sexual misconduct" means any sexual activity between
1105an employee and an individual held for examination or admitted
1106for mental health treatment a patient, regardless of the consent
1107of that individual the patient. The term does not include an act
1108done for a bona fide medical purpose or an internal search
1109conducted in the lawful performance of duty by an employee.
1110     (2)  An employee who engages in sexual misconduct with an
1111individual a patient who:
1112     (a)  Is in the custody of the department; or
1113     (b)  Resides in a receiving facility or a treatment
1114facility, as those terms are defined in s. 394.455,
1115
1116commits a felony of the second degree, punishable as provided in
1117s. 775.082, s. 775.083, or s. 775.084. An employee may be found
1118guilty of violating this subsection without having committed the
1119crime of sexual battery.
1120     (3)  The consent of an individual held for examination or
1121admitted for treatment the patient to the sexual activity is not
1122a defense to prosecution under this section.
1123     (4)  This section does not apply to an employee who:
1124     (a)  Is legally married to the individual patient; or
1125     (b)  Has no reason to believe that the person with whom the
1126employee engaged in sexual misconduct is an individual a patient
1127receiving services as described in subsection (2).
1128     Section 10.  Section 394.4595, Florida Statutes, is amended
1129to read:
1130     394.4595  Florida statewide and local advocacy councils;
1131access to patients and records.-Any facility designated by the
1132department as a receiving or treatment facility must allow
1133access to any individual held for examination or admitted for
1134mental health treatment patient and his or her the clinical and
1135legal records of any patient admitted pursuant to the provisions
1136of this act by members of the Florida statewide and local
1137advocacy councils.
1138     Section 11.  Section 394.4597, Florida Statutes, is amended
1139to read:
1140     394.4597  Persons to be notified; appointment of a
1141patient's representative.-
1142     (1)  VOLUNTARY ADMISSION PATIENTS.-At the time an
1143individual a patient is voluntarily admitted to a receiving or
1144treatment facility, the identity and contact information of the
1145a person to be notified in case of an emergency shall be entered
1146in the patient's clinical record.
1147     (2)  INVOLUNTARY ADMISSION PATIENTS.-
1148     (a)  At the time an individual a patient is admitted to a
1149facility for involuntary examination or placement, or when a
1150petition for involuntary placement is filed, the names,
1151addresses, and telephone numbers of the individual's patient's
1152guardian or guardian advocate, or representative if he or she
1153the patient has no guardian or guardian advocate, health care
1154surrogate, and the patient's attorney shall be entered in the
1155patient's clinical record.
1156     (a)(b)  If the individual patient has no guardian or
1157guardian advocate, he or she the patient shall be asked to
1158designate a representative. If the individual patient is unable
1159or unwilling to designate a representative, the facility shall
1160select a representative.
1161     (b)(c)  The individual patient shall be consulted with
1162regard to the selection of a representative by the receiving or
1163treatment facility and may shall have authority to request that
1164the any such representative be replaced.
1165     (c)(d)  If When the receiving or treatment facility selects
1166a representative, first preference shall be given to a health
1167care surrogate, if one has been previously selected by the
1168patient. If the individual patient has not previously selected a
1169health care surrogate, the selection, except for good cause
1170documented in the patient's clinical record, shall be made from
1171the following list in the order of listing:
1172     1.  The individual's patient's spouse.
1173     2.  An adult child of the individual patient.
1174     3.  A parent of the individual patient.
1175     4.  The adult next of kin of the individual patient.
1176     5.  An adult friend of the individual patient.
1177     6.  The appropriate Florida local advocacy council as
1178provided in s. 402.166.
1179     (d)(e)  A licensed professional providing services to the
1180individual patient under this part, an employee of a facility
1181providing direct services to the individual patient under this
1182part, a department employee, a person providing other
1183substantial services to the individual patient in a professional
1184or business capacity, or a creditor of the individual may
1185patient shall not be appointed as the patient's representative.
1186     (e)  The representative selected by the individual or
1187designated by the facility has the right, authority, and
1188responsibility to:
1189     1.  Receive notice of the individual's admission;
1190     2.  Receive notice of proceedings affecting the individual;
1191     3.  Have immediate access to the individual unless such
1192access is documented to be detrimental to the individual;
1193     4.  Receive notice of any restriction of the individual's
1194right to communicate or receive visitors;
1195     5.  Receive a copy of the inventory of personal effects
1196upon the individual's admission and to request an amendment to
1197the inventory at any time;
1198     6.  Receive disposition of the individual's clothing and
1199personal effects if not returned to the individual, or to
1200approve an alternate plan;
1201     7.  Petition on behalf of the individual for a writ of
1202habeas corpus to question the cause and legality of the
1203individual's detention or to allege that the individual is being
1204unjustly denied a right or privilege granted under this section,
1205or that a procedure authorized under this section is being
1206abused;
1207     8.  Apply for a change of venue for the individual's
1208involuntary placement hearing for the convenience of the parties
1209or witnesses or because of the individual's condition;
1210     9.  Receive written notice of any restriction of the
1211individual's right to inspect his or her clinical record;
1212     10.  Receive notice of the release of the individual from a
1213receiving facility where an involuntary examination was
1214performed;
1215     11.  Receive a copy of any petition for the individual's
1216involuntary placement filed with the court; and
1217     12.  Be informed by the court of the individual's right to
1218an independent expert evaluation pursuant to involuntary
1219placement procedures.
1220     Section 12.  Section 394.4598, Florida Statutes, is amended
1221to read:
1222     394.4598  Guardian advocate.-
1223     (1)  The administrator may petition the court for the
1224appointment of a guardian advocate based upon the opinion of a
1225psychiatrist that an individual held for examination or admitted
1226for mental health treatment the patient is incompetent to
1227consent to treatment. If the court finds that the individual a
1228patient is incompetent to consent to treatment and has not been
1229adjudicated incapacitated and a guardian having with the
1230authority to consent to mental health treatment has not been
1231appointed, it shall appoint a guardian advocate. The individual
1232patient has the right to have an attorney represent him or her
1233at the hearing. If the individual person is indigent, the court
1234shall appoint the office of the public defender to represent him
1235or her at the hearing. The individual patient has the right to
1236testify, cross-examine witnesses, and present witnesses. The
1237proceeding must shall be recorded either electronically or
1238stenographically, and testimony shall be provided under oath.
1239One of the professionals authorized to give an opinion in
1240support of a petition for involuntary placement, as described in
1241s. 394.4655 or s. 394.467, must testify. The A guardian advocate
1242must meet the qualifications of a guardian pursuant to contained
1243in part IV of chapter 744., except that A professional providing
1244services to the individual under referred to in this part, an
1245employee of the facility providing direct services to the
1246individual patient under this part, a departmental employee, a
1247facility administrator, or a member of the Florida local
1248advocacy council may shall not be appointed. A person who is
1249appointed as a guardian advocate must agree to the appointment.
1250     (2)  A facility requesting appointment of a guardian
1251advocate must, prior to the appointment, provide the prospective
1252guardian advocate with information concerning about the duties
1253and responsibilities of guardian advocates, including the
1254information about the ethics of medical decisionmaking. Before
1255asking a guardian advocate to give consent to treatment for an
1256individual held for examination or admitted for mental health
1257treatment a patient, the facility must shall provide to the
1258guardian advocate sufficient information so that the guardian
1259advocate can decide whether to give express and informed consent
1260to the treatment, including information that the treatment is
1261essential to the care of the individual patient, and that the
1262treatment does not present an unreasonable risk of serious,
1263hazardous, or irreversible side effects. Before giving consent
1264to treatment, the guardian advocate must meet and talk with the
1265individual patient and the individual's patient's physician
1266face-to-face in person, if at all possible, and by telephone, if
1267not. The guardian advocate shall make every effort to make the
1268mental health care decision that he or she believes the
1269individual would have made under the circumstances if the
1270individual were capable of making such decision. The decision of
1271the guardian advocate may be reviewed by the court, upon
1272petition of the individual's patient's attorney or, the
1273patient's family, or the facility administrator.
1274     (3)  Before Prior to a guardian advocate may exercise
1275exercising his or her authority, the guardian advocate must
1276complete shall attend a training course approved by the court.
1277The This training course, of not less than 4 hours, must
1278include, at minimum, information concerning individual about the
1279patient rights, psychotropic medications, diagnosis of mental
1280illness, the ethics of medical decisionmaking, and duties of
1281guardian advocates. This training course shall take the place of
1282the training required for guardians appointed under pursuant to
1283chapter 744.
1284     (4)  The information provided to be supplied to prospective
1285guardian advocates before prior to their appointment and the
1286training course for guardian advocates must be developed and
1287completed through a course developed by the department and
1288approved by the chief judge of the circuit court and taught by a
1289court-approved organization. Court-approved organizations may
1290include, but are not limited to, community or junior colleges,
1291guardianship organizations, and the local bar association or The
1292Florida Bar. The court may, in its discretion, waive some or all
1293of the training requirements for guardian advocates or impose
1294additional requirements. The court shall make its decision on a
1295case-by-case basis and, in making its decision, shall consider
1296the experience and education of the guardian advocate, the
1297duties assigned to the guardian advocate, and the needs of the
1298individual whom the guardian advocate represents patient.
1299     (5)  In selecting a guardian advocate, the court shall give
1300preference to a health care surrogate, if one has already been
1301designated by the individual held for examination or admitted
1302for mental health treatment patient. If the individual patient
1303has not previously selected a health care surrogate, except for
1304good cause documented in the court record, the selection shall
1305be made from the following list in the order of listing:
1306     (a)   The individual's patient's spouse.
1307     (b)   An adult child of the individual patient.
1308     (c)  A parent of the individual patient.
1309     (d)  The adult next of kin of the individual patient.
1310     (e)  An adult friend of the individual patient.
1311     (f)  An adult trained and willing to serve as guardian
1312advocate for the individual patient.
1313     (6)  If a guardian having with the authority to consent to
1314medical treatment has not already been appointed, or if the
1315individual held for examination or admitted for mental health
1316treatment patient has not already designated a health care
1317surrogate, the court may authorize the guardian advocate to
1318consent to medical treatment, as well as mental health
1319treatment. Unless otherwise limited by the court, a guardian
1320advocate that has with authority to consent to medical treatment
1321shall have the same authority to make health care decisions and
1322be subject to the same restrictions as a proxy appointed under
1323part IV of chapter 765. Unless the guardian advocate has sought
1324and received express court approval in proceeding separate from
1325the proceeding to determine the competence of the patient to
1326consent to medical treatment, the guardian advocate may not
1327consent to:
1328     (a)  Abortion.
1329     (b)  Sterilization.
1330     (c)  Electroconvulsive treatment.
1331     (d)  Psychosurgery.
1332     (e)  Experimental treatments that have not been approved by
1333a federally approved institutional review board in accordance
1334with 45 C.F.R. part 46 or 21 C.F.R. part 56.
1335
1336The court shall must base its decision on evidence that the
1337treatment or procedure is essential to the care of the
1338individual patient and that the treatment does not present an
1339unreasonable risk of serious, hazardous, or irreversible side
1340effects. The court shall follow the procedures set forth in
1341subsection (1) of this section.
1342     (7)  The guardian advocate shall be discharged when the
1343individual whom he or she represents patient is discharged from
1344an order for involuntary outpatient placement or involuntary
1345inpatient placement or when the individual patient
1346transferred from involuntary to voluntary status. The court or a
1347hearing officer shall consider the competence of the individual
1348patient pursuant to subsection (1) and may consider an
1349involuntarily placed individual's patient's competence to
1350consent to treatment at any hearing. Upon sufficient evidence,
1351the court may restore, or the magistrate hearing officer may
1352recommend that the court restore, the individual's patient's
1353competence. A copy of the order restoring competence or the
1354certificate of discharge containing the restoration of
1355competence shall be provided to the individual patient and the
1356guardian advocate.
1357     Section 13.  Section 394.4599, Florida Statutes, is amended
1358to read:
1359     394.4599  Notice.-
1360     (1)  VOLUNTARY ADMISSION PATIENTS.-Notice of an
1361individual's a voluntary patient's admission shall only be given
1362only at the individual's request of the patient, except that in
1363an emergency, notice shall be given as determined by the
1364facility.
1365     (2)  INVOLUNTARY ADMISSION PATIENTS.-
1366     (a)  If notice of involuntary admission Whenever notice is
1367required to be given under this part, such notice shall be given
1368to the individual admitted patient and his or her the patient's
1369guardian, guardian advocate, attorney, and representative.
1370     1.  If When notice is required to be given to an individual
1371a patient, it shall be given both orally and in writing, in the
1372language and terminology that the individual patient can
1373understand, and, if needed, the facility shall provide an
1374interpreter for the individual patient.
1375     2.  Notice to an individual's a patient's guardian,
1376guardian advocate, health care surrogate or proxy, attorney, and
1377representative shall be given by United States mail and by
1378registered or certified mail with the receipts attached to the
1379patient's clinical record. Hand delivery by a facility employee
1380may be used as an alternative, with delivery documented in the
1381clinical record. If notice is given by a state attorney or an
1382attorney for the department, a certificate of service is shall
1383be sufficient to document service.
1384     (b)  A receiving facility shall give prompt notice of the
1385whereabouts of an individual a patient who is being
1386involuntarily held for examination to the individual's guardian
1387or representative, by telephone or in person within 24 hours
1388after the individual's patient's arrival at the facility, unless
1389the patient requests that no notification be made. Contact
1390attempts must shall be documented in the individual's patient's
1391clinical record and shall begin as soon as reasonably possible
1392after the individual's patient's arrival. Notice that an
1393individual is being involuntarily held must a patient is being
1394admitted as an involuntary patient shall be given to the Florida
1395local advocacy council by no later than the next working day
1396after the individual patient is admitted.
1397     (c)  The written notice of the filing of the petition for
1398the involuntary placement of an individual being held must
1399include contain the following:
1400     1.  Notice that the petition has been filed with the
1401circuit court in the county in which the individual patient is
1402hospitalized and the court's address of such court.
1403     2.  Notice that the office of the public defender has been
1404appointed to represent the individual patient in the proceeding,
1405if the individual patient is not otherwise represented by
1406counsel.
1407     3.  The date, time, and place of the hearing and the name
1408of each examining expert and every other person expected to
1409testify in support of continued detention.
1410     4.  Notice that the individual patient, the individual's
1411patient's guardian or representative, or the administrator may
1412apply for a change of venue for the convenience of the parties
1413or witnesses or because of the individual's condition of the
1414patient.
1415     5.  Notice that the individual patient is entitled to an
1416independent expert examination and, if the individual patient
1417cannot afford such an examination, that the court will provide
1418for one.
1419     (d)  A treatment facility shall provide notice of an
1420individual's a patient's involuntary admission on the next
1421regular working day after the individual's patient's arrival at
1422the facility.
1423     (e)  If an individual When a patient is to be transferred
1424from one facility to another, notice shall be given by the
1425facility where the individual patient is located before prior to
1426the transfer.
1427     Section 14.  Section 394.460, Florida Statutes, is
1428repealed.
1429     Section 15.  Section 394.461, Florida Statutes, is amended
1430to read:
1431     394.461  Designation of receiving and treatment
1432facilities.-The department may is authorized to designate and
1433monitor receiving facilities and treatment facilities and may
1434suspend or withdraw such designation for failure to comply with
1435this part and rules adopted under this part. Only governmental
1436facilities, and other facilities Unless designated by the
1437department, may facilities are not permitted to hold or treat
1438individuals on an involuntary basis patients under this part.
1439     (1)  RECEIVING FACILITY.-The department may designate any
1440community facility as a receiving facility. Any other facility
1441within the state, including a private facility, as a receiving
1442facility if or a federal facility, may be so designated by the
1443department, provided that such designation is agreed to by the
1444governing body or authority of the facility.
1445     (2)  TREATMENT FACILITY.-The department may designate any
1446state-owned, state-operated, or state-supported facility as a
1447state treatment facility. An individual may A civil patient
1448shall not be admitted to a civil state treatment facility
1449without previously undergoing a transfer evaluation. Before a
1450court hearing for involuntary placement in a state treatment
1451facility, the court shall receive and consider the information
1452documented in the transfer evaluation. Any other facility,
1453including a private facility or a federal facility, may be
1454designated as a treatment facility by the department if,
1455provided that such designation is agreed to by the appropriate
1456governing body or authority of the facility.
1457     (3)  GOVERNMENTAL FACILITIES.-Governmental facilities may
1458provide voluntary and involuntary mental health examination and
1459treatment for individuals in their care and custody and must
1460protect the rights of these individuals, pursuant to this part.
1461     (4)(3)  PRIVATE FACILITIES.-Private facilities designated
1462as receiving and treatment facilities by the department may
1463provide examination and treatment of individuals on an of
1464involuntary or patients, as well as voluntary basis patients,
1465and are subject to all the provisions of this part.
1466     (5)(4)  REPORT.-
1467     (a)  A facility designated as a public receiving or
1468treatment facility under this section shall annually report to
1469the department on an annual basis the following data to the
1470department, unless such these data are currently being submitted
1471to the Agency for Health Care Administration:
1472     1.  Number of licensed beds by payor class.
1473     2.  Number of contract days by payor class.
1474     3.  Number of persons served admissions by payor class and
1475diagnoses.
1476     4.  Number of bed days by payor class.
1477     5.  Average length of stay by payor class.
1478     6.  Total revenues by payor class.
1479     (b)  For the purposes of this subsection, "payor class"
1480means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private-
1481pay health insurance, private-pay health maintenance
1482organization, private preferred provider organization, the
1483Department of Children and Family Services, other government
1484programs, self-pay individuals patients, and charity care.
1485     (c)  The data required under this subsection shall be
1486submitted to the department within no later than 90 days after
1487following the end of the facility's fiscal year. A facility
1488designated as a public receiving or treatment facility shall
1489submit its initial report for the 6-month period ending June 30,
14902008.
1491     (d)  The department shall issue an annual report based on
1492the data collected required pursuant to this subsection, which
1493must. The report shall include individual facilities' data by
1494facility, as well as statewide totals. The report shall be
1495submitted to the Governor, the President of the Senate, and the
1496Speaker of the House of Representatives.
1497     (6)(5)  RULES.-The department shall adopt rules relating
1498to:
1499     (a)  Procedures and criteria for receiving and evaluating
1500facility applications for designation as a receiving or
1501treatment facility, which may include an onsite facility
1502inspection and evaluation of an applicant's licensing status and
1503performance history, as well as consideration of local service
1504needs.
1505     (b)  Minimum standards consistent with this part which that
1506a facility must meet and maintain in order to be designated as a
1507receiving or treatment facility, and procedures for monitoring
1508continued adherence to such standards.
1509     (c)  Procedures for receiving complaints against a
1510designated facility and for initiating inspections and
1511investigations of facilities alleged to have violated the
1512provisions of this part or rules adopted under this part.
1513     (d)  Procedures and criteria for the suspension or
1514withdrawal of designation as a receiving or treatment facility.
1515     Section 16.  Section 394.4615, Florida Statutes, is amended
1516to read:
1517     394.4615  Clinical records; confidentiality.-
1518     (1)  A clinical record shall be maintained for each
1519individual held for examination or admitted for mental health
1520treatment patient. The record must shall include data pertaining
1521to admission and such other information as may be required under
1522rules of the department. A clinical record is confidential and
1523exempt from the provisions of s. 119.07(1). Unless waived by the
1524express and informed consent of the individual, by the patient
1525or by his or her the patient's guardian, or guardian advocate,
1526health care surrogate or proxy, or, if the patient is deceased,
1527by his or her the patient's personal representative or the
1528family member who stands next in line of intestate succession,
1529the confidential status of the clinical record is shall not be
1530lost by either authorized or unauthorized disclosure to any
1531person, organization, or agency.
1532     (2)  The clinical record of an individual held for
1533examination or admitted for mental health treatment shall be
1534released if when:
1535     (a)  The individual patient or the individual's patient's
1536guardian, guardian advocate, or health care surrogate or proxy
1537authorizes the release. The guardian, or guardian advocate, or
1538surrogate shall be provided access to the appropriate clinical
1539records of the patient. The individual patient or the
1540individual's patient's guardian, or guardian advocate, or
1541surrogate or proxy may authorize the release of information and
1542clinical records to appropriate persons to ensure the continuity
1543of the individual's patient's health care or mental health care.
1544     (b)  The individual patient is represented by counsel and
1545the records are needed by such the patient's counsel for
1546adequate representation.
1547     (c)  A petition for involuntary placement is filed and the
1548records are needed by the state attorney to evaluate and confirm
1549the allegations set forth in the petition or to prosecute the
1550petition.
1551     (d)(c)  The court orders such release. In determining
1552whether there is good cause for disclosure, the court shall
1553weigh the need for the information to be disclosed against the
1554possible harm of disclosure to the individual person to whom
1555such information pertains.
1556     (e)(d)  The individual patient is committed to, or is to be
1557returned to, the Department of Corrections from the Department
1558of Children and Family Services, and the Department of
1559Corrections requests such records. The These records shall be
1560furnished without charge to the Department of Corrections.
1561     (3)  Information from the clinical record may be released
1562if in the following circumstances:
1563     (a)  The individual When a patient has declared an
1564intention to harm other persons. If When such declaration has
1565been made, the administrator may authorize the release of
1566sufficient information to provide adequate warning to the person
1567threatened with harm by the patient.
1568     (b)  When The administrator of the facility or secretary of
1569the department deems that release to a qualified researcher as
1570defined in administrative rule, an aftercare treatment provider,
1571or an employee or agent of the department is necessary for
1572treatment of the individual patient, maintenance of adequate
1573records, compilation of treatment data, aftercare planning, or
1574evaluation of programs.
1575     (c)  The information is necessary for the purpose of
1576determining whether an individual a person meets the criteria
1577for involuntary outpatient placement or for preparing the
1578proposed treatment plan pursuant to s. 394.4655, the clinical
1579record may be released to the state attorney, the public
1580defender or the individual's patient's private legal counsel,
1581the court, and to the appropriate mental health professionals,
1582including the service provider identified in s. 394.4655(6)(b)
1583394.4655(6)(b)2., in accordance with state and federal law.
1584     (4)  Information from clinical records may be used for
1585statistical and research purposes if the information is
1586abstracted in such a way as to protect the identity of
1587individuals served and meets department policy.
1588     (5)  Information from clinical records may be used by the
1589Agency for Health Care Administration, the department, and the
1590Florida advocacy councils for the purpose of monitoring facility
1591activity and complaints concerning facilities.
1592     (6)  Clinical records relating to a Medicaid recipient
1593shall be furnished to the Medicaid Fraud Control Unit in the
1594Department of Legal Affairs, upon request.
1595     (7)  Any person, agency, or entity receiving information
1596pursuant to this section shall maintain such information as
1597confidential and exempt from the provisions of s. 119.07(1).
1598     (8)  Any facility or private mental health practitioner who
1599acts in good faith in releasing information pursuant to this
1600section is not subject to civil or criminal liability for such
1601release.
1602     (9)  Nothing in This section does not is intended to
1603prohibit the parent or next of kin of an individual a person who
1604is held for examination in or admitted for treated under a
1605mental health treatment facility or program from requesting and
1606receiving information limited to a summary of that individual's
1607person's treatment plan and current physical and mental
1608condition. Release of such information must shall be in
1609accordance with the code of ethics of the profession involved.
1610     (10)  An adult individual Patients shall have reasonable
1611access to his or her their clinical records, unless such access
1612is determined by the individual's patient's physician to be
1613harmful to the individual patient. If the individual's patient's
1614right to inspect his or her clinical record is restricted by the
1615facility, written notice of the such restriction must shall be
1616given to the individual patient and to his or her the patient's
1617guardian, guardian advocate, attorney, and representative. In
1618addition, the restriction must shall be recorded in the clinical
1619record, together with the reasons for it. The restriction
1620expires of a patient's right to inspect his or her clinical
1621record shall expire after 7 days but may be renewed, after
1622review, for subsequent 7-day periods.
1623     (11)  Any person who fraudulently alters, defaces, or
1624falsifies the clinical record of an individual any person
1625receiving mental health services in a facility subject to
1626part, or causes or procures any of these offenses to be
1627committed, commits a misdemeanor of the second degree,
1628punishable as provided in s. 775.082 or s. 775.083.
1629     Section 17.  Section 394.462, Florida Statutes, is amended
1630to read:
1631     394.462  Transportation.-
1632     (1)  TRANSPORTATION TO A RECEIVING FACILITY.-
1633     (a)  Each county shall designate a single law enforcement
1634agency within the county, or portions thereof, to take an
1635individual a person into custody upon the entry of an ex parte
1636order or the execution of a certificate for involuntary
1637examination by an authorized professional and to transport that
1638individual person to the nearest receiving facility, excluding a
1639governmental facility, for examination. A law enforcement
1640officer acting in good faith pursuant to this part may not be
1641held criminally or civilly liable for false imprisonment. The
1642designated law enforcement agency may decline to transport the
1643individual person to a receiving facility only if:
1644     1.  The county or jurisdiction designated by the county has
1645contracted on an annual basis with an emergency medical
1646transport service or private transport company for
1647transportation of individuals persons to receiving facilities
1648pursuant to this section at the sole cost of the county; and
1649     2.  The law enforcement agency and the emergency medical
1650transport service or private transport company agree that the
1651continued presence of law enforcement personnel is not necessary
1652for the safety of the individual being transported person or
1653others.
1654     (b)3.  If transportation for involuntary examination is
1655provided by an emergency medical transport service or private
1656transport company, the county or law enforcement agency The
1657jurisdiction designated by the county may seek reimbursement for
1658transportation expenses. The individual being transported is
1659party responsible for payment for such transportation is the
1660person receiving the transportation. The county shall seek
1661reimbursement from the following sources in the following order:
1662     1.a.  From an insurance company, health care corporation,
1663or other source, if the individual being transported person
1664receiving the transportation is covered by an insurance policy
1665or subscribes to a health care corporation or other source for
1666payment of such expenses.
1667     2.b.  From the individual being transported person
1668receiving the transportation.
1669     3.c.  From a financial settlement for medical care,
1670treatment, hospitalization, or transportation payable or
1671accruing to the injured party.
1672     (c)(b)  Any company that transports an individual a patient
1673pursuant to this subsection is considered an independent
1674contractor and is solely liable for the safe and dignified
1675transportation of the individual patient. Such company must be
1676insured and maintain at least provide no less than $100,000 in
1677liability insurance with respect to such the transportation of
1678patients.
1679     (d)(c)  Any company that contracts with a governing board
1680of a county to transport individuals for examination or
1681treatment must patients shall comply with the applicable rules
1682of the department to ensure their the safety and dignity of the
1683patients.
1684     (e)(d)  If When a law enforcement officer takes custody of
1685an individual a person pursuant to this part, the officer may
1686request assistance from emergency medical personnel if such
1687assistance is needed for the safety of the officer or the
1688individual person in custody.
1689     (f)(e)  If When a member of a mental health overlay program
1690or a mobile crisis response service who is a professional
1691authorized to initiate an involuntary examination pursuant to s.
1692394.463 and that professional evaluates an individual a person
1693and determines that transportation to a receiving facility is
1694needed, the service, at its discretion, may transport the
1695individual person to the facility or may call on the law
1696enforcement agency or other transportation arrangement best
1697suited to the needs of the individual being transported patient.
1698     (g)(f)  If a When any law enforcement officer has custody
1699of an individual a person based on either noncriminal or minor
1700criminal behavior that meets the statutory guidelines for
1701involuntary examination under this part, the law enforcement
1702officer shall transport the individual person to the nearest
1703receiving facility for examination.
1704     (h)(g)  If a When any law enforcement officer has arrested
1705an adult individual a person for a felony and it appears that
1706the individual person meets the statutory guidelines for
1707involuntary examination or placement under this part, the
1708individual such person shall first be processed in the same
1709manner as any other criminal suspect. The law enforcement agency
1710shall thereafter immediately notify the nearest public receiving
1711facility, which shall be responsible for promptly arranging for
1712the examination and treatment of the individual person. A
1713receiving facility is not required to admit an individual a
1714person charged with a crime for whom the facility determines and
1715documents that it is unable to provide adequate security, but
1716shall provide mental health examination and treatment to the
1717individual person where he or she is held.
1718     (i)(h)  If the appropriate law enforcement officer believes
1719that an individual a person has an emergency medical condition
1720as defined in s. 395.002, the individual person may be first
1721transported to a hospital for emergency medical treatment,
1722regardless of whether the hospital is a designated receiving
1723facility.
1724     (j)(i)  The costs of transportation, evaluation,
1725hospitalization, and treatment incurred under this subsection by
1726individuals persons who have been arrested for violations of any
1727state law or county or municipal ordinance may be recovered as
1728provided in s. 901.35.
1729     (k)(j)  The nearest receiving facility must accept
1730individuals persons brought by law enforcement officers for
1731involuntary examination.
1732     (l)(k)  Each law enforcement agency shall develop a
1733memorandum of understanding with each receiving facility within
1734the law enforcement agency's jurisdiction which reflects a
1735single set of protocols for the safe and secure transportation
1736of the person and transfer of custody of the person. These
1737protocols must also address crisis intervention measures.
1738     (m)(l)  If When a jurisdiction has entered into a contract
1739with an emergency medical transport service or a private
1740transport company for transportation of individuals persons to
1741receiving facilities, such service or company shall be given
1742preference for transportation of individuals persons from
1743nursing homes, assisted living facilities, adult day care
1744centers, or adult family-care homes, unless the behavior of the
1745individual person being transported is such that transportation
1746by a law enforcement officer is necessary.
1747     (n)(m)  Nothing in This section does not shall be construed
1748to limit emergency examination and treatment of incapacitated
1749individuals persons provided in accordance with the provisions
1750of s. 401.445.
1751     (2)  TRANSPORTATION TO A TREATMENT FACILITY.-
1752     (a)  If neither the individual held for examination or
1753admitted for mental health treatment or patient nor any person
1754legally obligated or responsible for the individual patient is
1755not able to pay for the expense of transporting an individual a
1756voluntary or involuntary patient to a treatment facility, the
1757governing board of the county in which the individual patient is
1758hospitalized shall arrange for the such required transportation
1759and shall ensure the safe and dignified transportation of the
1760individual patient. The governing board of each county may is
1761authorized to contract with private transport companies for such
1762the transportation of such patients to and from a treatment
1763facility.
1764     (b)  Any company that transports an individual a patient
1765pursuant to this subsection is considered an
1766contractor and is solely liable for the safe and
1767transportation of the individual patient. Such company
1768insured and provide at least no less than $100,000 in liability
1769insurance for such with respect to the transportation of
1770patients.
1771     (c)  Any company that contracts with the governing board of
1772a county to transport individuals must patients shall comply
1773with the applicable rules of the department to ensure the safety
1774and dignity of the individuals transported patients.
1775     (d)  County or municipal law enforcement and correctional
1776personnel and equipment may shall not be used to transport
1777individuals patients adjudicated incapacitated or found by the
1778court to meet the criteria for involuntary placement under
1779pursuant to s. 394.467, except in small rural counties where
1780there are no cost-efficient alternatives.
1781     (3)  TRANSFER OF CUSTODY.-Custody of a person who is
1782transported pursuant to this part, along with related
1783documentation, shall be relinquished to a responsible individual
1784at the appropriate receiving or treatment facility.
1785     (4)  EXCEPTIONS.-
1786     (a)  An exception to the requirements of this section may
1787be granted by the secretary of the department for the purposes
1788of improving service coordination or better meeting the special
1789needs of individuals. A proposal for an exception shall must be
1790submitted to the secretary by the circuit district administrator
1791after being approved by the governing board of each affected
1792county boards of any affected counties, prior to submission to
1793the secretary.
1794     1.(a)  A proposal for an exception must identify the
1795specific provision from which an exception is requested,;
1796describe how the proposal will be implemented by participating
1797law enforcement agencies and transportation authorities,; and
1798provide a plan for the coordination of services such as case
1799management.
1800     2.(b)  An The exception may be granted only for:
1801     a.1.  An arrangement centralizing and improving the
1802provision of services within a circuit district, which may
1803include an exception to the requirement for transportation to
1804the nearest receiving facility;
1805     b.2.  An arrangement whereby by which a facility may
1806provide, in addition to required psychiatric services, an
1807environment and services that which are uniquely tailored to the
1808needs of an identified group of individuals who have persons
1809with special needs, such as persons who have with hearing
1810impairments or visual impairments, or elderly persons who have
1811with physical frailties; or
1812     c.3.  A specialized transportation system that provides an
1813efficient and humane method of transporting individuals patients
1814to receiving facilities, among receiving facilities, and to
1815treatment facilities.
1816     2.(c)  Any exception approved pursuant to this subsection
1817must shall be reviewed and approved every 5 years by the
1818secretary.
1819     (b) The Department of Corrections may transport an
1820individual who is being released from its custody to a receiving
1821or treatment facility for involuntary examination or placement.
1822Such transport shall be to a facility, specified by the
1823department, which is able to meet the specific needs of the
1824individual, or, if such specification cannot be made due to
1825exigent circumstances, transport may be to the nearest receiving
1826facility.
1827     Section 18.  Section 394.4625, Florida Statutes, is amended
1828to read:
1829     394.4625  Voluntary admissions.-
1830     (1)  EXAMINATION AND TREATMENT AUTHORITY TO RECEIVE
1831PATIENTS.-
1832     (a)  A facility may receive for observation, diagnosis, or
1833treatment an adult who makes any person 18 years of age or older
1834making application by express and informed consent for admission
1835or any minor person age 17 or under for whom such application is
1836made by his or her guardian.
1837     1.  If found to show evidence of mental illness, to be
1838competent to provide express and informed consent, and to be
1839suitable for treatment, an adult such person 18 years of age or
1840older may be admitted to the facility.
1841     2.  A minor person age 17 or under may be admitted only
1842with the minor's assent, which must be obtained in conjunction
1843with consent from the minor's guardian. The minor's assent means
1844that the minor has affirmatively agreed to stay at the facility
1845for examination or mental health treatment. Mere failure to
1846object, absent affirmative agreement, is not assent. The minor's
1847assent must be verified through a clinical assessment that is
1848documented in the clinical record and conducted within 12 hours
1849after admission by a licensed professional authorized to
1850initiate an involuntary examination pursuant to s. 394.463. In
1851verifying the minor's assent, the examining professional must
1852first provide the minor with an explanation of why the minor
1853will be examined and treated, what the minor can expect while in
1854the facility, and when the minor may expect to be released,
1855using language that is appropriate to the minor's age,
1856experience, maturity, and condition. Unless the minor's assent
1857is verified pursuant to this section, a petition for involuntary
1858inpatient placement must be filed with the court within 1
1859working day after admission or the minor must be released to his
1860or her guardian within 24 hours after admission only after a
1861hearing to verify the voluntariness of the consent.
1862     (b)  A mental health overlay program, or a mobile crisis
1863response service, or a licensed professional who is authorized
1864to initiate an involuntary examination pursuant to s. 394.463
1865and is employed by a community mental health center or clinic
1866must, pursuant to circuit district procedure approved by the
1867respective circuit district administrator, conduct an initial
1868assessment of the ability of the following individuals persons
1869to give express and informed consent to treatment before such
1870individuals persons may be admitted voluntarily:
1871     1.  An individual A person 60 years of age or older for
1872whom transfer is being sought from a nursing home, assisted
1873living facility, adult day care center, or adult family-care
1874home, if when such person has been diagnosed as suffering from
1875dementia.
1876     2.  An individual A person 60 years of age or older for
1877whom transfer is being sought from a nursing home pursuant to s.
1878400.0255(11) 400.0255(12).
1879     3.  An individual A person for whom all decisions
1880concerning medical treatment are currently being lawfully made
1881by a the health care surrogate or proxy designated under chapter
1882765.
1883     (c)  If When an initial assessment of the ability of an
1884individual a person to give express and informed consent to
1885treatment is required under this section, and a mobile crisis
1886response service does not respond to a the request for an
1887assessment within 2 hours after the request is made or informs
1888the requesting facility that it will not be able to respond
1889within 2 hours after the request is made, the requesting
1890facility may arrange for assessment by a any licensed
1891professional authorized to initiate an involuntary examination
1892under pursuant to s. 394.463. The professional may not be who is
1893not employed by or under contract with, or and does not have a
1894financial interest in, either the facility initiating the
1895transfer or the receiving facility to which the transfer may be
1896made, and may not have a financial interest in the outcome of
1897the assessment.
1898     (d)  A facility may not admit an individual on as a
1899voluntary status patient a person who has been adjudicated
1900incapacitated, unless the condition of incapacity has been
1901judicially removed. If a facility admits an individual on
1902voluntary status as a voluntary patient a person who is later
1903determined to have been adjudicated incapacitated, and the
1904condition of incapacity had not been removed by the time of the
1905admission, the facility must either discharge the patient or
1906transfer the individual patient to involuntary status.
1907     (e)  The health care surrogate or proxy of an individual on
1908a voluntary status patient may not consent to the provision of
1909mental health treatment for that individual the patient. An
1910individual on voluntary status A voluntary patient who is
1911unwilling or unable to provide express and informed consent to
1912mental health treatment must either be discharged or transferred
1913to involuntary status.
1914     (f)  Within 24 hours after an individual's voluntary
1915admission of a voluntary patient, the admitting physician shall
1916document in the patient's clinical record that the individual
1917patient is able to give express and informed consent for
1918admission. If the individual patient is not able to give express
1919and informed consent for admission, the facility must shall
1920either discharge the patient or transfer the individual patient
1921to involuntary status pursuant to subsection (5).
1922     (2)  RELEASE OR DISCHARGE OF VOLUNTARY PATIENTS.-
1923     (a)  A facility shall discharge an individual admitted on a
1924voluntary status who patient:
1925     1.  Who Has sufficiently improved so that retention in the
1926facility is no longer desirable. The individual A patient may
1927also be discharged to the care of a community facility.
1928     2.  Who Has revoked revokes consent to admission or
1929requests discharge. The individual A voluntary patient or his or
1930her a relative, friend, or attorney of the patient may request
1931discharge either orally or in writing at any time following
1932admission to the facility. The individual patient must be
1933discharged within 24 hours after of the request, unless the
1934request is rescinded or the individual patient is transferred to
1935involuntary status pursuant to this section. The 24-hour time
1936period may be extended by a treatment facility if when necessary
1937for adequate discharge planning, but may shall not exceed 3 days
1938exclusive of weekends and holidays. If the individual patient,
1939or another on his or her the patient's behalf, makes an oral
1940request for discharge to a staff member, such request must shall
1941be immediately entered in the patient's clinical record. If the
1942request for discharge is made by a person other than the
1943individual patient, the discharge may be conditioned upon the
1944individual's express and informed consent of the patient.
1945     (b)  An individual on A voluntary status patient who has
1946been admitted to a facility and who refuses to consent to or
1947revokes consent to treatment must shall be discharged within 24
1948hours after such refusal or revocation, unless transferred to
1949involuntary status pursuant to this section or unless the
1950refusal or revocation is freely and voluntarily rescinded by the
1951individual patient.
1952     (c)  An individual on voluntary status who has been charged
1953with a crime shall be returned to the custody of a law
1954enforcement officer upon release or discharge from a facility.
1955     (3)  NOTICE OF RIGHT TO DISCHARGE.-At the time of admission
1956and at least every 6 months thereafter, an individual on a
1957voluntary status patient shall be notified in writing of his or
1958her right to apply for a discharge.
1959     (4)  TRANSFER TO VOLUNTARY STATUS.-An individual on
1960involuntary status patient who has been certified by a physician
1961or psychologist as competent to provide express and informed
1962consent and who applies to be transferred to voluntary status
1963shall be transferred to voluntary status immediately, unless the
1964individual patient has been charged with a crime, or has been
1965involuntarily placed for treatment by a court pursuant to s.
1966394.467 and continues to meet the criteria for involuntary
1967placement. When transfer to voluntary status occurs, notice
1968shall be given as provided in s. 394.4599.
1969     (5)  TRANSFER TO INVOLUNTARY STATUS.-If an individual on
1970When a voluntary status patient, or an authorized person on the
1971individual's the patient's behalf, makes a request for
1972discharge, the request for discharge, unless freely and
1973voluntarily rescinded, must be communicated to a physician,
1974clinical psychologist, or psychiatrist as quickly as possible,
1975but within not later than 12 hours after the request is made. If
1976the individual patient meets the criteria for involuntary
1977placement, the administrator of the facility must file with the
1978court a petition for involuntary placement, within 2 court
1979working days after the request for discharge is made. If the
1980petition is not filed within 2 court working days, the
1981individual must patient shall be discharged. Pending the filing
1982of the petition, the individual patient may be held and
1983emergency treatment rendered in the least restrictive manner,
1984upon the written order of a physician, if it is determined that
1985such treatment is necessary for the safety of the individual
1986patient or others.
1987     Section 19.  Section 394.463, Florida Statutes, is amended
1988to read:
1989     394.463  Involuntary examination.-
1990     (1)  CRITERIA.-An individual A person may be taken to a
1991receiving facility for involuntary examination if there is
1992reason to believe that he or she the person has a mental illness
1993and because of this his or her mental illness:
1994     (a)1.  The individual person has refused voluntary
1995examination after conscientious explanation and disclosure of
1996the purpose of the examination; or
1997     2.  The individual person is unable to determine for
1998himself or herself whether examination is necessary; and
1999     (b)1.  Without care or treatment:, the person
2000     1.  The individual is likely to suffer from neglect or
2001refuse to care for himself or herself; such neglect or refusal
2002poses a real and present threat of substantial harm to his or
2003her well-being; and it is not apparent that such harm may be
2004avoided through the help of willing family members or friends or
2005the provision of other services; or
2006     2.  There is a substantial likelihood that without care or
2007treatment the individual person will cause serious bodily harm
2008to self himself or herself or others in the near future, as
2009evidenced by recent behavior.
2010     (2)  INVOLUNTARY EXAMINATION.-
2011     (a)  An involuntary examination may be initiated by any one
2012of the following means:
2013     1.  A court may enter an ex parte order stating that an
2014individual a person appears to meet the criteria for involuntary
2015examination, giving the findings on which that conclusion is
2016based. The ex parte order for involuntary examination must be
2017based on sworn testimony, written or oral, which includes
2018specific facts that support the finding that the criteria have
2019been met. Any behavior relied on for the issuance of the ex
2020parte order must have occurred within the preceding 14 days. If
2021other less restrictive means are not available, such as
2022voluntary appearance for outpatient evaluation, A law
2023enforcement officer, or other designated agent of the court,
2024shall take the individual person into custody and deliver him or
2025her to the nearest receiving facility for involuntary
2026examination. The order of the court order must shall be made a
2027part of the patient's clinical record. A No fee may not shall be
2028charged for the filing of an order under this subsection. Any
2029receiving facility accepting the individual patient based on the
2030this order must send a copy of the order to the Agency for
2031Health Care Administration on the next working day. The order is
2032shall be valid only until the individual is delivered to the
2033receiving facility until executed or, if not executed, for the
2034period specified in the order itself, whichever occurs first. If
2035a no time limit is not specified in the order, the order is
2036shall be valid for 7 days after the date it that the order was
2037signed.
2038     2.  A law enforcement officer shall take an individual a
2039person who appears to meet the criteria for involuntary
2040examination into custody and deliver or arrange for the delivery
2041of the individual the person or have him or her delivered to the
2042nearest receiving facility for examination. The officer shall
2043complete execute a written report detailing the circumstances
2044under which the individual person was taken into custody., and
2045The report must shall be made a part of the patient's clinical
2046record. Any receiving facility accepting the individual patient
2047based on the this report must send a copy of the report to the
2048Agency for Health Care Administration on the next working day.
2049     3.  A physician, clinical psychologist, psychiatric nurse,
2050mental health counselor, marriage and family therapist, or
2051clinical social worker, or physician assistant may execute a
2052certificate stating that he or she has examined the individual a
2053person within the preceding 48 hours and finds that the
2054individual person appears to meet the criteria for involuntary
2055examination and stating the observations upon which that
2056conclusion is based. If other less restrictive means are not
2057available, such as voluntary appearance for outpatient
2058evaluation, A law enforcement officer shall take the individual
2059person named in the certificate into custody and deliver him or
2060her to the nearest receiving facility for involuntary
2061examination. The law enforcement officer shall complete execute
2062a written report detailing the circumstances under which the
2063individual person was taken into custody. The report and
2064certificate shall be made a part of the patient's clinical
2065record. Any receiving facility accepting the individual patient
2066based on the this certificate must send a copy of the
2067certificate to the Agency for Health Care Administration on the
2068next working day. The certificate is valid only until the
2069individual is delivered to the receiving facility or until 7
2070calendar days after the certificate was executed, whichever
2071occurs first.
2072     (b)  A person who initiates an involuntary examination of a
2073minor shall make and document immediate attempts to notify the
2074minor's guardian of such examination. A receiving facility
2075accepting a minor for involuntary examination must immediately
2076notify the minor's guardian upon the minor's arrival.
2077     (c)(b)  An individual may A person shall not be removed
2078from a any program or residential placement licensed under
2079chapter 400 or chapter 429 and transported to a receiving
2080facility for involuntary examination unless an ex parte order, a
2081professional certificate, or a law enforcement officer's report
2082is first prepared. If the condition of the individual person is
2083such that preparation of a law enforcement officer's report is
2084not practicable before removal, the report must shall be
2085completed as soon as possible after removal, but in any case
2086before the individual person is transported to a receiving
2087facility. A receiving facility admitting an individual a person
2088for involuntary examination who is not accompanied by the
2089required ex parte order, professional certificate, or law
2090enforcement officer's report must shall notify the Agency for
2091Health Care Administration of such admission by certified mail
2092by no later than the next working day. The provisions of this
2093paragraph do not apply when transportation is provided by the
2094patient's family or guardian.
2095     (d)(c)  A law enforcement officer acting in accordance with
2096an ex parte order issued pursuant to this subsection may serve
2097and execute such order on any day of the week, at any time of
2098the day or night.
2099     (e)(d)  A law enforcement officer acting in accordance with
2100an ex parte order issued pursuant to this subsection may use
2101such reasonable physical force if as is necessary to gain entry
2102to the premises, and any dwellings, buildings, or other
2103structures located on the premises, and to take custody of the
2104individual person who is the subject of the ex parte order.
2105     (f)(e)  The Agency for Health Care Administration shall
2106receive and maintain the copies of ex parte orders, involuntary
2107outpatient placement orders issued pursuant to s. 394.4655,
2108involuntary inpatient placement orders issued pursuant to s.
2109394.467, professional certificates, and law enforcement
2110officers' reports. These documents shall be considered part of
2111the clinical record, governed by the provisions of s. 394.4615.
2112The agency shall prepare annual reports analyzing the data
2113obtained from these documents, without information identifying
2114individuals held for examination or admitted for mental health
2115treatment patients, and shall provide copies of reports to the
2116department, the President of the Senate, the Speaker of the
2117House of Representatives, and the minority leaders of the Senate
2118and the House of Representatives.
2119     (g)(f)  An individual A patient shall be examined by a
2120physician or clinical psychologist at a receiving facility
2121without unnecessary delay to determine if the criteria for
2122involuntary inpatient placement is met. Emergency treatment may
2123be provided and may, upon the order of a physician, be given
2124emergency treatment if it is determined that such treatment is
2125necessary for the safety of the patient or others. The patient
2126may not be released by the receiving facility or its contractor
2127without the documented approval of a psychiatrist, a clinical
2128psychologist, or, if the receiving facility is a hospital, the
2129release may also be approved by an attending emergency
2130department physician with experience in the diagnosis and
2131treatment of mental and nervous disorders and after completion
2132of an involuntary examination pursuant to this subsection.
2133However, a patient may not be held in a receiving facility for
2134involuntary examination longer than 72 hours.
2135     (h)  An individual may not be held for involuntary
2136examination for more than 72 hours. Based on the individual's
2137needs, one of the following actions must be taken within the 72-
2138hour period:
2139     1.  The individual shall be released after the completion
2140of the involuntary examination and with the documented approval
2141of a psychiatrist or a clinical psychologist or, if the facility
2142is a hospital, the release may be approved by an attending
2143emergency department physician;
2144     2.  The individual shall be asked to give express and
2145informed consent for voluntary admission if a physician or
2146clinical psychologist has determined that the individual is
2147competent to consent to treatment; or
2148     3.  A petition for involuntary placement shall be completed
2149and filed in the circuit court if involuntary outpatient or
2150inpatient treatment is deemed necessary. If the 72-hour period
2151ends on a weekend or holiday, the petition must be filed by the
2152next working day. If inpatient treatment is deemed necessary,
2153the least restrictive treatment consistent with the optimum
2154improvement of the individual's condition must be made
2155available.
2156     (i)  An individual released from a receiving or treatment
2157facility on a voluntary or involuntary basis who is charged with
2158a crime shall be returned to the custody of a law enforcement
2159officer.
2160     (j)(g)  If an individual A person for whom an involuntary
2161examination has been initiated who is also being evaluated or
2162treated at a hospital for an emergency medical condition
2163specified in s. 395.002, must be examined by a receiving
2164facility within 72 hours. the 72-hour period begins when the
2165individual patient arrives at the hospital and ceases when the
2166attending physician documents that the individual patient has an
2167emergency medical condition. The 72-hour period resumes when the
2168physician documents that the emergency medical condition has
2169stabilized or does not exist. If the patient is examined at a
2170hospital providing emergency medical services by a professional
2171qualified to perform an involuntary examination and is found as
2172a result of that examination not to meet the criteria for
2173involuntary outpatient placement pursuant to s. 394.4655(1) or
2174involuntary inpatient placement pursuant to s. 394.467(1), the
2175patient may be offered voluntary placement, if appropriate, or
2176released directly from the hospital providing emergency medical
2177services. The finding by the professional that the patient has
2178been examined and does not meet the criteria for involuntary
2179inpatient placement or involuntary outpatient placement must be
2180entered into the patient's clinical record. Nothing in this
2181paragraph is intended to prevent A hospital providing emergency
2182medical services may transfer an individual from appropriately
2183transferring a patient to another hospital before prior to
2184stabilization if, provided the requirements of s. 395.1041(3)(c)
2185are have been met.
2186     (h)  One of the following must occur within 12 hours after
2187the patient's attending physician documents that the
2188individual's patient's medical condition has stabilized or that
2189an emergency medical condition does not exist:
2190     1.  The individual shall be examined by a physician or
2191clinical psychologist and, if found not to meet the criteria for
2192involuntary examination pursuant to s. 394.463, shall be
2193released directly from the hospital providing the emergency
2194medical services. The results of the examination, including the
2195final disposition, shall be entered into the clinical record; or
2196     2.  The individual shall be transferred to a receiving
2197facility for examination if appropriate medical and mental
2198health treatment is available. However, the receiving facility
2199must be notified of the transfer within 2 hours after the
2200individual's condition has been stabilized or after
2201determination that an emergency medical condition does not
2202exist.
2203     1.  The patient must be examined by a designated receiving
2204facility and released; or
2205     2.  The patient must be transferred to a designated
2206receiving facility in which appropriate medical treatment is
2207available. However, the receiving facility must be notified of
2208the transfer within 2 hours after the patient's condition has
2209been stabilized or after determination that an emergency medical
2210condition does not exist.
2211     (i)  Within the 72-hour examination period or, if the 72
2212hours ends on a weekend or holiday, no later than the next
2213working day thereafter, one of the following actions must be
2214taken, based on the individual needs of the patient:
2215     1.  The patient shall be released, unless he or she is
2216charged with a crime, in which case the patient shall be
2217returned to the custody of a law enforcement officer;
2218     2.  The patient shall be released, subject to the
2219provisions of subparagraph 1., for voluntary outpatient
2220treatment;
2221     3.  The patient, unless he or she is charged with a crime,
2222shall be asked to give express and informed consent to placement
2223as a voluntary patient, and, if such consent is given, the
2224patient shall be admitted as a voluntary patient; or
2225     4.  A petition for involuntary placement shall be filed in
2226the circuit court when outpatient or inpatient treatment is
2227deemed necessary. When inpatient treatment is deemed necessary,
2228the least restrictive treatment consistent with the optimum
2229improvement of the patient's condition shall be made available.
2230When a petition is to be filed for involuntary outpatient
2231placement, it shall be filed by one of the petitioners specified
2232in s. 394.4655(3)(a). A petition for involuntary inpatient
2233placement shall be filed by the facility administrator.
2234     (3)  NOTICE OF RELEASE.-Notice of the release shall be
2235given to the individual's patient's guardian or representative,
2236to any person who executed a certificate admitting the
2237individual patient to the receiving facility, and to any court
2238that which ordered the individual's patient's evaluation.
2239     Section 20.  Section 394.4655, Florida Statutes, is amended
2240to read:
2241     394.4655  Involuntary outpatient placement.-
2242     (1)  CRITERIA FOR INVOLUNTARY OUTPATIENT PLACEMENT.-An
2243individual A person may be ordered to involuntary outpatient
2244placement upon a finding of the court that by clear and
2245convincing evidence that:
2246     (a)  The individual is an adult person is 18 years of age
2247or older;
2248     (b)  The individual person has a mental illness;
2249     (c)  The individual person is unlikely to survive safely in
2250the community without supervision, based on a clinical
2251determination;
2252     (d)  The individual person has a history of lack of
2253compliance with treatment for mental illness;
2254     (e)  The individual person has:
2255     1.  At least twice within the immediately preceding 36
2256months been involuntarily admitted to a receiving or treatment
2257facility as defined in s. 394.455, or has received mental health
2258services in a forensic or correctional facility. The 36-month
2259period does not include any period during which the individual
2260person was admitted or incarcerated; or
2261     2.  Engaged in one or more acts of serious violent behavior
2262toward self or others, or attempts at serious bodily harm to
2263self himself or herself or others, within the preceding 36
2264months;
2265     (f)  Due to The person is, as a result of his or her mental
2266illness, the individual is unlikely to voluntarily participate
2267in the recommended treatment plan and either he or she has
2268refused voluntary placement for treatment after sufficient and
2269conscientious explanation and disclosure of the purpose of
2270placement for treatment or he or she is unable to determine for
2271himself or herself whether placement is necessary;
2272     (g)  In view of the individual's person's treatment history
2273and current behavior, the individual person is in need of
2274involuntary outpatient placement in order to prevent a relapse
2275or deterioration that would be likely to result in serious
2276bodily harm to self himself or herself or others, or a
2277substantial harm to his or her well-being as set forth in s.
2278394.463(1);
2279     (h)  It is likely that the individual person will benefit
2280from involuntary outpatient placement; and
2281     (i)  All available, less restrictive alternatives that
2282would offer an opportunity for improvement of his or her
2283condition have been judged to be inappropriate or unavailable.
2284     (2)  INVOLUNTARY OUTPATIENT PLACEMENT.-
2285     (a)1.  An individual A patient who is being recommended for
2286involuntary outpatient placement by the administrator of the
2287receiving facility where the patient has been examined may be
2288retained by the facility after adherence to the notice
2289procedures provided in s. 394.4599.
2290     1.  The recommendation must be supported by the opinion of
2291a psychiatrist and the second opinion of a clinical psychologist
2292or another psychiatrist, both of whom have personally examined
2293the individual patient within the preceding 72 hours, that the
2294criteria for involuntary outpatient placement are met. However,
2295in a county having a population of fewer than 50,000, if the
2296administrator certifies that a psychiatrist or clinical
2297psychologist is not available to provide the second opinion, the
2298second opinion may be provided by a licensed physician who has
2299postgraduate training and experience in diagnosis and treatment
2300of mental and nervous disorders or by a psychiatric nurse. Any
2301second opinion authorized in this subparagraph may be conducted
2302through a face-to-face examination, in person or by electronic
2303means. Such recommendation must be entered on an involuntary
2304outpatient placement certificate that authorizes the receiving
2305facility to retain the patient pending completion of a hearing.
2306The certificate shall be made a part of the patient's clinical
2307record.
2308     2.  If the individual patient has been stabilized and no
2309longer meets the criteria for involuntary examination pursuant
2310to s. 394.463(1), he or she the patient must be released from
2311the receiving facility while awaiting the hearing for
2312involuntary outpatient placement.
2313     3.  Before filing a petition for involuntary outpatient
2314treatment, the administrator of the a receiving facility or a
2315designated department representative must identify the service
2316provider that will have primary responsibility for service
2317provision under an order for involuntary outpatient placement,
2318unless the individual person is otherwise participating in
2319outpatient psychiatric treatment and is not in need of public
2320financing for that treatment, in which case the individual, if
2321eligible, may be ordered to involuntary treatment pursuant to
2322the existing psychiatric treatment relationship.
2323     4.3.   The service provider shall prepare a written
2324proposed treatment plan in consultation with the individual
2325being held patient or his or her the patient's guardian
2326advocate, if appointed, for the court's consideration for
2327inclusion in the involuntary outpatient placement order. The
2328service provider shall also provide a copy of the proposed
2329treatment plan to the individual patient and the administrator
2330of the receiving facility. The treatment plan must specify the
2331nature and extent of the individual's patient's mental illness,
2332address the reduction of symptoms that necessitate involuntary
2333outpatient placement, and include measurable goals and
2334objectives for the services and treatment that are provided to
2335treat the individual's person's mental illness and assist the
2336individual person in living and functioning in the community or
2337to prevent a relapse or deterioration. Service providers may
2338select and supervise other providers individuals to implement
2339specific aspects of the treatment plan. The services in the
2340treatment plan must be deemed clinically appropriate by a
2341physician, clinical psychologist, psychiatric nurse, mental
2342health counselor, marriage and family therapist, or clinical
2343social worker who consults with, or is employed or contracted
2344by, the service provider. The service provider must certify to
2345the court in the proposed treatment plan whether sufficient
2346services for improvement and stabilization are currently
2347available and whether the service provider agrees to provide
2348those services. If the service provider certifies that the
2349services in the proposed treatment plan are not available, the
2350petitioner may not file the petition.
2351     (b)  If an individual a patient in involuntary inpatient
2352placement meets the criteria for involuntary outpatient
2353placement, the administrator of the treatment facility may,
2354before the expiration of the period during which the treatment
2355facility is authorized to retain the individual patient,
2356recommend involuntary outpatient placement.
2357     1.  The recommendation must be supported by the opinion of
2358a psychiatrist and the second opinion of a clinical psychologist
2359or another psychiatrist, both of whom have personally examined
2360the individual patient within the preceding 72 hours, that the
2361criteria for involuntary outpatient placement are met. However,
2362in a county having a population of fewer than 50,000, if the
2363administrator certifies that a psychiatrist or clinical
2364psychologist is not available to provide the second opinion, the
2365second opinion may be provided by a licensed physician who has
2366postgraduate training and experience in diagnosis and treatment
2367of mental and nervous disorders or by a psychiatric nurse. Any
2368second opinion authorized in this subparagraph may be conducted
2369through a face-to-face examination, in person or by electronic
2370means. Such recommendation must be entered on an involuntary
2371outpatient placement certificate, and the certificate must be
2372made a part of the patient's clinical record.
2373     (c)1.  The administrator of the treatment facility shall
2374provide a copy of the involuntary outpatient placement
2375certificate and a copy of the state mental health discharge form
2376to a department representative in the county where the
2377individual patient will be residing. For persons who are leaving
2378a state mental health treatment facility, the petition for
2379involuntary outpatient placement must be filed in the county
2380where the patient will be residing.
2381     2.  The service provider that will have primary
2382responsibility for service provision shall be identified by the
2383designated department representative prior to the order for
2384involuntary outpatient placement and shall must, before prior to
2385filing a petition for involuntary outpatient placement, certify
2386to the court whether the services recommended in the
2387individual's patient's discharge plan are available in the local
2388community and whether the service provider agrees to provide
2389those services. The service provider shall must develop with the
2390individual patient, or the individual's patient's guardian
2391advocate, if one is appointed, a treatment or service plan that
2392addresses the needs identified in the discharge plan. The plan
2393must be deemed to be clinically appropriate by a physician,
2394clinical psychologist, psychiatric nurse, mental health
2395counselor, marriage and family therapist, or clinical social
2396worker, as defined in this chapter, who consults with, or is
2397employed or contracted by, the service provider.
2398     3.  If the service provider certifies that the services in
2399the proposed treatment or service plan are not available, the
2400petitioner may not file the petition.
2401     (3)  PETITION FOR INVOLUNTARY OUTPATIENT PLACEMENT.-
2402     (a)  A petition for involuntary outpatient placement may be
2403filed by:
2404     1.  The administrator of a receiving facility; or
2405     2.  The administrator of a treatment facility.
2406     (b)  Each required criterion for involuntary outpatient
2407placement must be alleged and substantiated in the petition for
2408involuntary outpatient placement. A copy of the certificate
2409recommending involuntary outpatient placement completed by a
2410qualified professional specified in subsection (2) must be
2411attached to the petition. A copy of the proposed treatment plan
2412must be attached to the petition. Before the petition is filed,
2413the service provider shall certify that the services in the
2414proposed treatment plan are available. If the necessary services
2415are not available in the patient's local community where the
2416individual will reside to respond to the person's individual
2417needs, the petition may not be filed.
2418     (c)  A The petition for involuntary outpatient placement
2419must be filed in the county where the individual who is the
2420subject of the petition patient is located, unless the
2421individual the patient is being placed from a state treatment
2422facility, in which case the petition must be filed in the county
2423where the individual patient will reside. When the petition is
2424has been filed, the clerk of the court shall provide copies of
2425the petition and the proposed treatment plan to the department,
2426the individual patient, the individual's patient's guardian or
2427representative, the state attorney, and the public defender or
2428the patient's private counsel representing the individual. A fee
2429may not be charged for filing a petition under this subsection.
2430     (4)  APPOINTMENT OF COUNSEL.-Within 1 court working day
2431after the filing of a petition for involuntary outpatient
2432placement, the court shall appoint a the public defender to
2433represent the individual person who is the subject of the
2434petition, unless the individual person is otherwise represented
2435by counsel. The clerk of the court shall immediately notify the
2436public defender of the appointment. The public defender shall
2437represent the individual person until the petition is dismissed,
2438the court order expires, or the individual patient is discharged
2439from involuntary outpatient placement. An attorney who
2440represents the individual patient shall have access to the
2441individual patient, witnesses, and records relevant to the
2442presentation of the individual's patient's case and shall
2443represent the interests of the individual patient, regardless of
2444the source of payment to the attorney.
2445     (5)  CONTINUANCE OF HEARING.-The patient is entitled, with
2446the concurrence of the patient's counsel, to at least one
2447continuance of the hearing. The continuance shall be for a
2448period of up to 4 weeks.
2449     (5)(6)  HEARING ON INVOLUNTARY OUTPATIENT PLACEMENT.-
2450     (a)1.  The court shall hold the hearing on involuntary
2451outpatient placement within 5 working days after the filing of
2452the petition, unless a continuance is granted. The hearing shall
2453be held in the county where the petition is filed, shall be as
2454convenient to the individual who is the subject of the petition
2455patient as is consistent with orderly procedure, and shall be
2456conducted in physical settings not likely to be injurious to the
2457individual's patient's condition. If the court finds that the
2458individual's patient's attendance at the hearing is not
2459consistent with the individual's best interests, of the patient
2460and if the individual's patient's counsel does not object, the
2461court may waive the presence of the individual patient from all
2462or any portion of the hearing. The state attorney for the
2463circuit in which the individual patient is located shall
2464represent the state, rather than the petitioner, as the real
2465party in interest in the proceeding.
2466     (b)2.  The court may appoint a magistrate master to preside
2467at the hearing. One of the professionals who executed the
2468involuntary outpatient placement certificate shall be a witness.
2469The individual who is the subject of the petition patient and
2470his or her the patient's guardian or representative shall be
2471informed by the court of the right to an independent expert
2472examination. If the individual patient cannot afford such an
2473examination, the court shall provide for one. The independent
2474expert's report is shall be confidential and not discoverable,
2475unless the expert is to be called as a witness for the
2476individual patient at the hearing. The court shall allow
2477testimony from persons individuals, including family members,
2478deemed by the court to be relevant under state law, regarding
2479the individual's person's prior history and how that prior
2480history relates to the individual's person's current condition.
2481The testimony in the hearing must be given under oath, and the
2482proceedings must be recorded. The individual patient may refuse
2483to testify at the hearing.
2484     (c)  At the hearing on involuntary outpatient placement,
2485the court shall consider testimony and evidence regarding the
2486competence of the individual being held to consent to treatment.
2487If the court finds that the individual is incompetent to
2488consent, it shall appoint a guardian advocate as provided in s.
2489394.4598.
2490     (d)  The individual who is the subject of the petition is
2491entitled to at least one continuance of the hearing for up to 4
2492weeks, with the concurrence of the individual's counsel.
2493However, the individual's counsel may not request a continuance
2494unless the continuance is the individual's expressed desire.
2495     (6)  COURT ORDER.-
2496     (a)(b)1.  If the court concludes that the individual who is
2497the subject of the petition patient meets the criteria for
2498involuntary outpatient placement under pursuant to subsection
2499(1), the court shall issue an order for involuntary outpatient
2500placement. The court order may shall be for a period of up to 6
2501months. The order must specify the nature and extent of the
2502individual's patient's mental illness. The court order of the
2503court and the treatment plan must shall be made part of the
2504patient's clinical record. The service provider shall discharge
2505an individual a patient from involuntary outpatient placement
2506when the order expires or any time the individual patient no
2507longer meets the criteria for involuntary placement. Upon
2508discharge, the service provider shall send a certificate of
2509discharge to the court.
2510     (b)2.  The court may not order the department or the
2511service provider to provide services if the program or service
2512is not available in the patient's local community of the
2513individual being served, if there is no space available in the
2514program or service for the individual patient, or if funding is
2515not available for the program or service. A copy of the order
2516must be sent to the Agency for Health Care Administration by the
2517service provider within 1 working day after it is received from
2518the court. After the placement order is issued, the service
2519provider and the individual patient may modify provisions of the
2520treatment plan. For any material modification of the treatment
2521plan to which the individual patient or the individual's
2522patient's guardian advocate, if appointed, agrees does agree,
2523the service provider shall send notice of the modification to
2524the court. Any material modifications of the treatment plan
2525which are contested by the individual patient or the
2526individual's patient's guardian advocate, if appointed, must be
2527approved or disapproved by the court consistent with the
2528requirements of subsection (2).
2529     (c)3.  If, in the clinical judgment of a physician, the
2530individual being served patient has failed or has refused to
2531comply with the treatment ordered by the court, and, in the
2532clinical judgment of the physician, efforts were made to solicit
2533compliance and the individual patient may meet the criteria for
2534involuntary examination, the individual a person may be brought
2535to a receiving facility pursuant to s. 394.463 for involuntary
2536examination. If, after examination, the individual patient does
2537not meet the criteria for involuntary inpatient placement under
2538pursuant to s. 394.467, the individual patient must be
2539discharged from the receiving facility. The involuntary
2540outpatient placement order remains shall remain in effect unless
2541the service provider determines that the individual patient no
2542longer meets the criteria for involuntary outpatient placement
2543or until the order expires. The service provider shall must
2544determine whether modifications should be made to the existing
2545treatment plan and must continue to attempt to continue to
2546engage the individual patient in treatment. For any material
2547modification of the treatment plan to which the individual
2548patient or the individual's patient's guardian advocate, if
2549appointed, agrees does agree, the service provider shall send
2550notice of the modification to the court. Any material
2551modifications of the treatment plan which are contested by the
2552individual patient or the individual's patient's guardian
2553advocate, if appointed, must be approved or disapproved by the
2554court consistent with the requirements of subsection (2).
2555     (d)(c)  If, at any time before the conclusion of the
2556initial hearing on involuntary outpatient placement, it appears
2557to the court that the individual person does not meet the
2558criteria for involuntary outpatient placement under this section
2559but, instead, meets the criteria for involuntary inpatient
2560placement, the court may order the individual person admitted
2561for involuntary inpatient examination under s. 394.463. If the
2562individual person instead meets the criteria for involuntary
2563assessment, protective custody, or involuntary admission under
2564pursuant to s. 397.675, the court may order the individual
2565person to be admitted for involuntary assessment for a period of
25665 days pursuant to s. 397.6811. Thereafter, all proceedings are
2567shall be governed by chapter 397.
2568     (d)  At the hearing on involuntary outpatient placement,
2569the court shall consider testimony and evidence regarding the
2570patient's competence to consent to treatment. If the court finds
2571that the patient is incompetent to consent to treatment, it
2572shall appoint a guardian advocate as provided in s. 394.4598.
2573The guardian advocate shall be appointed or discharged in
2574accordance with s. 394.4598.
2575     (e)  The administrator of the receiving facility or the
2576designated department representative shall provide a copy of the
2577court order and adequate documentation of an individual's a
2578patient's mental illness to the service provider for involuntary
2579outpatient placement. Such documentation must include any
2580advance directives made by the individual patient, a psychiatric
2581evaluation of the individual patient, and any evaluations of the
2582individual patient performed by a clinical psychologist or a
2583clinical social worker.
2584     (7)  PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
2585PLACEMENT.-
2586     (a)1.  If an individual the person continues to meet the
2587criteria for involuntary outpatient placement, the service
2588provider shall, before the expiration of the period during which
2589the placement treatment is ordered for the person, file in the
2590circuit court a petition for continued involuntary outpatient
2591placement.
2592     1.2.  The existing involuntary outpatient placement order
2593remains in effect until disposition of on the petition for
2594continued involuntary outpatient placement.
2595     2.3.  A certificate must shall be attached to the petition
2596which includes a statement from the individual's person's
2597physician or clinical psychologist justifying the request, a
2598brief description of the individual's patient's treatment during
2599the time he or she was involuntarily placed, and a personalized
2600an individualized plan of continued treatment.
2601     3.4.  The service provider shall develop the individualized
2602plan of continued treatment in consultation with the individual
2603patient or his or her the patient's guardian advocate, if
2604appointed. When the petition has been filed, the clerk of the
2605court shall provide copies of the certificate and the
2606individualized plan of continued treatment to the department,
2607the individual patient, the individual's patient's guardian
2608advocate, the state attorney, and the individual's patient's
2609private counsel or the public defender.
2610     (b)  Within 1 court working day after the filing of a
2611petition for continued involuntary outpatient placement, the
2612court shall appoint the public defender to represent the
2613individual person who is the subject of the petition, unless the
2614individual person is otherwise represented by counsel. The clerk
2615of the court shall immediately notify the public defender of
2616such appointment. The public defender shall represent the
2617individual person until the petition is dismissed, or the court
2618order expires, or the individual patient is discharged from
2619involuntary outpatient placement. An Any attorney representing
2620the individual must patient shall have access to the individual
2621patient, witnesses, and records relevant to the presentation of
2622the individual's patient's case and shall represent the
2623interests of the individual patient, regardless of the source of
2624payment to the attorney.
2625     (c)  The court shall inform the individual who is the
2626subject of the petition and his or her guardian, guardian
2627advocate, or representative of the individual's right to an
2628independent expert examination. If the individual cannot afford
2629such an examination, the court shall provide one.
2630     (d)(c)  Hearings on petitions for continued involuntary
2631outpatient placement are shall be before the circuit court. The
2632court may appoint a magistrate master to preside at the hearing.
2633The procedures for obtaining an order pursuant to this paragraph
2634must shall be in accordance with subsection (5) (6), except that
2635the time period included in paragraph (1)(e) is not applicable
2636for in determining the appropriateness of additional periods of
2637involuntary outpatient placement.
2638     (e)(d)  Notice of the hearing shall be provided in
2639accordance with as set forth in s. 394.4599. The individual
2640being served patient and the individual's patient's attorney may
2641agree to a period of continued outpatient placement without a
2642court hearing.
2643     (f)(e)  The same procedure must shall be repeated before
2644the expiration of each additional period the individual being
2645served patient is placed in treatment.
2646     (g)(f)  If the individual in involuntary outpatient
2647placement patient has previously been found incompetent to
2648consent to treatment, the court shall consider testimony and
2649evidence regarding the individual's patient's competence.
2650Section 394.4598 governs the discharge of the guardian advocate
2651if the individual's patient's competency to consent to treatment
2652has been restored.
2653     Section 21.  Section 394.467, Florida Statutes, is amended
2654to read:
2655     394.467  Involuntary inpatient placement.-
2656     (1)  CRITERIA.-An individual A person may be placed in
2657involuntary inpatient placement for treatment upon a finding of
2658the court by clear and convincing evidence that:
2659     (a)  He or she has a mental illness is mentally ill and
2660because of his or her mental illness:
2661     1.a.  He or she has refused voluntary placement for
2662treatment after sufficient and conscientious explanation and
2663disclosure of the purpose of placement for treatment; or
2664     b.  He or she is unable to determine for himself or herself
2665whether placement is necessary; and
2666     2.a.  He or she is manifestly incapable of surviving alone
2667or with the help of willing and responsible family or friends,
2668including available alternative services, and, without
2669treatment, is likely to suffer from neglect or refuse to care
2670for himself or herself, and such neglect or refusal poses a real
2671and present threat of substantial harm to his or her well-being;
2672or
2673     b.  There is substantial likelihood that in the near future
2674he or she will inflict serious bodily harm on self or others
2675himself or herself or another person, as evidenced by recent
2676behavior causing, attempting, or threatening such harm; and
2677     (b)  All available less restrictive treatment alternatives
2678that which would offer an opportunity for improvement of his or
2679her condition have been judged to be inappropriate.
2680     (2)  ADMISSION TO A TREATMENT FACILITY.-An individual A
2681patient may be retained by a receiving facility or involuntarily
2682placed in a treatment facility upon the recommendation of the
2683administrator of the receiving facility where the individual
2684patient has been examined and after adherence to the notice and
2685hearing procedures provided in s. 394.4599. The recommendation
2686must be supported by the opinion of a psychiatrist and the
2687second opinion of a clinical psychologist or another
2688psychiatrist, both of whom have personally examined the
2689individual patient within the preceding 72 hours, that the
2690criteria for involuntary inpatient placement are met. However,
2691in a county that has a population of fewer than 50,000, if the
2692administrator certifies that a psychiatrist or clinical
2693psychologist is not available to provide the second opinion, the
2694second opinion may be provided by a licensed physician who has
2695postgraduate training and experience in diagnosis and treatment
2696of mental and nervous disorders or by a psychiatric nurse. Any
2697second opinion authorized in this subsection may be conducted
2698through a face-to-face examination, in person or by electronic
2699means. Such recommendation must shall be entered on an
2700involuntary inpatient placement certificate that authorizes the
2701receiving facility to retain the individual being held patient
2702pending transfer to a treatment facility or completion of a
2703hearing.
2704     (3)  PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.-
2705     (a)  The administrator of the facility shall file a
2706petition for involuntary inpatient placement in the court in the
2707county where the individual patient is located. Upon filing, the
2708clerk of the court shall provide copies to the department, the
2709individual patient, the individual's patient's guardian or
2710representative, and the state attorney and public defender of
2711the judicial circuit in which the individual patient is located.
2712A No fee may not shall be charged for the filing of a petition
2713under this subsection.
2714     (b)  A receiving or treatment facility filing a petition
2715for involuntary inpatient placement shall send a copy of the
2716petition to the Agency for Health Care Administration by the
2717next working day.
2718     (4)  APPOINTMENT OF COUNSEL.-
2719     (a)  Within 1 court working day after the filing of a
2720petition for involuntary inpatient placement, the court shall
2721appoint the public defender to represent the individual person
2722who is the subject of the petition, unless the individual person
2723is otherwise represented by counsel. The clerk of the court
2724shall immediately notify the public defender of such
2725appointment. Any attorney representing the individual patient
2726shall have access to the individual patient, witnesses, and
2727records relevant to the presentation of the individual's
2728patient's case and shall represent the interests of the
2729individual patient, regardless of the source of payment to the
2730attorney. An attorney representing an individual in involuntary
2731placement proceedings shall represent the individual's expressed
2732desires and must be present and actively participate in all
2733hearings on involuntary placement.
2734     (b)  The state attorney for the circuit in which the
2735individual is located shall represent the state rather than the
2736petitioning facility administrator as the real party in interest
2737in the proceeding. The state attorney shall have access to the
2738individual's clinical record and witnesses and shall
2739independently evaluate and confirm the allegations set forth in
2740the petition for involuntary placement. If the allegations are
2741substantiated, the state attorney shall vigorously prosecute the
2742petition. If the allegations are not substantiated, the state
2743attorney shall withdraw the petition. The state attorney shall
2744be present and actively participate in all hearings on
2745involuntary placement.
2746     (5)  CONTINUANCE OF HEARING.-The individual patient is
2747entitled, with the concurrence of the individual's patient's
2748counsel, to at least one continuance of the hearing. Requests
2749for a continuance from parties other than the individual or his
2750or her counsel may not be granted. The continuance shall be for
2751a period of up to 4 weeks. At the time the court is considering
2752a motion for continuance, the court shall also conduct a hearing
2753to consider the capacity of the individual to consent to
2754treatment if there is a pending petition for adjudication of
2755incompetence to consent to treatment. If the court finds that
2756the individual is not competent to consent to treatment, a
2757guardian advocate shall be appointed at the time the involuntary
2758placement hearing is continued to make mental health decisions
2759for the individual.
2760     (6)  HEARING ON INVOLUNTARY INPATIENT PLACEMENT.-
2761     (a)1.  The court shall hold the hearing on involuntary
2762inpatient placement within 5 working days after the petition is
2763filed, unless a continuance is granted.
2764     1.  Except for good cause documented in the court file, the
2765hearing shall be held in the receiving or treatment facility
2766county where the individual patient is located. If the hearing
2767cannot be held in the receiving or treatment facility, it must
2768held in a location and shall be as convenient to the individual
2769patient as is may be consistent with orderly procedure and which
2770is shall be conducted in physical settings not likely to be
2771injurious to the individual's patient's condition. If the
2772individual wishes to waive his or her court finds that the
2773patient's attendance at the hearing, the court must
2774that the waiver is knowing, intelligent, and voluntary before
2775waiving is not consistent with the best interests of the
2776patient, and the patient's counsel does not object, the court
2777may waive the presence of the individual patient from all or any
2778portion of the hearing. The state attorney for the circuit in
2779which the patient is located shall represent the state, rather
2780than the petitioning facility administrator, as the real party
2781in interest in the proceeding.
2782     2.  The court may appoint a general or special magistrate
2783to preside at the hearing. One of the two professionals who
2784executed the involuntary inpatient placement certificate shall
2785be a witness. The individual patient and the individual's
2786patient's guardian or representative shall be informed by the
2787court of the right to an independent expert examination. If the
2788individual patient cannot afford such an examination, the court
2789shall provide for one. The independent expert's report is shall
2790be confidential and not discoverable, unless the expert is to be
2791called as a witness for the individual patient at the hearing.
2792The testimony in the hearing must be given under oath, and the
2793proceedings must be recorded. The individual patient may refuse
2794to testify at the hearing.
2795     3.  The court shall allow testimony from persons, including
2796family members, deemed by the court to be relevant regarding the
2797individual's prior history and how that prior history relates to
2798the individual's current condition.
2799     (b)  If the court concludes that the individual patient
2800meets the criteria for involuntary inpatient placement, it shall
2801order that the individual patient be transferred to a treatment
2802facility or, if the individual patient is at a treatment
2803facility, that the individual patient be retained there or be
2804treated at any other appropriate receiving or treatment
2805facility, or that the individual patient receive services from a
2806receiving or treatment facility, on an involuntary basis, for a
2807period of up to 6 months. The order must shall specify the
2808nature and extent of the individual's patient's mental illness.
2809The facility shall discharge the individual a patient any time
2810the individual patient no longer meets the criteria for
2811involuntary inpatient placement, unless the individual patient
2812has transferred to voluntary status.
2813     (c)  If at any time before prior to the conclusion of the
2814hearing on involuntary inpatient placement it appears to the
2815court that the individual person does not meet the criteria for
2816involuntary inpatient placement under this section, but instead
2817meets the criteria for involuntary outpatient placement, the
2818court may order the individual person evaluated for involuntary
2819outpatient placement pursuant to s. 394.4655. The petition and
2820hearing procedures set forth in s. 394.4655 shall apply. If the
2821individual person instead meets the criteria for involuntary
2822assessment, protective custody, or involuntary admission
2823pursuant to s. 397.675, then the court may order the individual
2824person to be admitted for involuntary assessment for up to a
2825period of 5 days pursuant to s. 397.6811. Thereafter, all
2826proceedings are shall be governed by chapter 397.
2827     (d)  At the hearing on involuntary inpatient placement, the
2828court shall consider testimony and evidence regarding the
2829individual's patient's competence to consent to treatment. If
2830the court finds that the individual patient is incompetent to
2831consent to treatment, it shall appoint a guardian advocate as
2832provided in s. 394.4598.
2833     (e)  The administrator of the receiving facility shall
2834provide a copy of the court order and adequate documentation of
2835an individual's a patient's mental illness to the administrator
2836of a treatment facility if the individual whenever a patient is
2837ordered for involuntary inpatient placement, whether by civil or
2838criminal court. The documentation must shall include any advance
2839directives made by the individual patient, a psychiatric
2840evaluation of the individual patient, and any evaluations of the
2841individual patient performed by a clinical psychologist, a
2842marriage and family therapist, a mental health counselor, or a
2843clinical social worker. The administrator of a treatment
2844facility may refuse admission to an individual any patient
2845directed to its facilities on an involuntary basis, whether by
2846civil or criminal court order, who is not accompanied at the
2847same time by adequate orders and documentation.
2848     (7)  PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT
2849PLACEMENT.-
2850     (a)  Hearings on petitions for continued involuntary
2851inpatient placement shall be administrative hearings and shall
2852be conducted in accordance with the provisions of s. 120.57(1),
2853except that an any order entered by an the administrative law
2854judge is shall be final and subject to judicial review in
2855accordance with s. 120.68. Orders concerning an individual
2856patients committed after successfully pleading not guilty by
2857reason of insanity are shall be governed by the provisions of s.
2858916.15.
2859     (b)  If the individual patient continues to meet the
2860criteria for involuntary inpatient placement, the administrator
2861shall, before prior to the expiration of the period during which
2862the treatment facility is authorized to retain the individual
2863patient, file a petition requesting authorization for continued
2864involuntary inpatient placement. The request must shall be
2865accompanied by a statement from the individual's patient's
2866physician or clinical psychologist justifying the request, a
2867brief description of the individual's patient's treatment during
2868the time he or she was involuntarily placed, and a personalized
2869an individualized plan of continued treatment. Notice of the
2870hearing must shall be provided in accordance with as set forth
2871in s. 394.4599. If at the hearing the administrative law judge
2872finds that attendance at the hearing is not consistent with the
2873individual's best interests of the patient, the administrative
2874law judge may waive the presence of the individual patient from
2875all or any portion of the hearing, unless the individual
2876patient, through counsel, objects to the waiver of presence. The
2877testimony in the hearing must be under oath, and the proceedings
2878must be recorded.
2879     (c)  Unless the individual patient is otherwise represented
2880or is ineligible, he or she shall be represented at the hearing
2881on the petition for continued involuntary inpatient placement by
2882the public defender of the circuit in which the facility is
2883located.
2884     (d)  The Division of Administrative Hearings shall inform
2885the individual and his or her guardian, guardian advocate, or
2886representative of the right to an independent expert
2887examination. If the individual cannot afford such an
2888examination, the administrative law judge shall appoint an
2889independent expert and the county of the individual's residence
2890shall be billed for the cost of the examination.
2891     (e)(d)  If at a hearing it is shown that the individual
2892patient continues to meet the criteria for involuntary inpatient
2893placement, the administrative law judge shall sign the order for
2894continued involuntary inpatient placement for a period of up to
2895not to exceed 6 months. The same procedure must shall be
2896repeated before prior to the expiration of each additional
2897period the individual patient is retained.
2898     (f)(e)  If continued involuntary inpatient placement is
2899necessary for an individual a patient admitted while serving a
2900criminal sentence, but whose sentence is about to expire, or for
2901a minor patient involuntarily placed while a minor but who is
2902about to reach the age of 18, the administrator shall petition
2903the administrative law judge for an order authorizing continued
2904involuntary inpatient placement.
2905     (g)(f)  If the individual patient has been previously found
2906incompetent to consent to treatment, the administrative law
2907judge shall consider testimony and evidence regarding the
2908individual's patient's competence. If the administrative law
2909judge finds evidence that the individual patient is now
2910competent to consent to treatment, the administrative law judge
2911may issue a recommended order to the court that found the
2912individual patient incompetent to consent to treatment that the
2913individual's patient's competence be restored and that any
2914guardian advocate previously appointed be discharged.
2915     (8)  RETURN TO FACILITY OF PATIENTS.-If an individual held
2916When a patient at a treatment facility leaves the facility
2917without authorization, the administrator may authorize a search
2918for, the patient and the return of, the individual patient to
2919the facility. The administrator may request the assistance of a
2920law enforcement agency in the search for and return of the
2921patient.
2922     Section 22.  Section 394.46715, Florida Statutes, is
2923amended to read:
2924     394.46715  Rulemaking authority.-The department may adopt
2925rules to administer of Children and Family Services shall have
2926rulemaking authority to implement the provisions of ss. 394.455,
2927394.4598, 394.4615, 394.463, 394.4655, and 394.467 as amended or
2928created by this act. These rules are shall be for the purpose of
2929protecting the health, safety, and well-being of individuals
2930persons examined, treated, or placed under this part act.
2931     Section 23.  Section 394.4672, Florida Statutes, is amended
2932to read:
2933     394.4672  Procedure for placement of veteran with federal
2934agency.-
2935     (1)  If a Whenever it is determined by the court determines
2936that an individual a person meets the criteria for involuntary
2937placement and he or she it appears that such person is eligible
2938for care or treatment by the United States Department of
2939Veterans Affairs or other agency of the United States
2940Government, the court, upon receipt of a certificate from the
2941United States Department of Veterans Affairs or such other
2942agency showing that facilities are available and that the
2943individual person is eligible for care or treatment therein, may
2944place that individual person with the United States Department
2945of Veterans Affairs or other federal agency. The individual
2946person whose placement is sought shall be personally served with
2947notice of the pending placement proceeding in the manner as
2948provided in this part., and nothing in This section does not
2949shall affect the individual's his or her right to appear and be
2950heard in the proceeding. Upon placement, the individual is
2951person shall be subject to the rules and regulations of the
2952United States Department of Veterans Affairs or other federal
2953agency.
2954     (2)  The judgment or order of placement issued by a court
2955of competent jurisdiction of another state or of the District of
2956Columbia which places an individual, placing a person with the
2957United States Department of Veterans Affairs or other federal
2958agency for care or treatment has, shall have the same force and
2959effect in this state as in the jurisdiction of the court
2960entering the judgment or making the order.; and The courts of
2961the placing state or of the District of Columbia shall retain be
2962deemed to have retained jurisdiction over of the individual
2963person so placed. Consent is hereby given to the application of
2964the law of the placing state or district with respect to the
2965authority of the chief officer of any facility of the United
2966States Department of Veterans Affairs or other federal agency
2967operated in this state to retain custody or to transfer, parole,
2968or discharge the individual person.
2969     (3)  Upon receipt of a certificate of the United States
2970Department of Veterans Affairs or another such other federal
2971agency that facilities are available for the care or treatment
2972individuals who have mental illness of mentally ill persons and
2973that the individual person is eligible for that care or
2974treatment, the administrator of the receiving or treatment
2975facility may cause the transfer of that individual person to the
2976United States Department of Veterans Affairs or other federal
2977agency. Upon effecting such transfer, the committing court shall
2978be notified by the transferring agency. An individual may not No
2979person shall be transferred to the United States Department of
2980Veterans Affairs or other federal agency if he or she is
2981confined pursuant to the conviction of any felony or misdemeanor
2982or if he or she has been acquitted of the charge solely on the
2983ground of insanity, unless prior to transfer the court placing
2984the individual such person enters an order for the transfer
2985after appropriate motion and hearing and without objection by
2986the United States Department of Veterans Affairs.
2987     (4)  An individual Any person transferred as provided in
2988this section shall be deemed to be placed with the United States
2989Department of Veterans Affairs or other federal agency pursuant
2990to the original placement.
2991     Section 24.  Section 394.4674, Florida Statutes, is
2992repealed.
2993     Section 25.  Section 394.4685, Florida Statutes, is amended
2994to read:
2995     394.4685  Transfer between of patients among facilities.-
2996     (1)  TRANSFER BETWEEN PUBLIC FACILITIES.-
2997     (a)  An individual A patient who has been admitted to a
2998public receiving facility, or his or her the family member,
2999guardian, or guardian advocate of such patient, may request the
3000transfer of the individual patient to another public receiving
3001facility. An individual A patient who has been admitted to a
3002public treatment facility, or his or her the family member,
3003guardian, or guardian advocate of such patient, may request the
3004transfer of the individual patient to another public treatment
3005facility. Depending on the medical treatment or mental health
3006treatment needs of the individual patient and the availability
3007of appropriate facility resources, the individual patient may be
3008transferred at the discretion of the department. If the
3009department approves the transfer of an individual on involuntary
3010status patient, notice in accordance with according to the
3011provisions of s. 394.4599 must shall be given before prior to
3012the transfer by the transferring facility. The department shall
3013respond to the request for transfer within 2 working days after
3014receipt of the request by the facility administrator.
3015     (b)  If When required by the medical treatment or mental
3016health treatment needs of the individual patient or the
3017efficient use utilization of a public receiving or public
3018treatment facility, an individual a patient may be transferred
3019from one receiving facility to another, or one treatment
3020facility to another, at the department's discretion, or, with
3021the express and informed consent of the individual patient or
3022the individual's patient's guardian or guardian advocate, to a
3023facility in another state. Notice in accordance with according
3024to the provisions of s. 394.4599 must shall be given before
3025prior to the transfer by the transferring facility. If prior
3026notice is not possible, notice of the transfer must shall be
3027provided as soon as practicable after the transfer.
3028     (2)  TRANSFER FROM PUBLIC TO PRIVATE FACILITIES.-
3029     (a)  An individual A patient who has been admitted to a
3030public receiving or public treatment facility and has requested,
3031either personally or through his or her guardian or guardian
3032advocate, and is able to pay for treatment in a private facility
3033shall be transferred at the individual's patient's expense to a
3034private facility upon acceptance of the individual patient by
3035the private facility.
3036     (b)  A public facility may request the transfer of an
3037individual from the facility to a private facility, and the
3038individual may be transferred upon acceptance of the individual
3039by the private facility.
3040     (3)  TRANSFER FROM PRIVATE TO PUBLIC FACILITIES.-
3041     (a)  An individual A patient or his or her the patient's
3042guardian or guardian advocate may request the transfer of the
3043individual patient from a private to a public facility, and the
3044individual patient may be so transferred upon acceptance of the
3045individual patient by the public facility.
3046     (b)  A private facility may request the transfer of an
3047individual a patient from the facility to a public facility, and
3048the individual patient may be so transferred upon acceptance of
3049the individual patient by the public facility. The cost of such
3050transfer is shall be the responsibility of the transferring
3051facility.
3052     (c)  A public facility must respond to a request for the
3053transfer of an individual a patient within 2 working days after
3054receipt of the request.
3055     (4)  TRANSFER BETWEEN PRIVATE FACILITIES.-An individual
3056being held A patient in a private facility or his or her the
3057patient's guardian or guardian advocate may request the transfer
3058of the individual patient to another private facility at any
3059time, and the individual patient shall be transferred upon
3060acceptance of the individual patient by the facility to which
3061transfer is sought.
3062     Section 26.  Section 394.469, Florida Statutes, is amended
3063to read:
3064     394.469  Discharge of involuntary placements patients.-
3065     (1)  POWER TO DISCHARGE.-At any time an individual a
3066patient is found to no longer meet the criteria for involuntary
3067placement, the administrator shall:
3068     (a)  Discharge the individual patient, unless the patient
3069is under a criminal charge, in which case the patient shall be
3070transferred to the custody of the appropriate law enforcement
3071officer;
3072     (b)  Transfer the individual patient to voluntary status on
3073his or her own authority or at the individual's patient's
3074request, unless the individual patient is under criminal charge
3075or adjudicated incapacitated; or
3076     (c)  Return an individual released from a receiving or
3077treatment facility on voluntary or involuntary status who is
3078charged with a crime to the custody of a law enforcement officer
3079Place an improved patient, except a patient under a criminal
3080charge, on convalescent status in the care of a community
3081facility.
3082     (2)  NOTICE.-Notice of discharge or transfer of an
3083individual must be provided in accordance with a patient shall
3084be given as provided in s. 394.4599.
3085     Section 27.  Section 394.473, Florida Statutes, is amended
3086to read:
3087     394.473  Attorney's fee; expert witness fee.-
3088     (1)  In the case of an indigent person for whom An attorney
3089is appointed to represent an indigent individual pursuant to the
3090provisions of this part, the attorney shall be compensated by
3091the state pursuant to s. 27.5304. In the case of an indigent
3092person, the court may appoint a public defender. A The public
3093defender appointed to represent an indigent person may shall
3094receive no additional compensation other than that usually paid
3095his or her office.
3096     (2)  An In the case of an indigent person for whom expert
3097whose testimony is required for an indigent individual in a
3098court hearing pursuant to the provisions of this part act, the
3099expert, except one who is classified as a full-time employee of
3100the state or who is receiving remuneration from the state for
3101his or her time in attendance at the hearing, shall be
3102compensated by the state pursuant to s. 27.5304.
3103     Section 28.  Section 394.475, Florida Statutes, is amended
3104to read:
3105     394.475  Acceptance, examination, and involuntary placement
3106of Florida residents from out-of-state mental health
3107authorities.-
3108     (1)  Upon the request of the state mental health authority
3109of another state, the department may is authorized to accept an
3110individual as a patient, for up to a period of not more than 15
3111days, a person who is and has been a bona fide resident of this
3112state for at least a period of not less than 1 year.
3113     (2)  An individual Any person received pursuant to
3114subsection (1) shall be examined by the staff of the state
3115facility where the individual such patient has been admitted
3116accepted, which examination shall be completed during the 15-day
3117period.
3118     (3)  If, upon examination, the individual such a person
3119requires continued involuntary placement, a petition for a
3120hearing regarding involuntary placement shall be filed with the
3121court of the county where wherein the treatment facility
3122receiving the individual patient is located or the county where
3123the individual patient is a resident.
3124     (4)  During the pendency of the examination period and the
3125pendency of the involuntary placement proceedings, an individual
3126such person may continue to be held in the treatment facility
3127unless the court having jurisdiction enters an order to the
3128contrary.
3129     Section 29.  Section 394.4785, Florida Statutes, is amended
3130to read:
3131     394.4785  Children and adolescents; admission and placement
3132in mental health facilities.-
3133     (1)  A child or adolescent as defined in s. 394.492 may not
3134be admitted to a state-owned or state-operated mental health
3135treatment facility. A child may be admitted pursuant to s.
3136394.4625 or s. 394.467 to a crisis stabilization unit or a
3137residential treatment center licensed under this chapter or a
3138hospital licensed under chapter 395. The treatment center, unit,
3139or hospital must provide the least restrictive available
3140treatment that is appropriate to the individual needs of the
3141child or adolescent and must adhere to the guiding principles,
3142system of care, and service planning provisions of contained in
3143part III of this chapter.
3144     (2)  A child or adolescent, as defined in s. 394.492, who
3145is younger than person under the age of 14 years of age and who
3146is admitted to a any hospital licensed pursuant to chapter 395
3147may not be admitted to a bed in a room or ward with an adult
3148patient in a mental health unit or share common areas with an
3149adult patient in a mental health unit. However, an adolescent a
3150person 14 years of age or older may be admitted to a bed in a
3151room or ward in the mental health unit with an adult if the
3152admitting physician documents in the case record that such
3153placement is medically indicated or for reasons of safety. Such
3154placement shall be reviewed by the attending physician or a
3155designee or on-call physician each day and documented in the
3156clinical case record.
3157     Section 30.  Subsection (2) of section 394.4786, Florida
3158Statutes, is amended to read:
3159     394.4786  Intent.-
3160     (2)  Further, the Legislature intends that a specialty
3161psychiatric hospital that provides health care to specified
3162indigent individuals patients be eligible for reimbursement up
3163to the amount that hospital contributed to the Public Medical
3164Assistance Trust Fund in the previous fiscal year.
3165     Section 31.  Subsection (2) of section 394.47865, Florida
3166Statutes, is amended to read:
3167     394.47865  South Florida State Hospital; privatization.-
3168     (2)  The contractor shall operate South Florida State
3169Hospital as a mental health treatment facility that serves
3170voluntarily and involuntarily committed indigent adult
3171individuals adults who meet the criteria of this part I of this
3172chapter and who reside in the South Florida State Hospital
3173service area.
3174     (a)  South Florida State Hospital shall remain a
3175participant in the mental health disproportionate share program
3176so long as such individuals the residents receive eligible
3177services.
3178     (b)  The department and the contractor shall ensure that
3179the treatment facility is operated as a part of a total
3180continuum of care for individuals persons who are mentally ill.
3181The contractor shall have as its primary goal for the treatment
3182facility to effectively treat and assist individuals held at the
3183facility residents to return to the community as quickly as
3184possible.
3185     Section 32.  Section 394.4787, Florida Statutes, is amended
3186to read:
3187     394.4787  Definitions; ss. 394.4786, 394.4787, 394.4788,
3188and 394.4789.-As used in ss. 394.4786-394.4789, the term this
3189section and ss. 394.4786, 394.4788, and 394.4789:
3190     (1)  "Acute mental health services" means mental health
3191services provided through inpatient hospitalization.
3192     (2)  "Agency" means the Agency for Health Care
3193Administration.
3194     (3)  "Charity care" means that portion of hospital charges
3195for care provided to an individual a patient whose family income
3196for the 12 months preceding the determination is equal to or
3197below 150 percent of the current federal nonfarm poverty
3198guideline or the amount of hospital charges due from the
3199individual patient which exceeds 25 percent of the annual family
3200income and for which there is no compensation. Charity care does
3201shall not include administrative or courtesy discounts,
3202contractual allowances to third party payors, or failure of a
3203hospital to collect full charges due to partial payment by
3204governmental programs.
3205     (4)  "Indigent" means an individual whose financial status
3206would qualify him or her for charity care.
3207     (5)  "Operating expense" means all common and accepted
3208costs appropriate in developing and maintaining the operating of
3209the patient care facility and its activities.
3210     (6)  "PMATF" means the Public Medical Assistance Trust
3211Fund.
3212     (7)  "Specialty psychiatric hospital" has the same meaning
3213as in means a hospital licensed by the agency pursuant to s.
3214395.002(28), and includes facilities licensed under and part II
3215of chapter 408 as a specialty psychiatric hospital.
3216     Section 33.  Subsections (1), (2), and (6) of section
3217394.4788, Florida Statutes, are amended to read:
3218     394.4788  Use of certain PMATF funds for the purchase of
3219acute care mental health services.-
3220     (1)  A hospital may be eligible to be reimbursed an amount
3221no greater than the hospital's previous year contribution to the
3222PMATF for acute mental health services provided to indigent
3223individuals who are mentally ill persons who have been
3224determined by the agency or its agent to require such treatment
3225and who:
3226     (a)  Do not meet Medicaid eligibility criteria, unless the
3227agency makes a referral for a Medicaid eligible individual
3228patient pursuant to s. 394.4789;
3229     (b)  Meet the criteria for mental illness under this part;
3230and
3231     (c)  Meet the definition of charity care.
3232     (2)  The agency shall annually calculate a per diem
3233reimbursement rate for each specialty psychiatric hospital to be
3234paid to the specialty psychiatric hospitals for the provision of
3235acute mental health services provided to indigent individuals
3236who are mentally ill individuals patients who meet the criteria
3237in subsection (1). After the first rate period, providers shall
3238be notified of new reimbursement rates for each new state fiscal
3239year by June 1. The new reimbursement rates shall commence on
3240July 1.
3241     (6)  Hospitals that agree to participate in the program set
3242forth in this section and ss. 394.4786, 394.4787, and 394.4789
3243shall agree that payment from the PMATF is payment in full for
3244all individuals patients for which reimbursement is received
3245under this section and ss. 394.4786, 394.4787, and 394.4789,
3246until the funds for this program are no longer available.
3247     Section 34.  Section 394.4789, Florida Statutes, is amended
3248to read:
3249     394.4789  Establishment of referral process and eligibility
3250determination.-
3251     (1)  The department shall adopt by rule a referral process
3252that provides which shall provide each participating specialty
3253psychiatric hospital with a system for accepting into the
3254hospital's care indigent individuals who are mentally ill
3255persons referred by the department. It is the intent of the
3256Legislature that a hospital that which seeks payment under s.
3257394.4788 shall accept referrals from the department. However, a
3258hospital may shall have the right to refuse the admission of an
3259individual a patient due to lack of functional bed space or lack
3260of services appropriate to a patient's specific treatment and is
3261not no hospital shall be required to accept referrals if the
3262costs for treating the referred patient are no longer
3263reimbursable because the hospital has reached the level of
3264contribution made to the PMATF in the previous fiscal year.
3265Furthermore, a hospital that does not seek compensation for
3266indigent individuals who are mentally ill patients under the
3267provisions of this part is act shall not be obliged to accept
3268department referrals, notwithstanding any agreements it may have
3269entered into with the department. The right of refusal in this
3270subsection does shall not affect a hospital's requirement to
3271provide emergency care pursuant to s. 395.1041 or other state or
3272federal law statutory requirements related to the provision of
3273emergency care.
3274     (2)  The department shall adopt by rule a patient
3275eligibility form and is shall be responsible for eligibility
3276determination. However, the department may contract with
3277participating psychiatric hospitals for eligibility
3278determination. The eligibility form must shall provide the
3279mechanism for determining a patient's eligibility according to
3280the requirements of s. 394.4788(1).
3281     (a)  A specialty psychiatric hospital is shall be eligible
3282for reimbursement only if when an eligibility form has been
3283completed for each indigent individual who is mentally ill
3284person for whom reimbursement is sought.
3285     (b)  As part of eligibility determination, every effort
3286shall be made by the hospital to determine if any third party
3287insurance coverage is available.
3288     Section 35.  Paragraph (a) of subsection (3) of section
328939.407, Florida Statutes, is amended to read:
3290     39.407  Medical, psychiatric, and psychological examination
3291and treatment of child; physical, mental, or substance abuse
3292examination of person with or requesting child custody.-
3293     (3)(a)1.  Except as otherwise provided in subparagraph
3294(b)1. or paragraph (e), before the department provides
3295psychotropic medications to a child in its custody, the
3296prescribing physician shall attempt to obtain express and
3297informed consent, as defined in s. 394.455 394.455(9) and as
3298described in s. 394.459(3) 394.459(3)(a), from the child's
3299parent or legal guardian. The department shall must take steps
3300necessary to facilitate the inclusion of the parent in the
3301child's consultation with the physician. However, if the
3302parental rights of the parent have been terminated, the parent's
3303location or identity is unknown or cannot reasonably be
3304ascertained, or the parent declines to give express and informed
3305consent, the department may, after consultation with the
3306prescribing physician, seek court authorization to provide the
3307psychotropic medications to the child. Unless parental rights
3308have been terminated and if it is possible to do so, the
3309department shall continue to involve the parent in the
3310decisionmaking process regarding the provision of psychotropic
3311medications. If, at any time, a parent whose parental rights
3312have not been terminated provides express and informed consent
3313to the provision of a psychotropic medication, the requirements
3314of this section that the department seek court authorization do
3315not apply to that medication until such time as the parent no
3316longer consents.
3317     2.  If Any time the department seeks a medical evaluation
3318to determine the need to initiate or continue a psychotropic
3319medication for a child, the department must provide to the
3320evaluating physician all pertinent medical information known to
3321the department concerning that child.
3322     Section 36.  Subsection (3) of section 394.495, Florida
3323Statutes, is amended to read:
3324     394.495  Child and adolescent mental health system of care;
3325programs and services.-
3326     (3)  Assessments shall must be performed by:
3327     (a)  A clinical psychologist, clinical social worker,
3328physician, psychiatric nurse, or psychiatrist professional as
3329defined in s. 394.455 394.455(2), (4), (21), (23), or (24);
3330     (b)  A professional licensed under chapter 491; or
3331     (c)  A person who is under the direct supervision of a
3332professional listed in paragraph (a) or paragraph (b) as defined
3333in s. 394.455(2), (4), (21), (23), or (24) or a
3334licensed under chapter 491.
3335
3336The department shall adopt by rule statewide standards for
3337mental health assessments, which are must be based on current
3338relevant professional and accreditation standards.
3339     Section 37.  Subsection (6) of section 394.496, Florida
3340Statutes, is amended to read:
3341     394.496  Service planning.-
3342     (6)  A clinical psychologist, clinical social worker,
3343physician, psychiatric nurse, or psychiatrist professional as
3344defined in s. 394.455, 394.455(2), (4), (21), (23), or (24) or a
3345professional licensed under chapter 491, must be included among
3346those persons developing the services plan.
3347     Section 38.  Subsection (6) of section 394.9085, Florida
3348Statutes, is amended to read:
3349     394.9085  Behavioral provider liability.-
3350     (6)  For purposes of this section, the terms
3351"detoxification services," "addictions receiving facility," and
3352"receiving facility" have the same meanings as those provided in
3353ss. 397.311(18)(a)4., 397.311(18)(a)1., and 394.455 394.455(26),
3354respectively.
3355     Section 39.  Paragraph (d) of subsection (1) of section
3356419.001, Florida Statutes, is amended to read:
3357     419.001  Site selection of community residential homes.-
3358     (1)  For the purposes of this section, the following
3359definitions shall apply:
3360     (d)  "Resident" means any of the following: a frail elder
3361as defined in s. 429.65; a physically disabled or handicapped
3362person as defined in s. 760.22(7)(a); a developmentally disabled
3363person as defined in s. 393.063; a nondangerous individual who
3364has a mental illness as defined in s. 394.455 mentally ill
3365person as defined in s. 394.455(18); or a child who is found to
3366be dependent as defined in s. 39.01 or s. 984.03, or a child in
3367need of services as defined in s. 984.03 or s. 985.03.
3368     Section 40.  Subsection (7) of section 744.704, Florida
3369Statutes, is amended to read:
3370     744.704  Powers and duties.-
3371     (7)  A public guardian may shall not commit a ward to a
3372mental health treatment facility, as defined in s. 394.455
3373394.455(32), without an involuntary placement proceeding as
3374provided by law.
3375     Section 41.  This act shall take effect July 1, 2010.


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