August 05, 2020
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Amendment CaShTmL-040466.HTM
                                                  SENATE AMENDMENT
    Bill No. CS for CS for CS for CS for SB 700
    Amendment No. ___   Barcode 040466
                            CHAMBER ACTION
              Senate                               House
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       04/28/2004 02:55 PM         .                    
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11  Senators Smith and Peaden moved the following amendment:
12  
13         Senate Amendment 
14         On page 8, line 7, through
15            page 19, line 23, delete those lines
16  
17  and insert:  
18         Section 5.  Section 394.4655, Florida Statutes, is
19  created to read:
20         394.4655  Involuntary outpatient placement.--
21         (1)  CRITERIA FOR INVOLUNTARY OUTPATIENT PLACEMENT.--A
22  person may be ordered to involuntary outpatient placement upon
23  a finding of the court that by clear and convincing evidence:
24         (a)  The person is 18 years of age or older;
25         (b)  The person has a mental illness;
26         (c)  The person is unlikely to survive safely in the
27  community without supervision, based on a clinical
28  determination;
29         (d)  The person has a history of lack of compliance
30  with treatment for mental illness;
31         (e)  The person has:
                                  1
    4:24 PM   04/26/04                              s0700c4b-14j33

SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 1. At least twice within the immediately preceding 36 2 months been involuntarily admitted to a receiving or treatment 3 facility as defined in s. 394.455, or has received mental 4 health services in a forensic or correctional facility. The 5 36-month period does not include any period during which the 6 person was admitted or incarcerated; or 7 2. Engaged in one or more acts of serious violent 8 behavior toward self or others, or attempts at serious bodily 9 harm to himself or herself or others, within the preceding 36 10 months; 11 (f) The person is, as a result of his or her mental 12 illness, unlikely to voluntarily participate in the 13 recommended treatment plan and either he or she has refused 14 voluntary placement for treatment after sufficient and 15 conscientious explanation and disclosure of the purpose of 16 placement for treatment or he or she is unable to determine 17 for himself or herself whether placement is necessary; 18 (g) In view of the person's treatment history and 19 current behavior, the person is in need of involuntary 20 outpatient placement in order to prevent a relapse or 21 deterioration that would be likely to result in serious bodily 22 harm to himself or herself or others, or a substantial harm to 23 his or her well-being as set forth in s. 394.463(1); 24 (h) It is likely that the person will benefit from 25 involuntary outpatient placement; and 26 (i) All available less restrictive alternatives that 27 would offer an opportunity for improvement of his or her 28 condition have been judged to be inappropriate or unavailable. 29 (2) INVOLUNTARY OUTPATIENT PLACEMENT.-- 30 (a)1. A patient may be retained by a receiving 31 facility upon the recommendation of the administrator of a 2 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 receiving facility where the patient has been examined and 2 after adherence to the notice of hearing procedures provided 3 in s. 394.4599. The recommendation must be supported by the 4 opinion of a psychiatrist and the second opinion of a clinical 5 psychologist or another psychiatrist, both of whom have 6 personally examined the patient within the preceding 72 hours, 7 that the criteria for involuntary outpatient placement are 8 met. However, in a county having a population of fewer than 9 50,000, if the administrator certifies that no psychiatrist or 10 clinical psychologist is available to provide the second 11 opinion, the second opinion may be provided by a licensed 12 physician who has postgraduate training and experience in 13 diagnosis and treatment of mental and nervous disorders or by 14 a psychiatric nurse as defined in this chapter. Such a 15 recommendation must be entered on an involuntary outpatient 16 placement certificate, which certificate must authorize the 17 receiving facility to retain the patient pending completion of 18 a hearing. The certificate shall be made a part of the 19 patient's clinical record. 20 2. If the patient has been stabilized and no longer 21 meets the criteria for involuntary examination pursuant to s. 22 394.463(1), the patient must be released from the receiving 23 facility while awaiting the hearing for involuntary outpatient 24 placement. Prior to filing a petition for involuntary 25 outpatient treatment, the administrator of a receiving 26 facility or a designated department representative shall 27 identify the service provider that will have primary 28 responsibility for service provision under an order for 29 involuntary outpatient placement, unless the person is 30 otherwise participating in outpatient psychiatric treatment 31 and is not in need of public financing for that treatment, in 3 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 which case the individual, if eligible, may be ordered to 2 involuntary treatment pursuant to the existing psychiatric 3 treatment relationship. 4 3. The service provider shall prepare a written 5 proposed treatment plan in consultation with the patient or 6 the patient's guardian advocate, if appointed, for the court's 7 consideration for inclusion in the involuntary outpatient 8 placement order. The service provider shall also provide a 9 copy of the proposed treatment plan to the patient and the 10 administrator of the receiving facility. The treatment plan 11 must specify the nature and extent of the patient's mental 12 illness. The treatment plan must address the reduction of 13 symptoms that necessitate involuntary outpatient placement and 14 include measurable goals and objectives for the services and 15 treatment that are provided to treat the person's mental 16 illness and to assist the person in living and functioning in 17 the community or to attempt to prevent a relapse or 18 deterioration. Service providers may select and provide 19 supervision to other individuals to implement specific aspects 20 of the treatment plan. The services in the treatment plan must 21 be deemed to be clinically appropriate by a physician, 22 clinical psychologist, psychiatric nurse, or clinical social 23 worker, as defined in this chapter, who consults with, or is 24 employed or contracted by, the service provider. The service 25 provider must certify to the court in the proposed treatment 26 plan whether sufficient services for improvement and 27 stabilization are currently available and whether the service 28 provider agrees to provide those services. If the service 29 provider certifies that the services in the proposed treatment 30 plan are not available, the petitioner may not file the 31 petition. 4 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 (b) If a patient in involuntary inpatient placement 2 meets the criteria for involuntary outpatient placement, the 3 administrator of the treatment facility may, before the 4 expiration of the period during which the treatment facility 5 is authorized to retain the patient, recommend involuntary 6 outpatient placement. The recommendation must be supported by 7 the opinion of a psychiatrist and the second opinion of a 8 clinical psychologist or another psychiatrist, both of whom 9 have personally examined the patient within the preceding 72 10 hours, that the criteria for involuntary outpatient placement 11 are met. However, in a county having a population of fewer 12 than 50,000, if the administrator certifies that no 13 psychiatrist or clinical psychologist is available to provide 14 the second opinion, the second opinion may be provided by a 15 licensed physician who has postgraduate training and 16 experience in diagnosis and treatment of mental and nervous 17 disorders or by a psychiatric nurse as defined in s. 18 394.455(23). Such a recommendation must be entered on an 19 involuntary outpatient placement certificate and the 20 certificate shall be made a part of the patient's clinical 21 record. 22 (c)1. The administrator of the treatment facility 23 shall provide a copy of the involuntary outpatient placement 24 certificate and a copy of the state mental health discharge 25 form to a department representative in the county where the 26 patient will be residing. For persons who are leaving a state 27 mental health treatment facility, the petition for involuntary 28 outpatient placement must be filed in the county where the 29 patient will be residing. 30 2. The service provider that will have primary 31 responsibility for service provision shall be identified by 5 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 the designated department representative prior to the order 2 for involuntary outpatient placement and must, prior to filing 3 a petition for involuntary outpatient placement, certify to 4 the court whether the services recommended in the patient's 5 discharge plan are available in the local community and 6 whether the service provider agrees to provide those services. 7 The service provider must develop with the patient, or the 8 patient's guardian advocate, if appointed, a treatment or 9 service plan that addresses the needs identified in the 10 discharge plan. The plan must be deemed to be clinically 11 appropriate by a physician, clinical psychologist, psychiatric 12 nurse, or clinical social worker, as defined in this chapter, 13 who consults with, or is employed or contracted by, the 14 service provider. 15 3. If the service provider certifies that the services 16 in the proposed treatment or service plan are not available, 17 the petitioner may not file the petition. 18 (3) PETITION FOR INVOLUNTARY OUTPATIENT PLACEMENT.-- 19 (a) A petition for involuntary outpatient placement 20 may be filed by: 21 1. The administrator of a receiving facility; or 22 2. The administrator of a treatment facility. 23 (b) Each required criterion for involuntary outpatient 24 placement must be alleged and substantiated in the petition 25 for involuntary outpatient placement. A copy of the 26 certificate recommending involuntary outpatient placement 27 completed by a qualified professional specified in subsection 28 (2) must be attached to the petition. A copy of the proposed 29 treatment plan must be attached to the petition. Before the 30 petition is filed, the service provider shall certify that the 31 services in the proposed treatment plan are available. If the 6 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 necessary services are not available in the patient's local 2 community to respond to the person's individual needs, the 3 petition may not be filed. 4 (c) The petition for involuntary outpatient placement 5 must be filed in the county where the patient is located, 6 unless the patient is being placed from a state treatment 7 facility, in which case, the petition must be filed in the 8 county where the patient will reside. When the petition has 9 been filed, the clerk of the court shall provide copies of the 10 petition and the proposed treatment plan to the department, 11 the patient, the patient's guardian or representative, the 12 state attorney, and the public defender or the patient's 13 private counsel. A fee may not be charged for filing a 14 petition under this subsection. 15 (4) APPOINTMENT OF COUNSEL.--Within 1 court working 16 day after the filing of a petition for involuntary outpatient 17 placement, the court shall appoint the public defender to 18 represent the person who is the subject of the petition, 19 unless the person is otherwise represented by counsel. The 20 clerk of the court shall immediately notify the public 21 defender of the appointment. The public defender shall 22 represent the person until the petition is dismissed, the 23 court order expires, or the patient is discharged from 24 involuntary outpatient placement. An attorney who represents 25 the patient shall have access to the patient, witnesses, and 26 records relevant to the presentation of the patient's case and 27 shall represent the interests of the patient, regardless of 28 the source of payment to the attorney. 29 (5) CONTINUANCE OF HEARING.--The patient is entitled, 30 with the concurrence of the patient's counsel, to at least one 31 continuance of the hearing. The continuance shall be for a 7 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 period of up to 4 weeks. 2 (6) HEARING ON INVOLUNTARY OUTPATIENT PLACEMENT.-- 3 (a)1. The court shall hold the hearing on involuntary 4 outpatient placement within 5 working days after the filing of 5 the petition, unless a continuance is granted. The hearing 6 shall be held in the county where the petition is filed, shall 7 be as convenient to the patient as is consistent with orderly 8 procedure, and shall be conducted in physical settings not 9 likely to be injurious to the patient's condition. If the 10 court finds that the patient's attendance at the hearing is 11 not consistent with the best interests of the patient and if 12 the patient's counsel does not object, the court may waive the 13 presence of the patient from all or any portion of the 14 hearing. The state attorney for the circuit in which the 15 patient is located shall represent the state, rather than the 16 petitioner, as the real party in interest in the proceeding. 17 2. The court may appoint a master to preside at the 18 hearing. One of the professionals who executed the involuntary 19 outpatient placement certificate shall be a witness. The 20 patient and the patient's guardian or representative shall be 21 informed by the court of the right to an independent expert 22 examination. If the patient cannot afford such an examination, 23 the court shall provide for one. The independent expert's 24 report shall be confidential and not discoverable, unless the 25 expert is to be called as a witness for the patient at the 26 hearing. The court shall allow testimony from individuals, 27 including family members, deemed by the court to be relevant 28 under state law, regarding the person's prior history and how 29 that prior history relates to the person's current condition. 30 The testimony in the hearing must be given under oath, and the 31 proceedings must be recorded. The patient may refuse to 8 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 testify at the hearing. 2 (b)1. If the court concludes that the patient meets 3 the criteria for involuntary outpatient placement pursuant to 4 subsection (1), the court shall issue an order for involuntary 5 outpatient placement. The court order shall be for a period of 6 up to 6 months. The order must specify the nature and extent 7 of the patient's mental illness. The order of the court and 8 the treatment plan shall be made part of the patient's 9 clinical record. The service provider shall discharge a 10 patient from involuntary outpatient placement when the order 11 expires or any time the patient no longer meets the criteria 12 for involuntary placement. Upon discharge, the service 13 provider shall send a certificate of discharge to the court. 14 2. The court may not order the department or the 15 service provider to provide services if the program or service 16 is not available in the patient's local community, if there is 17 no space available in the program or service for the patient, 18 or if funding is not available for the program or service. A 19 copy of the order must be sent to the Agency for Health Care 20 Administration by the service provider within 1 working day 21 after it is received from the court. After the placement order 22 is issued, the service provider and the patient may modify 23 provisions of the treatment plan. For any material 24 modification of the treatment plan to which the patient or the 25 patient's guardian advocate, if appointed, does agree, the 26 service provider shall send notice of the modification to the 27 court. Any material modifications of the treatment plan which 28 are contested by the patient or the patient's guardian 29 advocate, if appointed, must be approved or disapproved by the 30 court consistent with subsection (2). 31 3. If, in the clinical judgment of a physician, the 9 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 patient has failed or has refused to comply with the treatment 2 ordered by the court, and, in the clinical judgment of the 3 physician, efforts were made to solicit compliance and the 4 patient may meet the criteria for involuntary examination, a 5 person may be brought to a receiving facility pursuant to s. 6 394.463. If, after examination, the patient does not meet the 7 criteria for involuntary inpatient placement pursuant to s. 8 394.467, the patient must be discharged from the receiving 9 facility. The involuntary outpatient placement order shall 10 remain in effect unless the service provider determines that 11 the patient no longer meets the criteria for involuntary 12 outpatient placement or until the order expires. The service 13 provider must determine whether modifications should be made 14 to the existing treatment plan and must attempt to continue to 15 engage the patient in treatment. For any material modification 16 of the treatment plan to which the patient or the patient's 17 guardian advocate, if appointed, does agree, the service 18 provider shall send notice of the modification to the court. 19 Any material modifications of the treatment plan which are 20 contested by the patient or the patient's guardian advocate, 21 if appointed, must be approved or disapproved by the court 22 consistent with subsection (2). 23 (c) If, at any time before the conclusion of the 24 initial hearing on involuntary outpatient placement, it 25 appears to the court that the person does not meet the 26 criteria for involuntary outpatient placement under this 27 section but, instead, meets the criteria for involuntary 28 inpatient placement, the court may order the person admitted 29 for involuntary inpatient examination under s. 394.463. If the 30 person instead meets the criteria for involuntary assessment, 31 protective custody, or involuntary admission pursuant to s. 10 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 397.675, the court may order the person to be admitted for 2 involuntary assessment for a period of 5 days pursuant to s. 3 397.6811. Thereafter, all proceedings shall be governed by 4 chapter 397. 5 (d) At the hearing on involuntary outpatient 6 placement, the court shall consider testimony and evidence 7 regarding the patient's competence to consent to treatment. If 8 the court finds that the patient is incompetent to consent to 9 treatment, it shall appoint a guardian advocate as provided in 10 s. 394.4598. The guardian advocate shall be appointed or 11 discharged in accordance with s. 394.4598. 12 (e) The administrator of the receiving facility or the 13 designated department representative shall provide a copy of 14 the court order and adequate documentation of a patient's 15 mental illness to the service provider for involuntary 16 outpatient placement. Such documentation must include any 17 advance directives made by the patient, a psychiatric 18 evaluation of the patient, and any evaluations of the patient 19 performed by a clinical psychologist or a clinical social 20 worker. 21 (7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT 22 PLACEMENT.-- 23 (a)1. If the person continues to meet the criteria for 24 involuntary outpatient placement, the service provider shall, 25 before the expiration of the period during which the treatment 26 is ordered for the person, file in the circuit court a 27 petition for continued involuntary outpatient placement. 28 2. The existing involuntary outpatient placement order 29 remains in effect until disposition on the petition for 30 continued involuntary outpatient placement. 31 3. A certificate shall be attached to the petition 11 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 which includes a statement from the person's physician or 2 clinical psychologist justifying the request, a brief 3 description of the patient's treatment during the time he or 4 she was involuntarily placed, and an individualized plan of 5 continued treatment. 6 4. The service provider shall develop the 7 individualized plan of continued treatment in consultation 8 with the patient or the patient's guardian advocate, if 9 appointed. When the petition has been filed, the clerk of the 10 court shall provide copies of the certificate and the 11 individualized plan of continued treatment to the department, 12 the patient, the patient's guardian advocate, the state 13 attorney, and the patient's private counsel or the public 14 defender. 15 (b) Within 1 court working day after the filing of a 16 petition for continued involuntary outpatient placement, the 17 court shall appoint the public defender to represent the 18 person who is the subject of the petition, unless the person 19 is otherwise represented by counsel. The clerk of the court 20 shall immediately notify the public defender of such 21 appointment. The public defender shall represent the person 22 until the petition is dismissed or the court order expires or 23 the patient is discharged from involuntary outpatient 24 placement. Any attorney representing the patient shall have 25 access to the patient, witnesses, and records relevant to the 26 presentation of the patient's case and shall represent the 27 interests of the patient, regardless of the source of payment 28 to the attorney. 29 (c) Hearings on petitions for continued involuntary 30 outpatient placement shall be before the circuit court. The 31 court may appoint a master to preside at the hearing. The 12 4:24 PM 04/26/04 s0700c4b-14j33
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 040466 1 procedures for obtaining an order pursuant to this paragraph 2 shall be in accordance with subsection (6), except that the 3 time period included in paragraph (1)(e) is not applicable in 4 determining the appropriateness of additional periods of 5 involuntary outpatient placement. 6 (d) Notice of the hearing shall be provided as set 7 forth in s. 394.4599. The patient and the patient's attorney 8 may agree to a period of continued outpatient placement 9 without a court hearing. 10 (e) The same procedure shall be repeated before the 11 expiration of each additional period the patient is placed in 12 treatment. 13 (f) If the patient has previously been found 14 incompetent to consent to treatment, the court shall consider 15 testimony and evidence regarding the patient's competence. 16 Section 394.4598 governs the discharge of the guardian 17 advocate if the patient's competency to consent to treatment 18 has been restored. 19 20 21 22 23 24 25 26 27 28 29 30 31 13 4:24 PM 04/26/04 s0700c4b-14j33
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