An act relating to mental health and substance abuse;
amending s. 394.462, F.S.; providing for HIV testing of
persons being transported for mental health services upon
the request of law enforcement officers or other
designated agents who come into contact with the person's
body fluids; requiring the county health department to
provide HIV testing at no cost to such officers and
agents; amending s. 394.674, F.S.; establishing priority
populations who are eligible for services funded by the
Department of Children and Family Services; authorizing
the department to adopt rules; creating s. 394.4996, F.S.;
authorizing the department to establish facilities that
provide services as an integrated adult mental health
crisis stabilization unit and addictions receiving
facility; requiring licensure; providing eligibility
criteria for treatment services; authorizing the
department to adopt rules; amending s. 766.101, F.S.;
adding the department as a medical review committee to
evaluate the provision of mental health services in
certain facilities; adding facilities licensed under s.
394.875, F.S., to the definition of health care providers;
amending s. 553.80, F.S.; requiring that local
construction regulations for secure mental health
treatment facilities be enforced by the department;
amending s. 916.111, F.S.; requiring that a forensic
evaluator training course be provided annually in order
for mental health experts to be placed on the forensic
evaluator registry; providing that mental health
professionals that have taken the course within the last 5
years remain on the registry; requiring mental health
professionals on the registry to maintain training course
documentation and provide the department with current
information; amending s. 916.115, F.S.; allowing certain
persons who are supervised by a person who has taken the
forensic evaluator training course to assist in the
forensic evaluation process; amending s. 916.13, F.S.;
requiring defendants in the custody of the Department of
Corrections who are adjudicated incompetent to remain in
the custody of the Department of Corrections and receive
treatment from the department; requiring the Department of
Children and Family Services to determine whether the
inmate has regained competency; providing timelines for
competency hearings; amending s. 916.15, F.S.; providing a
timeline for holding a commitment hearing for defendants
who no longer meet the criteria for continued commitment
by reason of insanity; providing an exception for
defendants in the custody of the Department of
Corrections; requiring defendants in the custody of the
Department of Corrections who are charged with a new
felony and found not guilty by reason of insanity to
remain in the department's custody for the remainder of
their sentence; requiring the Department of Children and
Family Services to evaluate the inmate and file a report
with the court requesting a hearing for determining
continued commitment placment; requiring the Department of
Children and Family Services and the Agency for Health
Care Administration to prepare a mental health plan to be
submitted to the Legislature and the Governor; requiring a
study by the Office of Program Policy Analysis and
Governmental Accountability on mental health issues;
providing an effective date.
Be It Enacted by the Legislature of the State of Florida:
Section 1. Subsection (4) is added to section 394.462,
Florida Statutes, to read:
(a) In any case in which a law enforcement officer;
employee of an emergency medical transport service, private
transport company contracting with the county, or mobile crisis
response service; or other designated agent of the county,
department, or the court comes into contact with or is exposed to
the body fluids of a person being taken into custody for the
purpose of delivering him or her to a receiving or treatment
facility, hospital, community mental health center, or other
facility authorized to provide mental health evaluations or
services pursuant to this chapter, the court shall, upon request
of the law enforcement officer, employee, or agent, order the
person to undergo HIV testing within 48 hours after the issuance
1. The testing shall be performed in accordance with s.
2. The results of the test shall be disclosed to the law
enforcement officer, employee, or agent no later than 2 weeks
after the court receives the results.
3. The results of the test are not admissible in any
subsequent court proceeding involving the person being
(b) A law enforcement officer; employee of an emergency
medical transport service, private transport company contracting
with the county, or mobile crisis response service; or other
designated agent of the county, department, or the court who
comes into contact with or is exposed to the body fluids of a
person being transported pursuant to this section and who
requests HIV testing may obtain such test from his or her
respective county health department at no cost.
Section 2. Section 394.674, Florida Statutes, is amended to
394.674 Clinical Eligibility for publicly funded substance
abuse and mental health services; fee collection requirements.--
(1) To be eligible to receive substance abuse and mental
health services funded by the department, a person must be a
member of at least one of the department's priority populations
target groups approved by the Legislature, pursuant to s.
216.0166. The priority populations include:
(a) For adult mental health services:
1. Adults who have severe and persistent mental illness, as
designated by the department using criteria which include
severity of diagnosis, duration of the mental illness, ability to
independently perform activities of daily living, and receipt of
disability income for a psychiatric condition. Within this group
priority populations include:
a. Older adults in crisis.
b. Older adults who are at risk of being placed in a more
restrictive environment because of their mental illness.
c. Individuals deemed incompetent to proceed or not guilty
by reason of insanity under chapter 916.
d. Other individuals with criminal justice involvement.
2. Adults experiencing an acute mental or emotional crisis
as defined in s.394.67(18).
(b) For children's mental health services:
1. Children who have a serious emotional disturbance.
2. Children who have an emotional disturbance.
3. Children who are at risk of emotional disturbance.
(c) For substance abuse services:
1. Adults who have substance use disorders and have a
history of intravenous drug use.
2. Persons dually diagnosed as having co-occurring
substance abuse and mental health disorders.
3. Parents putting children at risk due to a substance
4. Persons who have a substance abuse disorder and have
been ordered by the court to receive treatment.
5. Children at risk for initiating drug use.
6. Children under state supervision.
7. Children who have a substance abuse disorder but who are
not under the supervision of a court or in the custody of a state
8. Persons identified as a priority population as a
condition of the receipt of the Substance Abuse Block Grant.
(2) Crisis services, as defined in s. 394.67, must, within
the limitations of available state and local matching resources,
be available to each person who is eligible for services under
subsection (1), regardless of the person's ability to pay for
such services. A person who is experiencing a mental health
crisis and who does not meet the criteria for involuntary
examination under s. 394.463(1), or a person who is experiencing
a substance abuse crisis and who does not meet the involuntary
admission criteria in s. 397.675, must contribute to the cost of
his or her care and treatment pursuant to the sliding fee scale
developed under subsection (4), unless charging a fee is
contraindicated because of the crisis situation.
(3) Mental health services, substance abuse services, and
crisis services, as defined in s. 394.67, must, within the
limitations of available state and local matching resources, be
available to each person who is eligible for services under
subsection (1). Such person must contribute to the cost of his or
her care and treatment pursuant to the sliding fee scale
developed under subsection (4).
(4) The department shall adopt rules relating to client
implement the clinical eligibility, client enrollment, and fee
collection requirements for publicly funded substance abuse and
mental health services. The rules must require that each provider
under contract with the department which enrolls eligible persons
into treatment to develop a sliding fee scale for persons who
have a net family income at or above 150 percent of the Federal
Poverty Income Guidelines, unless otherwise required by state or
federal law. The sliding fee scale must use the uniform schedule
department discounts its established client charges for services
supported with state, federal, or local funds, using, at a
minimum, factors such as family income, financial assets, and
family size as declared by the person or the person's guardian.
The rules must include uniform criteria to be used by all service
providers in developing the schedule of discounts for the sliding
fee scale. The rules must address the most expensive types of
treatment, such as residential and inpatient treatment, in order
to make it possible for a client to responsibly contribute to his
or her mental health or substance abuse care without jeopardizing
the family's financial stability. A person who is not eligible
for Medicaid and whose net family income is less than 150 percent
his or her treatment costs which is comparable to the copayment
amount required by the Medicaid program for Medicaid clients
pursuant to s. 409.9081. The rules must require that persons who
receive financial assistance from the Federal Government because
of a disability and are in long-term residential treatment
settings contribute to their board and care costs and treatment
costs and must be consistent with the provisions in s. 409.212.
(5) A person who meets the eligibility criteria in
subsection (1) shall be served in accordance with the appropriate
district substance abuse and mental health services plan
specified in s. 394.75 and within available resources.
(6) The department may adopt rules to administer this
Section 3. Section 394.4996, Florida Statutes, is created
394.4996 Integrated adult mental health crisis
stabilization and addictions receiving facilities.--
(1) Beginning July 1, 2008, the Agency for Health Care
Administration, in consultation with the Department of Children
and Family Services, may license facilities that integrate
services provided in an adult mental health crisis stabilization
unit with services provided in an adult addictions receiving
facility. Such a facility shall be licensed by the agency as an
adult crisis stabilization unit under part IV and shall meet all
licensure requirements for crisis stabilization units providing
(2) An integrated mental health crisis stabilization unit
and addictions receiving facility may provide services under this
section to adults, 18 years of age or older, who fall into one or
more of the following categories:
(a) An adult meeting the requirements for voluntary
admission for mental health treatment under s. 394.4625.
(b) An adult meeting the criteria for involuntary
examination for mental illness under s. 394.463.
(c) An adult qualifying for voluntary admission for
substance abuse treatment under s. 397.601.
(d) An adult meeting the criteria for involuntary admission
for substance abuse impairment under s. 397.675.
(3) The department, in consultation with the agency, shall
adopt by rule standards that address eligibility criteria;
clinical procedures; staffing requirements; operational,
administrative, and financing requirements; and the investigation
of complaints. Standards that are implemented specific to
substance abuse treatment services shall meet or exceed existing
standards for addiction receiving facilities.
Section 4. Subsection (1) of section 766.101, Florida
Statutes, is amended to read:
766.101 Medical review committee, immunity from
(1) As used in this section:
(a) The term "medical review committee" or "committee"
1.a. A committee of a hospital or ambulatory surgical
center licensed under chapter 395 or a health maintenance
organization certificated under part I of chapter 641;,
b. A committee of a physician-hospital organization, a
provider-sponsored organization, or an integrated delivery
c. A committee of a state or local professional society of
health care providers;,
d. A committee of a medical staff of a licensed hospital or
nursing home that, provided the medical staff operates pursuant
to written bylaws that have been approved by the governing board
of the hospital or nursing home;,
e. A committee of the Department of Corrections or the
Correctional Medical Authority as created under s. 945.602, or
employees, agents, or consultants of either the department or the
f. A committee of a professional service corporation formed
under chapter 621 or a corporation organized under chapter 607 or
chapter 617, which is formed and operated for the practice of
medicine as defined in s. 458.305(3), and which has at least 25
directly to patients;,
g. A committee of employees, agents, or consultants of the
Department of Children and Family Services which conducts peer
reviews, utilization reviews, or mortality reviews of mental
health treatment services provided to persons served under
h.g. A committee of a mental health treatment facility
licensed under chapter 394 or a community mental health center as
defined in s. 394.907, provided the quality assurance program
operates pursuant to the guidelines that which have been approved
by the governing board of the agency;,
i.h. A committee of a substance abuse treatment and
education prevention program licensed under chapter 397 provided
the quality assurance program operates pursuant to the guidelines
that which have been approved by the governing board of the
j.i. A peer review or utilization review committee
organized under chapter 440;,
k.j. A committee of the Department of Health, a county
health department, healthy start coalition, or certified rural
health network, when reviewing quality of care, or employees of
these entities when reviewing mortality records;, or
l.k. A continuous quality improvement committee of a
pharmacy licensed pursuant to chapter 465;,
which committee is formed to evaluate and improve the quality of
health care rendered by providers of health service or to
determine that health services rendered were professionally
indicated or were performed in compliance with the applicable
standard of care or that the cost of health care rendered was
considered reasonable by the providers of professional health
services in the area; or
2. A committee of an insurer, self-insurer, or joint
underwriting association of medical malpractice insurance, or
other persons conducting review under s. 766.106.
(b) The term "health care providers" means physicians
licensed under chapter 458, osteopathic physicians licensed under
chapter 459, podiatric physicians licensed under chapter 461,
optometrists licensed under chapter 463, dentists licensed under
chapter 466, chiropractic physicians licensed under chapter 460,
pharmacists licensed under chapter 465, or hospitals or
ambulatory surgical centers licensed under chapter 395, or
facilities licensed under s. 394.875.
Section 5. Subsection (1) of section 553.80, Florida
Statutes, is amended to read:
(1) Except as provided in paragraphs (a)-(g) (a)-(f), each
local government and each legally constituted enforcement
district with statutory authority shall regulate building
construction and, where authorized in the state agency's enabling
legislation, each state agency shall enforce the Florida Building
Code required by this part on all public or private buildings,
structures, and facilities, unless such responsibility has been
delegated to another unit of government pursuant to s. 553.79(9).
(a) Construction regulations relating to correctional
facilities under the jurisdiction of the Department of
Corrections and the Department of Juvenile Justice are to be
enforced exclusively by those departments.
(b) Construction regulations relating to elevator equipment
under the jurisdiction of the Bureau of Elevators of the
Department of Business and Professional Regulation shall be
enforced exclusively by that department.
(c) Construction regulations relating to secure mental
health treatment facilities under the jurisdiction of the
Department of Children and Family Services shall be enforced
exclusively by that department.
(d)(c) In addition to the requirements of s. 553.79 and
this section, facilities subject to the provisions of chapter 395
and part II of chapter 400 shall have facility plans reviewed and
construction surveyed by the state agency authorized to do so
under the requirements of chapter 395 and part II of chapter 400
and the certification requirements of the Federal Government.
(e)(d) Building plans approved under s. 553.77(3) and
state-approved manufactured buildings, including buildings
manufactured and assembled offsite and not intended for
habitation, such as lawn storage buildings and storage sheds, are
exempt from local code enforcing agency plan reviews except for
provisions of the code relating to erection, assembly, or
construction at the site. Erection, assembly, and construction at
the site are subject to local permitting and inspections. Lawn
storage buildings and storage sheds bearing the insignia of
approval of the department are not subject to s. 553.842. Such
buildings that do not exceed 400 square feet may be delivered and
installed without need of a contractor's or specialty license.
(f)(e) Construction regulations governing public schools,
state universities, and community colleges shall be enforced as
provided in subsection (6).
(g)(f) The Florida Building Code as it pertains to toll
collection facilities under the jurisdiction of the turnpike
enterprise of the Department of Transportation shall be enforced
exclusively by the turnpike enterprise.
The governing bodies of local governments may provide a schedule
of fees, as authorized by s. 125.56(2) or s. 166.222 and this
fees shall be used solely for carrying out the local government's
responsibilities in enforcing the Florida Building Code. The
authority of state enforcing agencies to set fees for enforcement
shall be derived from authority existing on July 1, 1998.
operate to limit such agencies from adjusting their fee schedule
in conformance with existing authority.
Section 6. Section 916.111, Florida Statutes, is amended to
916.111 Training of mental health experts.--The evaluation
of defendants for competency to proceed or for sanity at the time
of the commission of the offense shall be conducted in such a way
as to ensure uniform application of the criteria enumerated in
(1) A forensic evaluator training course approved by the
department must be provided at least annually to ensure that
mental health professionals have the opportunity to be placed on
the department's forensic evaluator registry.
(a) Beginning July 1, 2009, experts shall remain on the
registry if they have completed or retaken the required training
within the previous 5 years. Those who have not completed the
required training within the previous 5 years shall be removed
from the registry and may not conduct evaluations for the courts.
(b) A mental health professional who has completed the
training course within the previous 5 years is responsible for
maintaining documentation of completion of the required training
and providing the department with current contact information
during the 5-year period.
(2) The department shall develop, and may contract with
1.(a) A plan for training mental health professionals to
perform forensic evaluations and to standardize the criteria and
procedures to be used in these evaluations;
2.(b) Clinical protocols and procedures based upon the
criteria of Rules 3.210 and 3.216, Florida Rules of Criminal
3.(c) Training for mental health professionals in the
application of these protocols and procedures in performing
forensic evaluations and providing reports to the courts; and
(b)(2) To compile and maintain the necessary information
for evaluating the success of this program, including the number
of persons trained, the cost of operating the program, and the
effect on the quality of forensic evaluations as measured by
appropriateness of admissions to state forensic facilities and to
community-based care programs.
Section 7. Subsection (1) of section 916.115, Florida
Statutes, is amended to read:
916.115 Appointment of experts.--
(1) The court shall appoint no more than three experts to
determine the mental condition of a defendant in a criminal case,
including competency to proceed, insanity, involuntary placement,
and treatment. The experts may evaluate the defendant in jail or
in another appropriate local facility or in a facility of the
Department of Corrections.
(a) To the extent possible, the Appointed experts must
shall have completed forensic evaluator training as provided in
s. 916.111 approved by the department, and each shall be a
psychiatrist, licensed psychologist, or physician.
(b) Graduate students completing a practicum or internship,
psychological specialists or counselors, and postdoctoral fellows
at the state's mental health treatment facilities may assist in
the evaluation process as long as their reports are overseen and
signed by a supervising evaluator who has completed forensic
evaluator training within the previous 5 years.
(c)(b) The department shall maintain and annually provide
the courts with a forensic evaluator registry list of available
mental health professionals who have completed the approved
Section 8. Section 916.13, Florida Statutes, is amended to
916.13 Involuntary commitment of defendant adjudicated
(1) Except for a defendant who is serving a sentence in the
custody of the Department of Corrections, a Every defendant who
is charged with a felony and who is adjudicated incompetent to
proceed may be involuntarily committed for treatment upon a
finding by the court of clear and convincing evidence that:
(a) The defendant has a mental illness and because of the
1. The defendant is manifestly incapable of surviving alone
or with the help of willing and responsible family or friends,
including available alternative services, and, without treatment,
the defendant is likely to suffer from neglect or refuse to care
for herself or himself and such neglect or refusal poses a real
and present threat of substantial harm to the defendant's well-
2. There is a substantial likelihood that in the near
future the defendant will inflict serious bodily harm on herself
or himself or another person, as evidenced by recent behavior
causing, attempting, or threatening such harm;
(b) All available, less restrictive treatment alternatives,
including treatment in community residential facilities or
community inpatient or outpatient settings, which would offer an
opportunity for improvement of the defendant's condition have
been judged to be inappropriate; and
(c) There is a substantial probability that the mental
illness causing the defendant's incompetence will respond to
treatment and the defendant will regain competency to proceed in
the reasonably foreseeable future.
(2)(a) A defendant who has been charged with a felony and
who has been adjudicated incompetent to proceed due to mental
illness, and who meets the criteria for involuntary commitment to
the department under the provisions of this chapter, may be
committed to the department, and the department shall retain and
treat the defendant. Within No later than 6 months after the date
of admission and at the end of any period of extended commitment,
or at any time the administrator or designee shall have
determined that the defendant has regained competency to proceed
or no longer meets the criteria for continued commitment, the
administrator or designee shall file a report with the court
pursuant to the applicable Florida Rules of Criminal Procedure.
(b) A defendant who is serving a sentence in the custody of
the Department of Corrections, who is charged with a new felony
or is entitled to a mandatory appeal pursuant to Rule 3.851,
Florida Rules of Criminal Procedure, and who has been adjudicated
incompetent to proceed due to mental illness shall be retained in
the physical custody of the Department of Corrections and the
department shall administer a lesson plan for competency
restoration training provided by the Department of Children and
Family Services. Within 6 months after the administration of the
lesson plan and every 12 months thereafter, or at any time the
Department of Children and Family Services determines that the
defendant has regained competency to proceed, the Department of
Children and Family Services shall file a report with the court
pursuant to the applicable Florida Rules of Criminal Procedure.
(c) Within 15 days after the court receives notification
that a defendant is competent to proceed or no longer meets the
criteria for continued commitment, the defendant shall be
transported back to jail pursuant to s. 916.107(10) for the
purpose of holding a competency hearing.
(d) A competency hearing shall be held within 30 days after
a court receives notification that the defendant is competent to
Section 9. Section 916.15, Florida Statutes, is amended to
916.15 Involuntary commitment of defendant adjudicated not
guilty by reason of insanity.--
(1) The determination of whether a defendant is not guilty
by reason of insanity shall be determined in accordance with Rule
3.217, Florida Rules of Criminal Procedure.
(2) Except for a defendant who is serving a sentence in the
custody of the Department of Corrections, a defendant who is
acquitted of criminal charges because of a finding of not guilty
by reason of insanity may be involuntarily committed pursuant to
such finding if the defendant has a mental illness and, because
of the illness, is manifestly dangerous to himself or herself or
(3) Except for a defendant who is serving a sentence in the
custody of the Department of Corrections, a Every defendant
acquitted of criminal charges by reason of insanity and found to
treated in accordance with the provisions of this section and the
applicable Florida Rules of Criminal Procedure. The department
shall admit a defendant so adjudicated to an appropriate facility
or program for treatment and shall retain and treat such
(a) Within No later than 6 months after the date of
admission, prior to the end of any period of extended commitment,
or at any time the administrator or designee has shall have
determined that the defendant no longer meets the criteria for
continued commitment placement, the administrator or designee
shall file a report with the court pursuant to the applicable
Florida Rules of Criminal Procedure.
(b) Within 15 days after the court receives notification
that the defendant no longer meets the criteria for continued
commitment placement, the defendant shall, pursuant to s.
916.107(10), be transported back to jail for the purpose of
holding a commitment hearing.
(c) A commitment hearing shall be held within 30 days after
the court receives notification that the defendant no longer
meets the criteria for continued commitment placement.
(4) A defendant who is serving a sentence in the custody of
the Department of Corrections, who has been charged with a new
felony, and who has been adjudicated not guilty by reason of
insanity shall be retained in the physical custody of the
Department of Corrections for the remainder of his or her
sentence. Within 30 days before the defendant's anticipated
release date, the Department of Children and Family Services
shall evaluate the defendant and file a report with the court
requesting that the defendant be returned to the court's
jurisdiction to determine if the defendant continues to meet the
criteria for continued commitment placement.
(5)(4) In all proceedings under this section, both the
defendant and the state shall have the right to a hearing before
by the hospital administrator or the administrator's designee as
well as by the state and the defendant. The defendant shall have
the right to counsel at any such hearing. If In the event that a
defendant is determined to be indigent pursuant to s. 27.52, the
public defender shall represent the defendant. The parties shall
have access to the defendant's records at the treating facilities
and may interview or depose personnel who have had contact with
the defendant at the treating facilities.
Section 10. The Department of Children and Family Services
and the Agency for Health Care Administration, in consultation
with the Florida Substance Abuse and Mental Health Corporation
and the Criminal Justice, Mental Health, and Substance Abuse
Technical Assistance Center, shall prepare a plan relating to the
provision and management of mental health services for
consideration by the Legislature.
(1) The plan shall, at a minimum, include the following:
(a) A review and evaluation of the structure of governance
of mental health services and recommendations that will improve
the coordination of services at the local and state level,
maximize the use of resources, and inform and link target
populations with available services.
(b) A review and evaluation of, and recommendations
concerning, the development of methodologies to accurately
estimate target populations for mental health services, the
service needs of each target population, and the availability of
(c) Proposed guidelines for the development and
implementation of community-based mental health programs and
services that reduce the likelihood of future involvement with
the criminal justice system.
(d) Proposed guidelines for the development and
implementation of programs and services that facilitate the
transition and successful reentry into the community by providing
a continuum of mental health services to persons released from
criminal justice or forensic facilities.
(e) Recommended performance measures and reporting
requirements for state and local programs and services specified
in paragraphs (c) and (d).
(f) Proposed guidelines and strategies for providing a
continuum of care to persons receiving competency restoration
(2) The plan shall be submitted to the Governor, the
President of the Senate, and the Speaker of the House of
Representatives by January 1, 2010.
Section 11. The Office of Program Policy Analysis and
Government Accountability shall conduct a study and make
recommendations relating to mental health services by January
2009. The study shall include a review of the following:
(1) Mental health courts in this state compared with
similar courts in other states.
(2) Mental health funding in this state compared with
mental health funding in other states.
(3) A review of cost-containment strategies for mental
health services in other states.
(4) Mental health diversion programs in this state compared
with similar programs in other states.
Section 12. This act shall take effect July 1, 2008.