Bill Text: FL S0012 | 2016 | Regular Session | Engrossed
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Mental Health and Substance Abuse
Spectrum: Bipartisan Bill
Status: (Passed) 2016-04-15 - Chapter No. 2016-241, companion bill(s) passed, see CS/HB 373 (Ch. 2016-80), CS/CS/CS/HB 439 (Ch. 2016-127), HB 5101 (Ch. 2016-65) [S0012 Detail]
Download: Florida-2016-S0012-Engrossed.html
Bill Title: Mental Health and Substance Abuse
Spectrum: Bipartisan Bill
Status: (Passed) 2016-04-15 - Chapter No. 2016-241, companion bill(s) passed, see CS/HB 373 (Ch. 2016-80), CS/CS/CS/HB 439 (Ch. 2016-127), HB 5101 (Ch. 2016-65) [S0012 Detail]
Download: Florida-2016-S0012-Engrossed.html
CS for SB 12 First Engrossed 201612e1 1 A bill to be entitled 2 An act relating to mental health and substance abuse; 3 amending s. 29.004, F.S.; including services provided 4 to treatment-based mental health programs within case 5 management funded from state revenues as an element of 6 the state courts system; amending s. 39.001, F.S.; 7 providing legislative intent regarding mental illness 8 for purposes of the child welfare system; amending s. 9 39.407, F.S.; requiring assessment findings to be 10 provided to the plan that is financially responsible 11 for a child’s care in residential treatment under 12 certain circumstances; amending s. 39.507, F.S.; 13 providing for consideration of mental health issues 14 and involvement in treatment-based mental health 15 programs in adjudicatory hearings and orders; 16 providing requirements for certain court orders; 17 amending s. 39.521, F.S.; providing for consideration 18 of mental health issues and involvement in treatment 19 based mental health programs in disposition hearings; 20 providing requirements for certain court orders; 21 amending s. 394.455, F.S.; defining terms; revising 22 definitions; amending s. 394.4573, F.S.; requiring the 23 Department of Children and Families to submit a 24 certain assessment to the Governor and the Legislature 25 by a specified date; redefining terms; providing 26 essential elements of a coordinated system of care; 27 providing requirements for the department’s annual 28 assessment; authorizing the department to award 29 certain grants; deleting duties and measures of the 30 department regarding continuity of care management 31 systems; amending s. 394.4597, F.S.; revising the 32 prioritization of health care surrogates to be 33 selected for involuntary patients; specifying certain 34 persons who are prohibited from being selected as an 35 individual’s representative; amending s. 394.4598, 36 F.S.; specifying certain persons who are prohibited 37 from being appointed as a person’s guardian advocate; 38 amending s. 394.462, F.S.; requiring that counties 39 develop and implement transportation plans; providing 40 requirements for the plans; revising requirements for 41 transportation to receiving facilities and treatment 42 facilities; deleting exceptions to such requirements; 43 amending s. 394.463, F.S.; authorizing county or 44 circuit courts to enter ex parte orders for 45 involuntary examinations; requiring a facility to 46 provide copies of ex parte orders, reports, and 47 certifications to managing entities and the 48 department, rather than the Agency for Health Care 49 Administration; requiring the managing entity and 50 department to receive certain orders, certificates, 51 and reports; requiring the managing entity and the 52 department to receive and maintain copies of certain 53 documents; prohibiting a person from being held for 54 involuntary examination for more than a specified 55 period of time; providing exceptions; requiring 56 certain individuals to be released to law enforcement 57 custody; providing exceptions; amending s. 394.4655, 58 F.S.; providing for involuntary outpatient services; 59 requiring a service provider to document certain 60 inquiries; requiring the managing entity to document 61 certain efforts; making technical changes; amending s. 62 394.467, F.S.; revising criteria for involuntary 63 inpatient placement; requiring a facility filing a 64 petition for involuntary inpatient placement to send a 65 copy to the department and managing entity; revising 66 criteria for a hearing on involuntary inpatient 67 placement; revising criteria for a procedure for 68 continued involuntary inpatient services; specifying 69 requirements for a certain waiver of the patient’s 70 attendance at a hearing; requiring the court to 71 consider certain testimony and evidence regarding a 72 patient’s incompetence; amending s. 394.46715, F.S.; 73 revising rulemaking authority of the department; 74 amending s. 394.656, F.S.; revising the membership of 75 the Criminal Justice, Mental Health, and Substance 76 Abuse Statewide Grant Review Committee; providing 77 duties for the committee; authorizing a not-for-profit 78 community provider or managing entity to apply for 79 certain grants; revising eligibility for such grants; 80 defining a term; creating s. 394.761, F.S.; 81 authorizing the agency and the department to develop a 82 plan for revenue maximization; requiring the plan to 83 be submitted to the Legislature by a certain date; 84 amending s. 394.875, F.S.; requiring the department to 85 modify licensure rules and procedures to create an 86 option for a single, consolidated license for certain 87 providers by a specified date; amending s. 394.9082, 88 F.S.; providing a purpose for behavioral health 89 managing entities; revising definitions; providing 90 duties of the department; requiring the department to 91 revise its contracts with managing entities; providing 92 duties for managing entities; renaming the Crisis 93 Stabilization Services Utilization Database as the 94 Acute Care Utilization Database and requiring certain 95 substance abuse providers to provide utilization data; 96 deleting provisions relating to legislative findings 97 and intent, service delivery strategies, essential 98 elements, reporting requirements, and rulemaking 99 authority; amending s. 397.311, F.S.; defining the 100 terms “informed consent” and “involuntary services”; 101 revising the definition of the term “qualified 102 professional”; conforming a cross-reference; amending 103 s. 397.675, F.S.; revising the criteria for 104 involuntary admissions due to substance abuse or co 105 occurring mental health disorders; amending s. 106 397.679, F.S.; specifying the licensed professionals 107 who may complete a certificate for the involuntary 108 admission of an individual; amending s. 397.6791, 109 F.S.; providing a list of professionals authorized to 110 initiate a certificate for an emergency assessment or 111 admission of a person with a substance abuse disorder; 112 amending s. 397.6793, F.S.; revising the criteria for 113 initiation of a certificate for an emergency admission 114 for a person who is substance abuse impaired; amending 115 s. 397.6795, F.S.; revising the list of persons who 116 may deliver a person for an emergency assessment; 117 amending s. 397.681, F.S.; prohibiting the court from 118 charging a fee for involuntary petitions; amending s. 119 397.6811, F.S.; revising the list of persons who may 120 file a petition for an involuntary assessment and 121 stabilization; amending s. 397.6814, F.S.; prohibiting 122 a fee from being charged for the filing of a petition 123 for involuntary assessment and stabilization; amending 124 s. 397.6819, F.S.; revising the responsibilities of 125 service providers who admit an individual for an 126 involuntary assessment and stabilization; requiring a 127 managing entity to be notified of certain 128 recommendations; amending s. 397.695, F.S.; 129 authorizing certain persons to file a petition for 130 involuntary outpatient services of an individual; 131 providing procedures and requirements for such 132 petitions; amending s. 397.6951, F.S.; requiring that 133 certain additional information be included in a 134 petition for involuntary outpatient services; amending 135 s. 397.6955, F.S.; requiring a court to fulfill 136 certain additional duties upon the filing of a 137 petition for involuntary outpatient services; amending 138 s. 397.6957, F.S.; providing additional requirements 139 for a hearing on a petition for involuntary outpatient 140 services; amending s. 397.697, F.S.; authorizing a 141 court to make a determination of involuntary 142 outpatient services; authorizing a court to order a 143 respondent to undergo treatment through a privately 144 funded licensed service provider under certain 145 circumstances; prohibiting a court from ordering 146 involuntary outpatient services under certain 147 circumstances; requiring the service provider to 148 document certain inquiries; requiring the managing 149 entity to document certain efforts; requiring a copy 150 of the court’s order to be sent to the department and 151 managing entity; providing procedures for 152 modifications to such orders; amending s. 397.6971, 153 F.S.; establishing the requirements for an early 154 release from involuntary outpatient services; amending 155 s. 397.6975, F.S.; requiring the court to appoint 156 certain counsel; providing requirements for hearings 157 on petitions for continued involuntary outpatient 158 services; requiring notice of such hearings; amending 159 s. 397.6977, F.S.; conforming provisions to changes 160 made by the act; creating s. 397.6978, F.S.; providing 161 for the appointment of guardian advocates if an 162 individual is found incompetent to consent to 163 treatment; providing a list of persons prohibited from 164 being appointed as an individual’s guardian advocate; 165 providing requirements for a facility requesting the 166 appointment of a guardian advocate; requiring a 167 training course for guardian advocates; providing 168 requirements for the training course; providing 169 requirements for the prioritization of individuals to 170 be selected as guardian advocates; authorizing certain 171 guardian advocates to consent to medical treatment; 172 providing exceptions; providing procedures for the 173 discharge of a guardian advocate; amending s. 409.967, 174 F.S.; requiring managed care plans to provide for 175 quality care; amending s. 409.973, F.S.; providing an 176 integrated behavioral health initiative; amending s. 177 491.0045, F.S.; revising registration requirements for 178 interns; repealing s. 394.4674, F.S., relating to the 179 comprehensive plan and report on the 180 deinstitutionalization of patients in a treatment 181 facility; repealing s. 394.4985, F.S., relating to the 182 implementation of a districtwide information and 183 referral network; repealing s. 394.745, F.S., relating 184 to the annual report on the compliance of providers 185 under contract with the department; repealing s. 186 397.331, F.S., relating to definitions and legislative 187 intent; repealing part IX of chapter 397, consisting 188 of ss. 397.801, 397.811, and 397.821, F.S., relating 189 to substance abuse impairment services coordination; 190 repealing s. 397.901, F.S., relating to prototype 191 juvenile addictions receiving facilities; repealing s. 192 397.93, F.S., relating to target populations for 193 children’s substance abuse services; repealing s. 194 397.94, F.S., relating to the information and referral 195 network for children’s substance abuse services; 196 repealing s. 397.951, F.S., relating to substance 197 abuse treatment and sanctions; repealing s. 397.97, 198 F.S., relating to demonstration models for children’s 199 substance abuse services; repealing s. 397.98, F.S., 200 relating to utilization management for children’s 201 substance abuse services; amending ss. 39.407, 202 212.055, 394.4599, 394.495, 394.496, 394.9085, 203 397.321, 397.405, 397.407, 397.416, 397.4871, 409.966, 204 409.972, 440.102, 744.704, and 790.065, F.S.; 205 conforming cross-references; requiring the Department 206 of Children and Families to create a workgroup on the 207 use of advance directives for substance use disorders; 208 requiring a report to the Governor, President of the 209 Senate, and Speaker of the House of Representatives; 210 providing an effective date. 211 212 Be It Enacted by the Legislature of the State of Florida: 213 214 Section 1. Paragraph (e) is added to subsection (10) of 215 section 29.004, Florida Statutes, to read: 216 29.004 State courts system.—For purposes of implementing s. 217 14, Art. V of the State Constitution, the elements of the state 218 courts system to be provided from state revenues appropriated by 219 general law are as follows: 220 (10) Case management. Case management includes: 221 (e) Service referral, coordination, monitoring, and 222 tracking for mental health programs under chapter 394. 223 224 Case management may not include costs associated with the 225 application of therapeutic jurisprudence principles by the 226 courts. Case management also may not include case intake and 227 records management conducted by the clerk of court. 228 Section 2. Subsection (6) of section 39.001, Florida 229 Statutes, is amended to read: 230 39.001 Purposes and intent; personnel standards and 231 screening.— 232 (6) MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES.— 233 (a) The Legislature recognizes that early referral and 234 comprehensive treatment can help combat mental illness and 235 substance abuse disorders in families and that treatment is 236 cost-effective. 237 (b) The Legislature establishes the following goals for the 238 state related to mental illness and substance abuse treatment 239 services in the dependency process: 240 1. To ensure the safety of children. 241 2. To prevent and remediate the consequences of mental 242 illness and substance abuse disorders on families involved in 243 protective supervision or foster care and reduce the occurrences 244 of mental illness and substance abuse disorders, including 245 alcohol abuse or other related disorders, for families who are 246 at risk of being involved in protective supervision or foster 247 care. 248 3. To expedite permanency for children and reunify healthy, 249 intact families, when appropriate. 250 4. To support families in recovery. 251 (c) The Legislature finds that children in the care of the 252 state’s dependency system need appropriate health care services, 253 that the impact of mental illnesses and substance abuse on 254 health indicates the need for health care services to include 255 treatment for mental health and substance abuse disorders for 256services tochildren and parents where appropriate, and that it 257 is in the state’s best interest that such children be provided 258 the services they need to enable them to become and remain 259 independent of state care. In order to provide these services, 260 the state’s dependency system must have the ability to identify 261 and provide appropriate intervention and treatment for children 262 with personal or family-related mental illness and substance 263 abuse problems. 264 (d) It is the intent of the Legislature to encourage the 265 use of the mental health programs established under chapter 394 266 and the drug court program model established underbys. 397.334 267 and authorize courts to assess children and persons who have 268 custody or are requesting custody of children where good cause 269 is shown to identify and address mental illnesses and substance 270 abuse disordersproblemsas the court deems appropriate at every 271 stage of the dependency process. Participation in treatment, 272 including a treatment-based mental health court program or a 273 treatment-based drug court program, may be required by the court 274 following adjudication. Participation in assessment and 275 treatment beforeprior toadjudication isshall bevoluntary, 276 except as provided in s. 39.407(16). 277 (e) It is therefore the purpose of the Legislature to 278 provide authority for the state to contract with mental health 279 service providers and community substance abuse treatment 280 providers for the development and operation of specialized 281 support and overlay services for the dependency system, which 282 will be fully implemented and used as resources permit. 283 (f) Participation in a treatment-based mental health court 284 program or athetreatment-based drug court program does not 285 divest any public or private agency of its responsibility for a 286 child or adult, but is intended to enable these agencies to 287 better meet their needs through shared responsibility and 288 resources. 289 Section 3. Paragraph (c) of subsection (6) of section 290 39.407, Florida Statutes, is amended to read: 291 39.407 Medical, psychiatric, and psychological examination 292 and treatment of child; physical, mental, or substance abuse 293 examination of person with or requesting child custody.— 294 (6) Children who are in the legal custody of the department 295 may be placed by the department, without prior approval of the 296 court, in a residential treatment center licensed under s. 297 394.875 or a hospital licensed under chapter 395 for residential 298 mental health treatment only pursuant to this section or may be 299 placed by the court in accordance with an order of involuntary 300 examination or involuntary placement entered pursuant to s. 301 394.463 or s. 394.467. All children placed in a residential 302 treatment program under this subsection must have a guardian ad 303 litem appointed. 304 (c) Before a child is admitted under this subsection, the 305 child shall be assessed for suitability for residential 306 treatment by a qualified evaluator who has conducted a personal 307 examination and assessment of the child and has made written 308 findings that: 309 1. The child appears to have an emotional disturbance 310 serious enough to require residential treatment and is 311 reasonably likely to benefit from the treatment. 312 2. The child has been provided with a clinically 313 appropriate explanation of the nature and purpose of the 314 treatment. 315 3. All available modalities of treatment less restrictive 316 than residential treatment have been considered, and a less 317 restrictive alternative that would offer comparable benefits to 318 the child is unavailable. 319 320 A copy of the written findings of the evaluation and suitability 321 assessment must be provided to the department,andto the 322 guardian ad litem, and, if the child is a member of a Medicaid 323 Managed Health Care Plan, to the plan that is financially 324 responsible for the child’s care in residential treatment, any 325 of whom must be providedwhoshall havethe opportunity to 326 discuss the findings with the evaluator. 327 Section 4. Subsection (10) of section 39.507, Florida 328 Statutes, is amended to read: 329 39.507 Adjudicatory hearings; orders of adjudication.— 330 (10) After an adjudication of dependency, or a finding of 331 dependency in whichwhereadjudication is withheld, the court 332 may order a person who has,custodyor is requesting, custody of 333 the child to submit to a mental health or substance abuse 334 disorder assessment or evaluation. The order may be made only 335 upon good cause shown and pursuant to notice and procedural 336 requirements provided under the Florida Rules of Juvenile 337 Procedure. The assessment or evaluation must be administered by 338 an appropriateaqualified professional, as defined in s. 339 394.455 or s. 397.311. The court may also require such person to 340 participate in and comply with treatment and services identified 341 as necessary, including, when appropriate and available, 342 participation in and compliance with a mental health program 343 established under chapter 394 or a treatment-based drug court 344 program established under s. 397.334. In addition to supervision 345 by the department, the court, including a treatment-based mental 346 health court program or athetreatment-based drug court 347 program, may oversee the progress and compliance with treatment 348 by a person who has custody or is requesting custody of the 349 child. The court may impose appropriate available sanctions for 350 noncompliance upon a person who has custody or is requesting 351 custody of the child or make a finding of noncompliance for 352 consideration in determining whether an alternative placement of 353 the child is in the child’s best interests. Any order entered 354 under this subsection may be made only upon good cause shown. 355 This subsection does not authorize placement of a child with a 356 person seeking custody, other than the parent or legal 357 custodian, who requires mental health or substance abuse 358 disorder treatment. 359 Section 5. Paragraph (b) of subsection (1) of section 360 39.521, Florida Statutes, is amended to read: 361 39.521 Disposition hearings; powers of disposition.— 362 (1) A disposition hearing shall be conducted by the court, 363 if the court finds that the facts alleged in the petition for 364 dependency were proven in the adjudicatory hearing, or if the 365 parents or legal custodians have consented to the finding of 366 dependency or admitted the allegations in the petition, have 367 failed to appear for the arraignment hearing after proper 368 notice, or have not been located despite a diligent search 369 having been conducted. 370 (b) When any child is adjudicated by a court to be 371 dependent, the court having jurisdiction of the child has the 372 power by order to: 373 1. Require the parent and, when appropriate, the legal 374 custodian and the child to participate in treatment and services 375 identified as necessary. The court may require the person who 376 has custody or who is requesting custody of the child to submit 377 to a mental illness or substance abuse disorder assessment or 378 evaluation. The order may be made only upon good cause shown and 379 pursuant to notice and procedural requirements provided under 380 the Florida Rules of Juvenile Procedure. The assessment or 381 evaluation must be administered by an appropriateaqualified 382 professional, as defined in s. 394.455 or s. 397.311. The court 383 may also require such person to participate in and comply with 384 treatment and services identified as necessary, including, when 385 appropriate and available, participation in and compliance with 386 a mental health program established under chapter 394 or a 387 treatment-based drug court program established under s. 397.334. 388 In addition to supervision by the department, the court, 389 including a treatment-based mental health court program or athe390 treatment-based drug court program, may oversee the progress and 391 compliance with treatment by a person who has custody or is 392 requesting custody of the child. The court may impose 393 appropriate available sanctions for noncompliance upon a person 394 who has custody or is requesting custody of the child or make a 395 finding of noncompliance for consideration in determining 396 whether an alternative placement of the child is in the child’s 397 best interests. Any order entered under this subparagraph may be 398 made only upon good cause shown. This subparagraph does not 399 authorize placement of a child with a person seeking custody of 400 the child, other than the child’s parent or legal custodian, who 401 requires mental health or substance abuse treatment. 402 2. Require, if the court deems necessary, the parties to 403 participate in dependency mediation. 404 3. Require placement of the child either under the 405 protective supervision of an authorized agent of the department 406 in the home of one or both of the child’s parents or in the home 407 of a relative of the child or another adult approved by the 408 court, or in the custody of the department. Protective 409 supervision continues until the court terminates it or until the 410 child reaches the age of 18, whichever date is first. Protective 411 supervision shall be terminated by the court whenever the court 412 determines that permanency has been achieved for the child, 413 whether with a parent, another relative, or a legal custodian, 414 and that protective supervision is no longer needed. The 415 termination of supervision may be with or without retaining 416 jurisdiction, at the court’s discretion, and shall in either 417 case be considered a permanency option for the child. The order 418 terminating supervision by the department mustshallset forth 419 the powers of the custodian of the child andshallinclude the 420 powers ordinarily granted to a guardian of the person of a minor 421 unless otherwise specified. Upon the court’s termination of 422 supervision by the department,nofurther judicial reviews are 423 not required if, so long aspermanency has been established for 424 the child. 425 Section 6. Section 394.455, Florida Statutes, is amended to 426 read: 427 394.455 Definitions.—As used in this part,unless the428context clearly requires otherwise,the term: 429 (1) “Access center” means a facility staffed by medical, 430 behavioral, and substance abuse professionals which provides 431 emergency screening and evaluation for mental health or 432 substance abuse disorders and may provide transportation to an 433 appropriate facility if an individual is in need of more 434 intensive services. 435 (2) “Addictions receiving facility” is a secure, acute care 436 facility that, at a minimum, provides emergency screening, 437 evaluation, detoxification and stabilization services; is 438 operated 24 hours per day, 7 days per week; and is designated by 439 the department to serve individuals found to have substance 440 abuse impairment who qualify for services under this part. 441 (3)(1)“Administrator” means the chief administrative 442 officer of a receiving or treatment facility or his or her 443 designee. 444 (4) “Adult” means an individual who is 18 years of age or 445 older or who has had the disability of nonage removed under 446 chapter 743. 447 (5) “Advanced registered nurse practitioner” means any 448 person licensed in this state to practice professional nursing 449 who is certified in advanced or specialized nursing practice 450 under s. 464.012. 451 (6)(2)“Clinical psychologist” means a psychologist as 452 defined in s. 490.003(7) with 3 years of postdoctoral experience 453 in the practice of clinical psychology, inclusive of the 454 experience required for licensure, or a psychologist employed by 455 a facility operated by the United States Department of Veterans 456 Affairs that qualifies as a receiving or treatment facility 457 under this part. 458 (7)(3)“Clinical record” means all parts of the record 459 required to be maintained and includes all medical records, 460 progress notes, charts, and admission and discharge data, and 461 all other information recorded byafacility staff which 462 pertains to the patient’s hospitalization or treatment. 463 (8)(4)“Clinical social worker” means a person licensed as 464 a clinical social worker under s. 491.005 or s. 491.006chapter465491. 466 (9)(5)“Community facility” means aanycommunity service 467 provider that contractscontractingwith the department to 468 furnish substance abuse or mental health services under part IV 469 of this chapter. 470 (10)(6)“Community mental health center or clinic” means a 471 publicly funded, not-for-profit center thatwhichcontracts with 472 the department for the provision of inpatient, outpatient, day 473 treatment, or emergency services. 474 (11)(7)“Court,” unless otherwise specified, means the 475 circuit court. 476 (12)(8)“Department” means the Department of Children and 477 Families. 478 (13) “Designated receiving facility” means a facility 479 approved by the department which may be a public or private 480 hospital, crisis stabilization unit, addictions receiving 481 facility and provides, at a minimum, emergency screening, 482 evaluation, and short-term stabilization for mental health or 483 substance abuse disorders, and which may have an agreement with 484 a corresponding facility for transportation and services. 485 (14) “Detoxification facility” means a facility licensed to 486 provide detoxification services under chapter 397. 487 (15) “Electronic means” is a form of telecommunication 488 which requires all parties to maintain visual as well as audio 489 communication when being used to conduct an examination by a 490 qualified professional. 491 (16)(9)“Express and informed consent” means consent 492 voluntarily given in writing, by a competent person, after 493 sufficient explanation and disclosure of the subject matter 494 involved to enable the person to make a knowing and willful 495 decision without any element of force, fraud, deceit, duress, or 496 other form of constraint or coercion. 497 (17)(10)“Facility” means any hospital, community facility, 498 public or private facility, or receiving or treatment facility 499 providing for the evaluation, diagnosis, care, treatment, 500 training, or hospitalization of persons who appear to havea501mental illnessor who have been diagnosed as having a mental 502 illness or substance abuse impairment. The term“Facility”does 503 not include aanyprogram or an entity licensed underpursuant504tochapter 400 or chapter 429. 505 (18) “Governmental facility” means a facility owned, 506 operated, or administered by the Department of Corrections or 507 the United States Department of Veterans Affairs. 508 (19)(11)“Guardian” means the natural guardian of a minor, 509 or a person appointed by a court to act on behalf of a ward’s 510 person if the ward is a minor or has been adjudicated 511 incapacitated. 512 (20)(12)“Guardian advocate” means a person appointed by a 513 court to make decisions regarding mental health or substance 514 abuse treatment on behalf of a patient who has been found 515 incompetent to consent to treatment pursuant to this part.The516guardian advocate may be granted specific additional powers by517written order of the court, as provided in this part.518 (21)(13)“Hospital” means a hospitalfacility as defined in519s. 395.002 andlicensed under chapter 395 and part II of chapter 520 408. 521 (22)(14)“Incapacitated” means that a person has been 522 adjudicated incapacitated pursuant to part V of chapter 744 and 523 a guardian of the person has been appointed. 524 (23)(15)“Incompetent to consent to treatment” means a 525 state in whichthata person’s judgment is so affected by ahis526or hermental illness or a substance abuse impairment, that he 527 or shethe personlacks the capacity to make a well-reasoned, 528 willful, and knowing decision concerning his or her medical,or529 mental health, or substance abuse treatment. 530 (24) “Involuntary examination” means an examination 531 performed under s. 394.463 or s. 397.675 to determine whether a 532 person qualifies for involuntary services. 533 (25) “Involuntary services” in this part means court 534 ordered outpatient services or inpatient placement for mental 535 health treatment pursuant to s. 394.4655 or s. 394.467. 536 (26)(16)“Law enforcement officer” has the same meaning as 537 providedmeans a law enforcement officer as definedin s. 538 943.10. 539 (27) “Marriage and family therapist” means a person 540 licensed to practice marriage and family therapy under s. 541 491.005 or s. 491.006. 542 (28) “Mental health counselor” means a person licensed to 543 practice mental health counseling under s. 491.005 or s. 544 491.006. 545 (29)(17)“Mental health overlay program” means a mobile 546 service thatwhichprovides an independent examination for 547 voluntary admissionadmissionsand a range of supplemental 548 onsite services to persons with a mental illness in a 549 residential setting such as a nursing home, an assisted living 550 facility, or an adult family-care home,or a nonresidential 551 setting such as an adult day care center. Independent 552 examinations providedpursuant to this partthrough a mental 553 health overlay program must only be provided under contract with 554 the departmentfor this serviceor be attached to a public 555 receiving facility that is also a community mental health 556 center. 557 (30)(18)“Mental illness” means an impairment of the mental 558 or emotional processes that exercise conscious control of one’s 559 actions or of the ability to perceive or understand reality, 560 which impairment substantially interferes with the person’s 561 ability to meet the ordinary demands of living. For the purposes 562 of this part, the term does not include a developmental 563 disability as defined in chapter 393, intoxication, or 564 conditions manifested only by antisocial behavior or substance 565 abuseimpairment. 566 (31) “Minor” means an individual who is 17 years of age or 567 younger and who has not had the disability of nonage removed 568 pursuant to s. 743.01 or s. 743.015. 569 (32)(19)“Mobile crisis response service” means a 570 nonresidential crisis serviceattached to a public receiving571facility andavailable 24 hours a day, 7 days a week,through572 which provides immediate intensive assessments and 573 interventions, including screening for admission into a mental 574 health receiving facility, an addictions receiving facility, or 575 a detoxification facility,take placefor the purpose of 576 identifying appropriate treatment services. 577 (33)(20)“Patient” means any person, with or without a co 578 occurring substance abuse disorder who is held or accepted for 579 mental health treatment. 580 (34)(21)“Physician” means a medical practitioner licensed 581 under chapter 458 or chapter 459who has experience in the582diagnosis and treatment of mental and nervous disordersor a 583 physician employed by a facility operated by the United States 584 Department of Veterans Affairs or the United States Department 585 of Defensewhich qualifies as a receiving or treatment facility586under this part. 587 (35) “Physician assistant” means a person licensed under 588 chapter 458 or chapter 459 who has experience in the diagnosis 589 and treatment of mental disorders. 590 (36)(22)“Private facility” means any hospital or facility 591 operated by a for-profit or not-for-profit corporation or 592 association whichthatprovides mental health or substance abuse 593 services and is not a public facility. 594 (37)(23)“Psychiatric nurse” means an advanced registered 595 nurse practitioner certified under s. 464.012 who has a master’s 596 or doctoral degree in psychiatric nursing, holds a national 597 advanced practice certification as a psychiatric mental health 598 advanced practice nurse, and has 2 years of post-master’s 599 clinical experience under the supervision of a physician. 600 (38)(24)“Psychiatrist” means a medical practitioner 601 licensed under chapter 458 or chapter 459who has primarily602diagnosed and treated mental and nervous disordersfor at least 603a period of not less than3 years, inclusive of psychiatric 604 residency. 605 (39)(25)“Public facility” means aanyfacility that has 606 contracted with the department to provide mental health services 607 to all persons, regardless oftheirability to pay, and is 608 receiving state funds for such purpose. 609 (40) “Qualified professional” means a physician or a 610 physician assistant licensed under chapter 458 or chapter 459; a 611 professional licensed under chapter 490.003(7) or chapter 491; a 612 psychiatrist licensed under chapter 458 or chapter 459; or a 613 psychiatric nurse as defined in subsection (37). 614 (41)(26)“Receiving facility” means any public or private 615 facility or hospital designated by the department to receive and 616 hold or refer, as appropriate, involuntary patients under 617 emergency conditionsorfor mental health or substance abuse 618psychiatricevaluation and to provideshort-termtreatment or 619 transportation to the appropriate service provider. The term 620 does not include a county jail. 621 (42)(27)“Representative” means a person selected to 622 receive notice of proceedings during the time a patient is held 623 in or admitted to a receiving or treatment facility. 624 (43)(28)(a)“Restraint” means:a physical device, method,625or drug used to control behavior.626 (a) A physical restraint, includingisany manual method or 627 physical or mechanical device, material, or equipment attached 628 or adjacent to antheindividual’s body so that he or she cannot 629 easily remove the restraint and which restricts freedom of 630 movement or normal access to one’s body. Physical restraint 631 includes the physical holding of a person during a procedure to 632 forcibly administer psychotropic medication. Physical restraint 633 does not include physical devices such as orthopedically 634 prescribed appliances, surgical dressings and bandages, 635 supportive body bands, or other physical holding when necessary 636 for routine physical examinations and tests or for purposes of 637 orthopedic, surgical, or other similar medical treatment, when 638 used to provide support for the achievement of functional body 639 position or proper balance, or when used to protect a person 640 from falling out of bed. 641 (b) A drug orused as a restraint is amedication used to 642 control atheperson’s behavior or to restrict his or her 643 freedom of movement whichandis not part of the standard 644 treatment regimen of a person with a diagnosed mental illness 645who is a client of the department. Physically holding a person646during a procedure to forcibly administer psychotropic647medication is a physical restraint. 648(c) Restraint does not include physical devices, such as649orthopedically prescribed appliances, surgical dressings and650bandages, supportive body bands, or other physical holding when651necessary for routine physical examinations and tests; or for652purposes of orthopedic, surgical, or other similar medical653treatment; when used to provide support for the achievement of654functional body position or proper balance; or when used to655protect a person from falling out of bed.656 (44) “School psychologist” has the same meaning as in s. 657 490.003. 658 (45)(29)“Seclusion” means the physical segregationof a659person in any fashionor involuntary isolation of a person in a 660 room or area from which the person is prevented from leaving. 661 The prevention may be by physical barrier or by a staff member 662 who is acting in a manner, or who is physically situated, so as 663 to prevent the person from leaving the room or area. For 664 purposes of this partchapter, the term does not mean isolation 665 due to a person’s medical condition or symptoms. 666 (46)(30)“Secretary” means the Secretary of Children and 667 Families. 668 (47) “Service provider” means a receiving facility, any 669 facility licensed under chapter 397, a treatment facility, an 670 entity under contract with the department to provide mental 671 health or substance abuse services, a community mental health 672 center or clinic, a psychologist, a clinical social worker, a 673 marriage and family therapist, a mental health counselor, a 674 physician, a psychiatrist, an advanced registered nurse 675 practitioner, a psychiatric nurse, or a qualified professional 676 as defined in this section. 677 (48) “Substance abuse impairment” means a condition 678 involving the use of alcoholic beverages or any psychoactive or 679 mood-altering substance in such a manner that a person has lost 680 the power of self-control and has inflicted or is likely to 681 inflict physical harm on himself or herself or others. 682 (49)(31)“Transfer evaluation” means the process by which,683as approved by the appropriate district office of the684department,wherebya person who is being considered for 685 placement in a state treatment facility isfirstevaluated for 686 appropriateness of admission to a state treatmentthefacility 687by a community-based public receiving facility or by a community688mental health center or clinic if the public receiving facility689is not a community mental health center or clinic. 690 (50)(32)“Treatment facility” means aanystate-owned, 691 state-operated, or state-supported hospital, center, or clinic 692 designated by the department for extended treatment and 693 hospitalization, beyond that provided for by a receiving 694 facility, of persons who have a mental illness, including 695 facilities of the United States Government, and any private 696 facility designated by the department when rendering such 697 services to a person pursuant to the provisions of this part. 698 Patients treated in facilities of the United States Government 699 shall be solely those whose care is the responsibility of the 700 United States Department of Veterans Affairs. 701 (51) “Triage center” means a facility that is designated by 702 the department and has medical, behavioral, and substance abuse 703 professionals present or on call to provide emergency screening 704 and evaluation of individuals transported to the center by a law 705 enforcement officer. 706(33) “Service provider” means any public or private707receiving facility, an entity under contract with the Department708of Children and Families to provide mental health services, a709clinical psychologist, a clinical social worker, a marriage and710family therapist, a mental health counselor, a physician, a711psychiatric nurse as defined in subsection (23), or a community712mental health center or clinic as defined in this part.713(34) “Involuntary examination” means an examination714performed under s. 394.463 to determine if an individual715qualifies for involuntary inpatient treatment under s.716394.467(1) or involuntary outpatient treatment under s.717394.4655(1).718(35) “Involuntary placement” means either involuntary719outpatient treatment pursuant to s. 394.4655 or involuntary720inpatient treatment pursuant to s. 394.467.721(36) “Marriage and family therapist” means a person722licensed as a marriage and family therapist under chapter 491.723(37) “Mental health counselor” means a person licensed as a724mental health counselor under chapter 491.725(38) “Electronic means” means a form of telecommunication726that requires all parties to maintain visual as well as audio727communication.728 Section 7. Section 394.4573, Florida Statutes, is amended 729 to read: 730 394.4573 Coordinated system of care; annual assessment; 731 essential elementsContinuity of care management system; 732 measures of performance; system improvement grants; reports.—On 733 or before October 1 of each year, the department shall submit to 734 the Governor, the President of the Senate, and the Speaker of 735 the House of Representatives an assessment of the behavioral 736 health services in this state in the context of the No-Wrong 737 Door model and standards set forth in this section. The 738 department’s assessment shall be based on both quantitative and 739 qualitative data and must identify any significant regional 740 variations. The assessment must include information gathered 741 from managing entities; service providers; facilities performing 742 acute behavioral health care triage functions for the community; 743 crisis stabilization units; detoxification units; addictions 744 receiving facilities and hospitals, both public and private; law 745 enforcement; judicial officials; local governments; behavioral 746 health consumers and their family members; and the public. 747 (1) As used inFor the purposes ofthis section: 748 (a) “Case management” means those direct services provided 749 to a client in order to assess his or heractivities aimed at750assessingclientneeds, plan or arrangeplanningservices, 751 coordinate service providers, linklinkingthe service system to 752 a client, monitorcoordinating the various systemcomponents,753monitoringservice delivery, and evaluate patient outcomes 754evaluating the effectof service delivery. 755 (b) “Case manager” means an individual who works with 756 clients,and their families and significant others,to provide 757 case management. 758 (c) “Client manager” means an employee of the managing 759 entity or entity under contract with the managing entity 760departmentwho is assigned to specific provider agencies and 761 geographic areas to ensure that the full range of needed 762 services is available to clients. 763 (d) “Coordinated systemContinuityof caremanagement764system” meansa system thatassures, within available resources,765that clients have access tothe full array of behavioral and 766 related services in a region or community offered by all service 767 providers, whether participating under contract with the 768 managing entity or another method of community partnership or 769 mutual agreementwithin the mental health services delivery770system. 771 (e) “No-Wrong-Door model” means a model for the delivery of 772 acute care services to persons who have mental health or 773 substance abuse disorders, or both, which optimizes access to 774 care, regardless of the entry point to the behavioral health 775 care system. 776 (2) The essential elements of a coordinated system of care 777 include: 778 (a) Community interventions, such as prevention, primary 779 care for behavioral health needs, therapeutic and supportive 780 services, crisis response services, and diversion programs. 781 (b) A designated receiving system shall consist of one or 782 more facilities serving a defined geographic area and 783 responsible for assessment and evaluation, both voluntary and 784 involuntary, and treatment or triage for patients who present 785 with mental illness, substance abuse disorder, or co-occurring 786 disorders. A county or several counties shall plan the 787 designated receiving system through an inclusive process, that 788 includes the managing entity and is open to participation from 789 individuals with behavioral health needs, their families, 790 providers, law enforcement, and other parties. The county or 791 counties, in collaboration with the managing entity, shall 792 document the designated receiving system through memorandum of 793 agreement or other binding arrangements. The county or counties 794 and the managing entity shall approve the designated receiving 795 system by October 31, 2017, and the county or counties shall 796 review, update as necessary, and reapprove the designated 797 receiving system at least once every three years. The designated 798 receiving system shall function as a no-wrong-door model and may 799 be organized in any manner which functions as a no-wrong-door 800 model that responds to individual needs and integrates services 801 among various providers. Such models include but are not limited 802 to: 803 1. A central receiving system, which consists of a 804 designated central receiving facility that serves as a single 805 entry point for persons with mental health or substance abuse 806 disorders, or both. The central receiving facility must be 807 capable of assessment, evaluation, and triage or treatment for 808 various conditions and circumstances. 809 2. A coordinated receiving system, which consists of 810 multiple entry points that are linked by shared data systems, 811 formal referral agreements, and cooperative arrangements for 812 care coordination and case management. Each entry point must be 813 a designated receiving facility and must provide or arrange for 814 necessary services following an initial assessment and 815 evaluation. 816 3. A tiered receiving system, which consists of multiple 817 entry points, some of which offer only specialized or limited 818 services. Each service provider must be classified according to 819 its capabilities as either a designated receiving facility, or 820 another type of service provider such as a residential 821 detoxification center, triage center, or an access center. All 822 participating service providers must be linked by methods to 823 share data that are compliant with both state and federal 824 patient privacy and confidentiality laws, formal referral 825 agreements, and cooperative arrangements for care coordination 826 and case management. An accurate inventory of the participating 827 service providers which specifies the capabilities and 828 limitations of each provider must be maintained and made 829 available at all times to all first responders in the service 830 area. 831 (c) Transportation in accordance with a plan developed 832 under s. 394.462. 833 (d) Crisis services, including mobile response teams, 834 crisis stabilization units, addiction receiving facilities, and 835 detoxification facilities. 836 (e) Case management, including intensive case management 837 for individuals determined to be high-need or high-utilization 838 individuals under s. 394.9082(2)(e). 839 (f) Outpatient services. 840 (g) Residential services. 841 (h) Hospital inpatient care. 842 (i) Aftercare and other post-discharge services. 843 (j) Medication-assisted treatment and medication 844 management. 845 (k) Recovery support, including housing assistance and 846 support for competitive employment, educational attainment, 847 independent living skills development, family support and 848 education, and wellness management and self-care. 849 (3) The department’s annual assessment must compare the 850 status and performance of the extant behavioral health system 851 with the following standards and any other standards or measures 852 that the department determines to be applicable. 853 (a) The capacity of the contracted service providers to 854 meet estimated need when such estimates are based on credible 855 evidence and sound methodologies. 856 (b) The extent to which the behavioral health system uses 857 evidence-informed practices and broadly disseminates the results 858 of quality improvement activities to all service providers. 859 (c) The degree to which services are offered in the least 860 restrictive and most appropriate therapeutic environment. 861 (d) The scope of system-wide accountability activities used 862 to monitor patient outcomes and measure continuous improvement 863 in the behavioral health system. 864 (4) Subject to a specific appropriation by the Legislature, 865 the department may award system improvement grants to managing 866 entities based on the submission of a detailed plan to enhance 867 services, coordination, or performance measurement in accordance 868 with the model and standards specified in this section. Such a 869 grant must be awarded through a performance-based contract that 870 links payments to the documented and measurable achievement of 871 system improvementsThe department isdirected to implementa872continuity of care management system for the provision of mental873health care, through the provision of client and case874management, including clients referred from state treatment875facilities to community mental health facilities.Such system876shall include a network of client managers and case managers877throughout the state designed to:878(a) Reduce the possibility of a client’s admission or879readmission to a state treatment facility.880(b) Provide for the creation or designation of an agency in881each county to provide single intake services for each person882seeking mental health services. Such agency shall provide883information and referral services necessary to ensure that884clients receive the most appropriate and least restrictive form885of care, based on the individual needs of the person seeking886treatment. Such agency shall have a single telephone number,887operating 24 hours per day, 7 days per week, where practicable,888at a central location, where each client will have a central889record.890(c) Advocate on behalf of the client to ensure that all891appropriate services are afforded to the client in a timely and892dignified manner.893(d) Require that any public receiving facility initiating a894patient transfer to a licensed hospital for acute care mental895health services not accessible through the public receiving896facility shall notify the hospital of such transfer and send all897records relating to the emergency psychiatric or medical898condition.899(3) The department is directed to develop and include in900contracts with service providers measures of performance with901regard to goals and objectives as specified in the state plan.902Such measures shall use, to the extent practical, existing data903collection methods and reports and shall not require, as a904result of this subsection, additional reports on the part of905service providers. The department shall plan monitoring visits906of community mental health facilities with other state, federal,907and local governmental and private agencies charged with908monitoring such facilities.909 Section 8. Paragraphs (d) and (e) of subsection (2) of 910 section 394.4597, Florida Statutes, are amended to read: 911 394.4597 Persons to be notified; patient’s representative.— 912 (2) INVOLUNTARY PATIENTS.— 913 (d) When the receiving or treatment facility selects a 914 representative, first preference shall be given to a health care 915 surrogate, if one has been previously selected by the patient. 916 If the patient has not previously selected a health care 917 surrogate, the selection, except for good cause documented in 918 the patient’s clinical record, shall be made from the following 919 list in the order of listing: 920 1. The patient’s spouse. 921 2. An adult child of the patient. 922 3. A parent of the patient. 923 4. The adult next of kin of the patient. 924 5. An adult friend of the patient. 9256. The appropriate Florida local advocacy council as926provided in s. 402.166.927 (e) The following persons are prohibited from selection as 928 a patient’s representative: 929 1. A professional providing clinical services to the 930 patient under this part. 931 2. The licensed professional who initiated the involuntary 932 examination of the patient, if the examination was initiated by 933 professional certificate. 934 3. An employee, an administrator, or a board member of the 935 facility providing the examination of the patient. 936 4. An employee, an administrator, or a board member of a 937 treatment facility providing treatment for the patient. 938 5. A person providing any substantial professional services 939 to the patient, including clinical services. 940 6. A creditor of the patient. 941 7. A person subject to an injunction for protection against 942 domestic violence under s. 741.30, whether the order of 943 injunction is temporary or final, and for which the patient was 944 the petitioner. 945 8. A person subject to an injunction for protection against 946 repeat violence, stalking, sexual violence, or dating violence 947 under s. 784.046, whether the order of injunction is temporary 948 or final, and for which the patient was the petitionerA949licensed professional providing services to the patient under950this part, an employee of a facility providing direct services951to the patient under this part, a department employee, a person952providing other substantial services to the patient in a953professional or business capacity, or a creditor of the patient954shall not be appointed as the patient’s representative. 955 Section 9. Present subsections (2) through (7) of section 956 394.4598, Florida Statutes, are redesignated as subsections (3) 957 through (8), respectively, a new subsection (2) is added to that 958 section, and present subsections (3) and (4) of that section are 959 amended, to read: 960 394.4598 Guardian advocate.— 961 (2) The following persons are prohibited from appointment 962 as a patient’s guardian advocate: 963 (a) A professional providing clinical services to the 964 patient under this part. 965 (b) The licensed professional who initiated the involuntary 966 examination of the patient, if the examination was initiated by 967 professional certificate. 968 (c) An employee, an administrator, or a board member of the 969 facility providing the examination of the patient. 970 (d) An employee, an administrator, or a board member of a 971 treatment facility providing treatment of the patient. 972 (e) A person providing any substantial professional 973 services, excluding public and professional guardians, to the 974 patient, including clinical services. 975 (f) A creditor of the patient. 976 (g) A person subject to an injunction for protection 977 against domestic violence under s. 741.30, whether the order of 978 injunction is temporary or final, and for which the patient was 979 the petitioner. 980 (h) A person subject to an injunction for protection 981 against repeat violence, stalking, sexual violence, or dating 982 violence under s. 784.046, whether the order of injunction is 983 temporary or final, and for which the patient was the 984 petitioner. 985 (4)(3)In lieu of the training required of guardians 986 appointed pursuant to chapter 744,Prior toa guardian advocate 987 must, at a minimum, participate in a 4-hour training course 988 approved by the court before exercising his or her authority,989the guardian advocate shall attend a training course approved by990the court. At a minimum, this training course, of not less than9914 hours,must include, at minimum,information aboutthepatient 992 rights, psychotropic medications, the diagnosis of mental 993 illness, the ethics of medical decisionmaking, and duties of 994 guardian advocates.This training course shall take the place of995the training required for guardians appointed pursuant to996chapter 744.997 (5)(4)The required training course and the information to 998 be supplied to prospective guardian advocates beforeprior to999 their appointmentand the training course for guardian advocates1000 must be developedand completed through a course developedby 1001 the department,andapproved by the chief judge of the circuit 1002 court, and taught by a court-approved organization, which.1003Court-approved organizationsmay include, but isarenot limited 1004 to, a community collegecommunityor juniorcolleges, a 1005 guardianship organizationguardianship organizations, aand the1006 local bar association, or The Florida Bar. The training course 1007 may be web-based, provided in video format, or other electronic 1008 means but must be capable of ensuring the identity and 1009 participation of the prospective guardian advocate. The court 1010 may, in its discretion,waive some or all of the training 1011 requirements for guardian advocates or impose additional 1012 requirements. The court shall make its decision on a case-by 1013 case basis and, in making its decision, shall consider the 1014 experience and education of the guardian advocate, the duties 1015 assigned to the guardian advocate, and the needs of the patient. 1016 Section 10. Section 394.462, Florida Statutes, is amended 1017 to read: 1018 394.462 Transportation.—A transportation plan must be 1019 developed and implemented by each county, in consultation with 1020 the managing entity and in accordance with this section. A 1021 county may enter into a memorandum of understanding with the 1022 governing boards of nearby counties to establish a shared 1023 transportation plan. When multiple counties enter into a 1024 memorandum of understanding for this purpose, the counties shall 1025 provide a copy of the agreement to the managing entity. The 1026 transportation plan shall describe methods of transport to a 1027 facility within the designated receiving system for individuals 1028 subject to involuntary examination under s. 394.463 or 1029 involuntary assessment and stabilization under s. 397.675, and 1030 may identify responsibility for transportation between 1031 participating facilities when necessary and agreed to by the 1032 facility. The plan may rely on emergency medical transport 1033 services or private transport companies as appropriate. The plan 1034 shall comply with the transportation provisions of ss. 394.462, 1035 397.6772, 397.6795, 397.6822, and 397.697. 1036 (1) TRANSPORTATION TO A RECEIVING FACILITY.— 1037 (a) Each county shall designate a single law enforcement 1038 agency within the county, or portions thereof, to take a person 1039 into custody upon the entry of an ex parte order or the 1040 execution of a certificate for involuntary examination by an 1041 authorized professional and to transport that person to an 1042 appropriate facility within the designated receiving systemthe1043nearest receiving facilityfor examination. 1044 (b)1. The designated law enforcement agency may decline to 1045 transport the person to a receiving facility only if: 1046 a.1.The jurisdiction designated by the county has 1047 contracted on an annual basis with an emergency medical 1048 transport service or private transport company for 1049 transportation of persons to receiving facilities pursuant to 1050 this section at the sole cost of the county; and 1051 b.2.The law enforcement agency and the emergency medical 1052 transport service or private transport company agree that the 1053 continued presence of law enforcement personnel is not necessary 1054 for the safety of the person or others. 1055 2.3.The entity providing transportationjurisdiction1056designated by the countymay seek reimbursement for 1057 transportation expenses. The party responsible for payment for 1058 such transportation is the person receiving the transportation. 1059 The county shall seek reimbursement from the following sources 1060 in the following order: 1061 a. From a private or public third-party payoran insurance1062company, health care corporation, or other source, if the person 1063 receiving the transportation has applicable coverageis covered1064by an insurance policy or subscribes to a health care1065corporation or other source for payment of such expenses. 1066 b. From the person receiving the transportation. 1067 c. From a financial settlement for medical care, treatment, 1068 hospitalization, or transportation payable or accruing to the 1069 injured party. 1070 (c)(b)AAnycompany that transports a patient pursuant to 1071 this subsection is considered an independent contractor and is 1072 solely liable for the safe and dignified transport 1073transportationof the patient. Such company must be insured and 1074 provide no less than $100,000 in liability insurance with 1075 respect to the transporttransportationof patients. 1076 (d)(c)Any company that contracts with a governing board of 1077 a county to transport patients shall comply with the applicable 1078 rules of the department to ensure the safety and dignity ofthe1079 patients. 1080 (e)(d)When a law enforcement officer takes custody of a 1081 person pursuant to this part, the officer may request assistance 1082 from emergency medical personnel if such assistance is needed 1083 for the safety of the officer or the person in custody. 1084 (f)(e)When a member of a mental health overlay program or 1085 a mobile crisis response service is a professional authorized to 1086 initiate an involuntary examination pursuant to s. 394.463 or s. 1087 397.675 and that professional evaluates a person and determines 1088 that transportation to a receiving facility is needed, the 1089 service, at its discretion, may transport the person to the 1090 facility or may call on the law enforcement agency or other 1091 transportation arrangement best suited to the needs of the 1092 patient. 1093 (g)(f)When any law enforcement officer has custody of a 1094 person based on either noncriminal or minor criminal behavior 1095 that meets the statutory guidelines for involuntary examination 1096 under this part, the law enforcement officer shall transport the 1097 person to an appropriatethenearest receivingfacility within 1098 the designated receiving system for examination. 1099 (h)(g)When any law enforcement officer has arrested a 1100 person for a felony and it appears that the person meets the 1101 statutory guidelines for involuntary examination or placement 1102 under this part, such person mustshallfirst be processed in 1103 the same manner as any other criminal suspect. The law 1104 enforcement agency shall thereafter immediately notify the 1105 appropriatenearest publicreceivingfacility within the 1106 designated receiving system, which shall be responsible for 1107 promptly arranging for the examination and treatment of the 1108 person. A receiving facility is not required to admit a person 1109 charged with a crime for whom the facility determines and 1110 documents that it is unable to provide adequate security, but 1111 shall providemental healthexamination and treatment to the 1112 person where he or she is held. 1113 (i)(h)If the appropriate law enforcement officer believes 1114 that a person has an emergency medical condition as defined in 1115 s. 395.002, the person may be first transported to a hospital 1116 for emergency medical treatment, regardless of whether the 1117 hospital is a designated receiving facility. 1118 (j)(i)The costs of transportation, evaluation, 1119 hospitalization, and treatment incurred under this subsection by 1120 persons who have been arrested for violations of any state law 1121 or county or municipal ordinance may be recovered as provided in 1122 s. 901.35. 1123 (k)(j)Thenearestreceivingfacility within the designated 1124 receiving system must accept, pursuant to this part, persons 1125 brought by law enforcement officers, an emergency medical 1126 transport service, or a private transport company for 1127 involuntary examination. 1128 (l)(k)Each law enforcement agency designated pursuant to 1129 paragraph (a) shall establish a policy thatdevelop a memorandum1130of understanding with each receiving facility within the law1131enforcement agency’s jurisdictionwhichreflects a single set of 1132 protocols approved by the managing entity for the safe and 1133 secure transportationof the personand transfer of custody of 1134 the person.These protocols must also address crisis1135intervention measures.1136 (m)(l)When a jurisdiction has entered into a contract with 1137 an emergency medical transport service or a private transport 1138 company for transportation of persons toreceivingfacilities 1139 within the designated receiving system, such service or company 1140 shall be given preference for transportation of persons from 1141 nursing homes, assisted living facilities, adult day care 1142 centers, or adult family-care homes, unless the behavior of the 1143 person being transported is such that transportation by a law 1144 enforcement officer is necessary. 1145 (n)(m)Nothing inThis section may notshallbe construed 1146 to limit emergency examination and treatment of incapacitated 1147 persons provided in accordance withthe provisions ofs. 1148 401.445. 1149 (2) TRANSPORTATION TO A TREATMENT FACILITY.— 1150 (a) If neither the patient nor any person legally obligated 1151 or responsible for the patient is able to pay for the expense of 1152 transporting a voluntary or involuntary patient to a treatment 1153 facility, the transportation plan established by the governing 1154 board of the county or counties must specify howin whichthe 1155 hospitalized patient will be transported to, from, and between 1156 facilities in ais hospitalizedshallarrange for such required1157transportation and shall ensure thesafe and dignified manner 1158transportation of the patient.The governing board of each1159county is authorized to contract with private transport1160companies for the transportation of such patients to and from a1161treatment facility.1162 (b) AAnycompany that transports a patient pursuant to 1163 this subsection is considered an independent contractor and is 1164 solely liable for the safe and dignified transportation of the 1165 patient. Such company must be insured and provide no less than 1166 $100,000 in liability insurance with respect to the transport 1167transportationof patients. 1168 (c) AAnycompany that contracts with one or more counties 1169the governing board of a countyto transport patients in 1170 accordance with this section shall comply with the applicable 1171 rules of the department to ensure the safety and dignity ofthe1172 patients. 1173 (d) County or municipal law enforcement and correctional 1174 personnel and equipment mayshallnot be used to transport 1175 patients adjudicated incapacitated or found by the court to meet 1176 the criteria for involuntary placement pursuant to s. 394.467, 1177 except in small rural counties where there are no cost-efficient 1178 alternatives. 1179 (3) TRANSFER OF CUSTODY.—Custody of a person who is 1180 transported pursuant to this part, along with related 1181 documentation, shall be relinquished to a responsible individual 1182 at the appropriate receiving or treatment facility. 1183(4) EXCEPTIONS.—An exception to the requirements of this1184section may be granted by the secretary of the department for1185the purposes of improving service coordination or better meeting1186the special needs of individuals. A proposal for an exception1187must be submitted by the district administrator after being1188approved by the governing boards of any affected counties, prior1189to submission to the secretary.1190(a) A proposal for an exception must identify the specific1191provision from which an exception is requested;describehow the1192proposal will be implemented by participating law enforcement1193agencies and transportation authorities;and provide a plan for1194the coordination of services such as case management.1195(b) The exception may be granted only for:11961. An arrangement centralizing and improving the provision1197of services within a district, which may include an exception to1198the requirement for transportation to the nearest receiving1199facility;12002. An arrangement by which a facility may provide, in1201addition to required psychiatric services, an environment and1202services which are uniquely tailored to the needs of an1203identified group of persons with special needs, such as persons1204with hearing impairments or visual impairments, or elderly1205persons with physical frailties; or12063. A specialized transportation system that provides an1207efficient and humane method of transporting patients to1208receiving facilities, among receiving facilities, and to1209treatment facilities.1210(c) Any exception approved pursuant to this subsection1211shall be reviewed and approved every 5 years by the secretary.1212 Section 11. Subsection (2) of section 394.463, Florida 1213 Statutes, is amended to read: 1214 394.463 Involuntary examination.— 1215 (2) INVOLUNTARY EXAMINATION.— 1216 (a) An involuntary examination may be initiated by any one 1217 of the following means: 1218 1. A circuit or county court may enter an ex parte order 1219 stating that a person appears to meet the criteria for 1220 involuntary examination and specifying, givingthe findings on 1221 which that conclusion is based. The ex parte order for 1222 involuntary examination must be based on written or oral sworn 1223 testimony that includes specific facts that support the 1224 findings, written or oral. If other, less restrictive, means are 1225 not available, such as voluntary appearance for outpatient 1226 evaluation, a law enforcement officer, or other designated agent 1227 of the court, shall take the person into custody and deliver him 1228 or her to an appropriatethenearest receivingfacility within 1229 the designated receiving system for involuntary examination. The 1230 order of the court shall be made a part of the patient’s 1231 clinical record. ANofee may notshallbe charged for the 1232 filing of an order under this subsection. Anyreceivingfacility 1233 accepting the patient based on this order must send a copy of 1234 the order to the managing entity in the regionAgency for Health1235CareAdministration onthe next working day. The order may be 1236 submitted electronically through existing data systems, if 1237 available. The order shall be valid only until the person is 1238 delivered to the appropriate facilityexecutedor,if not1239executed,for the period specified in the order itself, 1240 whichever comes first. If no time limit is specified in the 1241 order, the order shall be valid for 7 days after the date that 1242 the order was signed. 1243 2. A law enforcement officer shall take a person who 1244 appears to meet the criteria for involuntary examination into 1245 custody and deliver the person or have him or her delivered to 1246 the appropriatenearestreceivingfacility within the designated 1247 receiving system for examination. The officer shall execute a 1248 written report detailing the circumstances under which the 1249 person was taken into custody, which mustand the report shall1250 be made a part of the patient’s clinical record. Anyreceiving1251 facility accepting the patient based on this report must send a 1252 copy of the report to the department and the managing entity 1253Agency for Health CareAdministration onthe next working day. 1254 3. A physician, clinical psychologist, psychiatric nurse, 1255 mental health counselor, marriage and family therapist, or 1256 clinical social worker may execute a certificate stating that he 1257 or she has examined a person within the preceding 48 hours and 1258 finds that the person appears to meet the criteria for 1259 involuntary examination and stating the observations upon which 1260 that conclusion is based. If other, less restrictive means, such 1261 as voluntary appearance for outpatient evaluation, are not 1262 available,such as voluntary appearance for outpatient1263evaluation,a law enforcement officer shall take into custody 1264 the person named in the certificateinto custodyand deliver him 1265 or her to the appropriatenearest receivingfacility within the 1266 designated receiving system for involuntary examination. The law 1267 enforcement officer shall execute a written report detailing the 1268 circumstances under which the person was taken into custody. The 1269 report and certificate shall be made a part of the patient’s 1270 clinical record. Anyreceivingfacility accepting the patient 1271 based on this certificate must send a copy of the certificate to 1272 the managing entityAgency for Health Care Administrationonthe 1273 next working day. The document may be submitted electronically 1274 through existing data systems, if applicable. 1275 (b) A person mayshallnot be removed from any program or 1276 residential placement licensed under chapter 400 or chapter 429 1277 and transported to a receiving facility for involuntary 1278 examination unless an ex parte order, a professional 1279 certificate, or a law enforcement officer’s report is first 1280 prepared. If the condition of the person is such that 1281 preparation of a law enforcement officer’s report is not 1282 practicable before removal, the report shall be completed as 1283 soon as possible after removal, but in any case before the 1284 person is transported to a receiving facility. Areceiving1285 facility admitting a person for involuntary examination who is 1286 not accompanied by the required ex parte order, professional 1287 certificate, or law enforcement officer’s report shall notify 1288 the managing entityAgency for Health Care Administrationof 1289 such admission by certified mail or by e-mail, if available, by 1290no later thanthe next working day. The provisions of this 1291 paragraph do not apply when transportation is provided by the 1292 patient’s family or guardian. 1293 (c) A law enforcement officer acting in accordance with an 1294 ex parte order issued pursuant to this subsection may serve and 1295 execute such order on any day of the week, at any time of the 1296 day or night. 1297 (d) A law enforcement officer acting in accordance with an 1298 ex parte order issued pursuant to this subsection may use such 1299 reasonable physical force as is necessary to gain entry to the 1300 premises, and any dwellings, buildings, or other structures 1301 located on the premises, and to take custody of the person who 1302 is the subject of the ex parte order. 1303 (e) The managing entity and the departmentAgency for1304Health Care Administrationshall receive and maintain the copies 1305 of ex parte petitions and orders, involuntary outpatient 1306 servicesplacementorders issued pursuant to s. 394.4655, 1307 involuntary inpatient placement orders issued pursuant to s. 1308 394.467, professional certificates, and law enforcement 1309 officers’ reports. These documents shall be considered part of 1310 the clinical record, governed by the provisions of s. 394.4615. 1311 These documents shall be used toThe agency shallprepare annual 1312 reports analyzing the data obtained from these documents, 1313 without information identifying patients, and shall provide 1314 copies of reports to the department, the President of the 1315 Senate, the Speaker of the House of Representatives, and the 1316 minority leaders of the Senate and the House of Representatives. 1317 (f) A patient shall be examined by a physician or,a 1318 clinical psychologist, or by a psychiatric nurse performing 1319 within the framework of an established protocol with a 1320 psychiatrist at areceivingfacility without unnecessary delay 1321 to determine if the criteria for involuntary services are met. 1322 Emergency treatment may be providedand may,upon the order of a 1323 physician, if the physician determinesbe given emergency1324treatment if it is determinedthat such treatment is necessary 1325 for the safety of the patient or others. The patient may not be 1326 released by the receiving facility or its contractor without the 1327 documented approval of a psychiatrist or a clinical psychologist 1328 or, if the receiving facility is owned or operated by a hospital 1329 or health system, the release may also be approved by a 1330 psychiatric nurse performing within the framework of an 1331 established protocol with a psychiatrist, or an attending 1332 emergency department physician with experience in the diagnosis 1333 and treatment of mental illnessand nervous disorders andafter 1334 completion of an involuntary examination pursuant to this 1335 subsection. A psychiatric nurse may not approve the release of a 1336 patient if the involuntary examination was initiated by a 1337 psychiatrist unless the release is approved by the initiating 1338 psychiatrist.However, a patient may not be held in a receiving1339facility for involuntary examination longer than 72 hours.1340 (g) A person may not be held for involuntary examination 1341 for more than 72 hours from the time of his or her arrival at 1342 the facility unless one of the following actions is taken at the 1343 end of the 72-hour examination period or the next business day 1344 after the end of the 72-hour examination period if the 1345 examination period ends on a weekend or holiday: 1346 1. The person must be released with the approval of a 1347 physician, psychiatrist, psychiatric nurse, or clinical 1348 psychologist. However, if the examination is conducted in a 1349 hospital, an attending emergency department physician with 1350 experience in the diagnosis and treatment of mental illness may 1351 approve the release. 1352 2. The person must be asked to give express and informed 1353 consent for voluntary admission if a physician, psychiatrist, 1354 psychiatric nurse, or clinical psychologist has determined that 1355 the individual is competent to consent to treatment. 1356 3. A petition for involuntary services must be completed 1357 and filed in the circuit court by the facility administrator. If 1358 electronic filing of the petition is not available in the county 1359 and the 72-hour period ends on a weekend or legal holiday, the 1360 petition must be filed by the next working day. If involuntary 1361 services are deemed necessary, the least restrictive treatment 1362 consistent with the optimum improvement of the person’s 1363 condition must be made available. 1364 (h) An individual discharged from a facility who is 1365 currently charged with a crime shall be released to the custody 1366 of a law enforcement officer, unless the individual has been 1367 released from law enforcement custody by posting of a bond, by a 1368 pretrial conditional release, or by other judicial release. 1369 (i)(g)A person for whom an involuntary examination has 1370 been initiated who is being evaluated or treated at a hospital 1371 for an emergency medical condition specified in s. 395.002 must 1372 be examined by an appropriatea receivingfacility within 72 1373 hours. The 72-hour period begins when the patient arrives at the 1374 hospital and ceases when the attending physician documents that 1375 the patient has an emergency medical condition. If the patient 1376 is examined at a hospital providing emergency medical services 1377 by a professional qualified to perform an involuntary 1378 examination and is found as a result of that examination not to 1379 meet the criteria for involuntary outpatient servicesplacement1380 pursuant to s. 394.4655(1) or involuntary inpatient placement 1381 pursuant to s. 394.467(1), the patient may be offered voluntary 1382 services or placement, if appropriate, or released directly from 1383 the hospital providing emergency medical services. The finding 1384 by the professional that the patient has been examined and does 1385 not meet the criteria for involuntary inpatient placement or 1386 involuntary outpatient servicesplacementmust be entered into 1387 the patient’s clinical record.Nothing inThis paragraph is not 1388 intended to prevent a hospital providing emergency medical 1389 services from appropriately transferring a patient to another 1390 hospital beforeprior tostabilization if, providedthe 1391 requirements of s. 395.1041(3)(c) have been met. 1392 (j)(h)One of the following must occur within 12 hours 1393 after the patient’s attending physician documents that the 1394 patient’s medical condition has stabilized or that an emergency 1395 medical condition does not exist: 1396 1. The patient must be examined by an appropriatea1397designated receivingfacility and released; or 1398 2. The patient must be transferred to a designated 1399receivingfacility in which appropriate medical treatment is 1400 available. However, thereceivingfacility must be notified of 1401 the transfer within 2 hours after the patient’s condition has 1402 been stabilized or after determination that an emergency medical 1403 condition does not exist. 1404(i) Within the 72-hour examination period or, if the 721405hours ends on a weekend or holiday, no later than the next1406working day thereafter, one of the following actions must be1407taken, based on the individual needs of the patient:14081. The patient shall be released, unless he or she is1409charged with a crime, in which case the patient shall be1410returned to the custody of a law enforcement officer;14112. The patient shall be released, subject to the provisions1412of subparagraph 1., for voluntary outpatient treatment;14133. The patient, unless he or she is charged with a crime,1414shall be asked to give express and informed consent to placement1415as a voluntary patient, and, if such consent is given, the1416patient shall be admitted as a voluntary patient; or14174. A petition for involuntary placement shall be filed in1418the circuit court when outpatient or inpatient treatment is1419deemed necessary. When inpatient treatment is deemed necessary,1420the least restrictive treatment consistent with the optimum1421improvement of the patient’s condition shall be made available.1422When a petition is to be filed for involuntary outpatient1423placement, it shall be filed by one of the petitioners specified1424in s. 394.4655(3)(a). A petition for involuntary inpatient1425placement shall be filed by the facility administrator.1426 Section 12. Section 394.4655, Florida Statutes, is amended 1427 to read: 1428 394.4655 Involuntary outpatient servicesplacement.— 1429 (1) CRITERIA FOR INVOLUNTARY OUTPATIENT SERVICES 1430PLACEMENT.—A person may be ordered to involuntary outpatient 1431 servicesplacementupon a finding of the court, by clear and 1432 convincing evidence, that the person meets all of the following 1433 criteriaby clear and convincing evidence: 1434 (a) The person is 18 years of age or older.;1435 (b) The person has a mental illness.;1436 (c) The person is unlikely to survive safely in the 1437 community without supervision, based on a clinical 1438 determination.;1439 (d) The person has a history of lack of compliance with 1440 treatment for mental illness.;1441 (e) The person has: 1442 1. At least twice within the immediately preceding 36 1443 months been involuntarily admitted to a receiving or treatment 1444 facility as defined in s. 394.455, or has received mental health 1445 services in a forensic or correctional facility. The 36-month 1446 period does not include any period during which the person was 1447 admitted or incarcerated; or 1448 2. Engaged in one or more acts of serious violent behavior 1449 toward self or others, or attempts at serious bodily harm to 1450 himself or herself or others, within the preceding 36 months.;1451 (f) The person is, as a result of his or her mental 1452 illness, unlikely to voluntarily participate in the recommended 1453 treatment plan andeither he or shehas refused voluntary 1454 servicesplacementfor treatment after sufficient and 1455 conscientious explanation and disclosure of why the services are 1456 necessarypurpose ofplacementfor treatmentorhe or sheis 1457 unable to determine for himself or herself whether services are 1458placement isnecessary.;1459 (g) In view of the person’s treatment history and current 1460 behavior, the person is in need of involuntary outpatient 1461 servicesplacementin order to prevent a relapse or 1462 deterioration that would be likely to result in serious bodily 1463 harm to himself or herself or others, or a substantial harm to 1464 his or her well-being as set forth in s. 394.463(1).;1465 (h) It is likely that the person will benefit from 1466 involuntary outpatient services.placement; and1467 (i) All available, less restrictive alternatives that would 1468 offer an opportunity for improvement of his or her condition 1469 have been judged to be inappropriate or unavailable. 1470 (2) INVOLUNTARY OUTPATIENT SERVICESPLACEMENT.— 1471 (a)1. A patient who is being recommended for involuntary 1472 outpatient servicesplacementby the administrator of the 1473receivingfacility where the patient has been examined may be 1474 retained by the facility after adherence to the notice 1475 procedures provided in s. 394.4599. The recommendation must be 1476 supported by the opinion of two qualified professionalsa1477psychiatrist and the second opinion of a clinical psychologist1478or another psychiatrist, both of whom have personally examined 1479 the patient within the preceding 72 hours, that the criteria for 1480 involuntary outpatient servicesplacementare met.However, in a1481county having a population of fewer than 50,000, if the1482administrator certifies that a psychiatrist or clinical1483psychologist is not available to provide the second opinion, the1484second opinion may be provided by a licensed physician who has1485postgraduate training and experience in diagnosis and treatment1486of mental and nervous disorders or by a psychiatric nurse. Any1487second opinion authorized in this subparagraph may be conducted1488through a face-to-face examination, in person or by electronic1489means.Such recommendation must be entered on an involuntary 1490 outpatient servicesplacementcertificate that authorizes the 1491receivingfacility to retain the patient pending completion of a 1492 hearing. The certificate mustshallbe made a part of the 1493 patient’s clinical record. 1494 2. If the patient has been stabilized and no longer meets 1495 the criteria for involuntary examination pursuant to s. 1496 394.463(1), the patient must be released from thereceiving1497 facility while awaiting the hearing for involuntary outpatient 1498 servicesplacement. Before filing a petition for involuntary 1499 outpatient servicestreatment, the administrator of thea1500receivingfacility or a designated department representative 1501 must identify the service provider that will have primary 1502 responsibility for service provision under an order for 1503 involuntary outpatient servicesplacement, unless the person is 1504 otherwise participating in outpatient psychiatric treatment and 1505 is not in need of public financing for that treatment, in which 1506 case the individual, if eligible, may be ordered to involuntary 1507 treatment pursuant to the existing psychiatric treatment 1508 relationship. 1509 3. The service provider shall prepare a written proposed 1510 treatment plan in consultation with the patient or the patient’s 1511 guardian advocate, if appointed, for the court’s consideration 1512 for inclusion in the involuntary outpatient servicesplacement1513 order. The service provider shall also provide a copy of the 1514 treatment plan that addresses the nature and extent of the 1515 mental illness and any co-occurring substance abuse disorders 1516 that necessitate involuntary outpatient services. The treatment 1517 plan must specify the likely level of care, including the use of 1518 medication, and anticipated discharge criteria for terminating 1519 involuntary outpatient services.The service provider shall also1520provide a copy of the proposed treatment plan to the patient and1521the administrator of the receiving facility. The treatment plan1522must specify the nature and extent of the patient’s mental1523illness, address the reduction of symptoms that necessitate1524involuntary outpatient placement, and include measurable goals1525and objectives for the services and treatment that are provided1526to treat the person’s mental illness and assist the person in1527living and functioning in the community or to prevent a relapse1528or deterioration.Service providers may select and supervise 1529 other individuals to implement specific aspects of the treatment 1530 plan. The services in thetreatmentplan must be deemed 1531 clinically appropriate by a physician, clinical psychologist, 1532 psychiatric nurse, mental health counselor, marriage and family 1533 therapist, or clinical social worker who consults with, or is 1534 employed or contracted by, the service provider. The service 1535 provider must certify to the court in the proposedtreatment1536 plan whether sufficient services for improvement and 1537 stabilization are currently available and whether the service 1538 provider agrees to provide those services. If the service 1539 provider certifies that the services in the proposed treatment 1540 plan are not available, the petitioner may not file the 1541 petition. The service provider must notify the managing entity 1542 as to the availability of the requested services. The managing 1543 entity must document such efforts to obtain the requested 1544 services. 1545 (b) If a patient in involuntary inpatient placement meets 1546 the criteria for involuntary outpatient servicesplacement, the 1547 administrator of thetreatmentfacility may, before the 1548 expiration of the period during which thetreatmentfacility is 1549 authorized to retain the patient, recommend involuntary 1550 outpatient servicesplacement. The recommendation must be 1551 supported by the opinion of two qualified professionalsa1552psychiatrist and the second opinion of a clinical psychologist1553or another psychiatrist, both of whom have personally examined 1554 the patient within the preceding 72 hours, that the criteria for 1555 involuntary outpatient servicesplacementare met.However, in a1556county having a population of fewer than 50,000, if the1557administrator certifies that a psychiatrist or clinical1558psychologist is not available to provide the second opinion, the1559second opinion may be provided by a licensed physician who has1560postgraduate training and experience in diagnosis and treatment1561of mental and nervous disorders or by a psychiatric nurse. Any1562second opinion authorized in this subparagraph may be conducted1563through a face-to-face examination, in person or by electronic1564means.Such recommendation must be entered on an involuntary 1565 outpatient servicesplacementcertificate, and the certificate 1566 must be made a part of the patient’s clinical record. 1567 (c)1. The administrator of the treatment facility shall 1568 provide a copy of the involuntary outpatient servicesplacement1569 certificate and a copy of the state mental health discharge form 1570 to the managing entitya department representativein the county 1571 where the patient will be residing. For persons who are leaving 1572 a state mental health treatment facility, the petition for 1573 involuntary outpatient servicesplacementmust be filed in the 1574 county where the patient will be residing. 1575 2. The service provider that will have primary 1576 responsibility for service provision shall be identified by the 1577 designated department representative beforeprior tothe order 1578 for involuntary outpatient servicesplacementand must, before 1579prior tofiling a petition for involuntary outpatient services 1580placement, certify to the court whether the services recommended 1581 in the patient’s discharge plan are availablein the local1582communityand whether the service provider agrees to provide 1583 those services. The service provider must develop with the 1584 patient, or the patient’s guardian advocate, if appointed, a 1585 treatment or service plan that addresses the needs identified in 1586 the discharge plan. The plan must be deemed to be clinically 1587 appropriate by a physician, clinical psychologist, psychiatric 1588 nurse, mental health counselor, marriage and family therapist, 1589 or clinical social worker, as defined in this chapter, who 1590 consults with, or is employed or contracted by, the service 1591 provider. 1592 3. If the service provider certifies that the services in 1593 the proposed treatment or service plan are not available, the 1594 petitioner may not file the petition. The service provider must 1595 notify the managing entity as to the availability of the 1596 requested services. The managing entity must document such 1597 efforts to obtain the requested services. 1598 (3) PETITION FOR INVOLUNTARY OUTPATIENT SERVICES 1599PLACEMENT.— 1600 (a) A petition for involuntary outpatient services 1601placementmay be filed by: 1602 1. The administrator of a receiving facility; or 1603 2. The administrator of a treatment facility. 1604 (b) Each required criterion for involuntary outpatient 1605 servicesplacementmust be alleged and substantiated in the 1606 petition for involuntary outpatient servicesplacement. A copy 1607 of the certificate recommending involuntary outpatient services 1608placementcompleted by twoaqualified professionals 1609professionalspecified in subsection (2)must be attached to the 1610 petition. A copy of the proposed treatment plan must be attached 1611 to the petition. Before the petition is filed, the service 1612 provider shall certify that the services in the proposed 1613treatmentplan are available. If the necessary services are not 1614 availablein the patient’s local community to respond to the1615person’s individual needs, the petition may not be filed. The 1616 service provider must notify the managing entity as to the 1617 availability of the requested services. The managing entity must 1618 document such efforts to obtain the requested services. 1619 (c) The petition for involuntary outpatient services 1620placementmust be filed in the county where the patient is 1621 located, unless the patient is being placed from a state 1622 treatment facility, in which case the petition must be filed in 1623 the county where the patient will reside. When the petition has 1624 been filed, the clerk of the court shall provide copies of the 1625 petition and the proposed treatment plan to the department, the 1626 managing entity, the patient, the patient’s guardian or 1627 representative, the state attorney, and the public defender or 1628 the patient’s private counsel. A fee may not be charged for 1629 filing a petition under this subsection. 1630 (4) APPOINTMENT OF COUNSEL.—Within 1 court working day 1631 after the filing of a petition for involuntary outpatient 1632 servicesplacement, the court shall appoint the public defender 1633 to represent the person who is the subject of the petition, 1634 unless the person is otherwise represented by counsel. The clerk 1635 of the court shall immediately notify the public defender of the 1636 appointment. The public defender shall represent the person 1637 until the petition is dismissed, the court order expires, or the 1638 patient is discharged from involuntary outpatient services 1639placement. An attorney who represents the patient must be 1640 providedshall haveaccess to the patient, witnesses, and 1641 records relevant to the presentation of the patient’s case and 1642 shall represent the interests of the patient, regardless of the 1643 source of payment to the attorney. 1644 (5) CONTINUANCE OF HEARING.—The patient is entitled, with 1645 the concurrence of the patient’s counsel, to at least one 1646 continuance of the hearing. The continuance shall be for a 1647 period of up to 4 weeks. 1648 (6) HEARING ON INVOLUNTARY OUTPATIENT SERVICESPLACEMENT.— 1649 (a)1. The court shall hold the hearing on involuntary 1650 outpatient servicesplacementwithin 5 working days after the 1651 filing of the petition, unless a continuance is granted. The 1652 hearing mustshallbe held in the county where the petition is 1653 filed, mustshallbe as convenient to the patient as is 1654 consistent with orderly procedure, and mustshallbe conducted 1655 in physical settings not likely to be injurious to the patient’s 1656 condition. If the court finds that the patient’s attendance at 1657 the hearing is not consistent with the best interests of the 1658 patient and if the patient’s counsel does not object, the court 1659 may waive the presence of the patient from all or any portion of 1660 the hearing. The state attorney for the circuit in which the 1661 patient is located shall represent the state, rather than the 1662 petitioner, as the real party in interest in the proceeding. 1663 2. The court may appoint a magistratemasterto preside at 1664 the hearing. One of the professionals who executed the 1665 involuntary outpatient servicesplacementcertificate shall be a 1666 witness. The patient and the patient’s guardian or 1667 representative shall be informed by the court of the right to an 1668 independent expert examination. If the patient cannot afford 1669 such an examination, the court shall ensure that one is 1670 provided, as otherwise provided by lawprovide for one. The 1671 independent expert’s report isshall beconfidential and not 1672 discoverable, unless the expert is to be called as a witness for 1673 the patient at the hearing. The court shall allow testimony from 1674 individuals, including family members, deemed by the court to be 1675 relevant under state law, regarding the person’s prior history 1676 and how that prior history relates to the person’s current 1677 condition. The testimony in the hearing must be given under 1678 oath, and the proceedings must be recorded. The patient may 1679 refuse to testify at the hearing. 1680 (b)1. If the court concludes that the patient meets the 1681 criteria for involuntary outpatient servicesplacementpursuant 1682 to subsection (1), the court shall issue an order for 1683 involuntary outpatient servicesplacement. The court order shall 1684 be for a period of up to 90 days6 months. The order must 1685 specify the nature and extent of the patient’s mental illness. 1686 The order of the court and the treatment plan mustshallbe made 1687 part of the patient’s clinical record. The service provider 1688 shall discharge a patient from involuntary outpatient services 1689placementwhen the order expires or any time the patient no 1690 longer meets the criteria for involuntary servicesplacement. 1691 Upon discharge, the service provider shall send a certificate of 1692 discharge to the court. 1693 2. The court may not order the department or the service 1694 provider to provide services if the program or service is not 1695 available in the patient’s local community, if there is no space 1696 available in the program or service for the patient, or if 1697 funding is not available for the program or service. The service 1698 provider must notify the managing entity as to the availability 1699 of the requested services. The managing entity must document 1700 such efforts to obtain the requested services. A copy of the 1701 order must be sent to the managing entityAgency for Health Care1702Administrationby the service provider within 1 working day 1703 after it is received from the court. The order may be submitted 1704 electronically through existing data systems. After the 1705placementorder for involuntary services is issued, the service 1706 provider and the patient may modifyprovisions ofthe treatment 1707 plan. For any material modification of the treatment plan to 1708 which the patient or, if one is appointed, the patient’s 1709 guardian advocate agrees,if appointed, does agree, the service 1710 provider shall send notice of the modification to the court. Any 1711 material modifications of the treatment plan which are contested 1712 by the patient or the patient’s guardian advocate, if applicable 1713appointed, must be approved or disapproved by the court 1714 consistent with subsection (2). 1715 3. If, in the clinical judgment of a physician, the patient 1716 has failed orhasrefused to comply with the treatment ordered 1717 by the court, and, in the clinical judgment of the physician, 1718 efforts were made to solicit compliance and the patient may meet 1719 the criteria for involuntary examination, a person may be 1720 brought to a receiving facility pursuant to s. 394.463. If, 1721 after examination, the patient does not meet the criteria for 1722 involuntary inpatient placement pursuant to s. 394.467, the 1723 patient must be discharged from thereceivingfacility. The 1724 involuntary outpatient servicesplacementorder shall remain in 1725 effect unless the service provider determines that the patient 1726 no longer meets the criteria for involuntary outpatient services 1727placementor until the order expires. The service provider must 1728 determine whether modifications should be made to the existing 1729 treatment plan and must attempt to continue to engage the 1730 patient in treatment. For any material modification of the 1731 treatment plan to which the patient or the patient’s guardian 1732 advocate, if applicableappointed, agreesdoes agree, the 1733 service provider shall send notice of the modification to the 1734 court. Any material modifications of the treatment plan which 1735 are contested by the patient or the patient’s guardian advocate, 1736 if applicableappointed, must be approved or disapproved by the 1737 court consistent with subsection (2). 1738 (c) If, at any time before the conclusion of the initial 1739 hearing on involuntary outpatient servicesplacement, it appears 1740 to the court that the person does not meet the criteria for 1741 involuntary outpatient servicesplacementunder this section 1742 but, instead, meets the criteria for involuntary inpatient 1743 placement, the court may order the person admitted for 1744 involuntary inpatient examination under s. 394.463. If the 1745 person instead meets the criteria for involuntary assessment, 1746 protective custody, or involuntary admission pursuant to s. 1747 397.675, the court may order the person to be admitted for 1748 involuntary assessment for a period of 5 days pursuant to s. 1749 397.6811. Thereafter, all proceedings areshall begoverned by 1750 chapter 397. 1751 (d) At the hearing on involuntary outpatient services 1752placement, the court shall consider testimony and evidence 1753 regarding the patient’s competence to consent to treatment. If 1754 the court finds that the patient is incompetent to consent to 1755 treatment, it shall appoint a guardian advocate as provided in 1756 s. 394.4598. The guardian advocate shall be appointed or 1757 discharged in accordance with s. 394.4598. 1758 (e) The administrator of the receiving facility or the 1759 designated department representative shall provide a copy of the 1760 court order and adequate documentation of a patient’s mental 1761 illness to the service provider for involuntary outpatient 1762 servicesplacement. Such documentation must include any advance 1763 directives made by the patient, a psychiatric evaluation of the 1764 patient, and any evaluations of the patient performed by a 1765clinicalpsychologist or a clinical social worker. 1766 (7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT SERVICES 1767PLACEMENT.— 1768 (a)1. If the person continues to meet the criteria for 1769 involuntary outpatient servicesplacement, the service provider 1770 shall, at least 10 days before the expiration of the period 1771 during which the treatment is ordered for the person, file in 1772 the circuit court a petition for continued involuntary 1773 outpatient servicesplacement. The court shall immediately 1774 schedule a hearing on the petition to be held within 15 days 1775 after the petition is filed. 1776 2. The existing involuntary outpatient servicesplacement1777 order remains in effect until disposition on the petition for 1778 continued involuntary outpatient servicesplacement. 1779 3. A certificate shall be attached to the petition which 1780 includes a statement from the person’s physician or clinical 1781 psychologist justifying the request, a brief description of the 1782 patient’s treatment during the time he or she was receiving 1783 involuntarily servicesplaced, and an individualized plan of 1784 continued treatment. 1785 4. The service provider shall develop the individualized 1786 plan of continued treatment in consultation with the patient or 1787 the patient’s guardian advocate, if applicableappointed. When 1788 the petition has been filed, the clerk of the court shall 1789 provide copies of the certificate and the individualized plan of 1790 continued treatment to the department, the patient, the 1791 patient’s guardian advocate, the state attorney, and the 1792 patient’s private counsel or the public defender. 1793 (b) Within 1 court working day after the filing of a 1794 petition for continued involuntary outpatient services 1795placement, the court shall appoint the public defender to 1796 represent the person who is the subject of the petition, unless 1797 the person is otherwise represented by counsel. The clerk of the 1798 court shall immediately notify the public defender of such 1799 appointment. The public defender shall represent the person 1800 until the petition is dismissed or the court order expires or 1801 the patient is discharged from involuntary outpatient services 1802placement. Any attorney representing the patient shall have 1803 access to the patient, witnesses, and records relevant to the 1804 presentation of the patient’s case and shall represent the 1805 interests of the patient, regardless of the source of payment to 1806 the attorney. 1807 (c) Hearings on petitions for continued involuntary 1808 outpatient services mustplacementshallbe before the circuit 1809 court. The court may appoint a magistratemasterto preside at 1810 the hearing. The procedures for obtaining an order pursuant to 1811 this paragraph must meet the requirements ofshall be in1812accordance withsubsection (6), except that the time period 1813 included in paragraph (1)(e) does not apply whenis not1814applicable indetermining the appropriateness of additional 1815 periods of involuntary outpatient servicesplacement. 1816 (d) Notice of the hearing mustshallbe provided as set 1817 forth in s. 394.4599. The patient and the patient’s attorney may 1818 agree to a period of continued outpatient servicesplacement1819 without a court hearing. 1820 (e) The same procedure mustshallbe repeated before the 1821 expiration of each additional period the patient is placed in 1822 treatment. 1823 (f) If the patient has previously been found incompetent to 1824 consent to treatment, the court shall consider testimony and 1825 evidence regarding the patient’s competence. Section 394.4598 1826 governs the discharge of the guardian advocate if the patient’s 1827 competency to consent to treatment has been restored. 1828 Section 13. Section 394.467, Florida Statutes, is amended 1829 to read: 1830 394.467 Involuntary inpatient placement.— 1831 (1) CRITERIA.—A person may be ordered forplaced in1832 involuntary inpatient placement for treatment upon a finding of 1833 the court by clear and convincing evidence that: 1834 (a) He or she has a mental illnessis mentally illand 1835 because of his or her mental illness: 1836 1.a. He or she has refused voluntary inpatient placement 1837 for treatment after sufficient and conscientious explanation and 1838 disclosure of the purpose of inpatient placement for treatment; 1839 or 1840 b. He or she is unable to determine for himself or herself 1841 whether inpatient placement is necessary; and 1842 2.a. He or she ismanifestlyincapable of surviving alone 1843 or with the help of willing and responsible family or friends, 1844 including available alternative services, and, without 1845 treatment, is likely to suffer from neglect or refuse to care 1846 for himself or herself, and such neglect or refusal poses a real 1847 and present threat of substantial harm to his or her well-being; 1848 or 1849 b. There is substantial likelihood that in the near future 1850 he or she will inflict serious bodily harm on self or others 1851himself or herself or another person, as evidenced by recent 1852 behavior causing, attempting, or threatening such harm; and 1853 (b) All available less restrictive treatment alternatives 1854 thatwhichwould offer an opportunity for improvement of his or 1855 her condition have been judged to be inappropriate. 1856 (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be 1857 retained by areceivingfacility or involuntarily placed in a 1858 treatment facility upon the recommendation of the administrator 1859 of thereceivingfacility where the patient has been examined 1860 and after adherence to the notice and hearing procedures 1861 provided in s. 394.4599. The recommendation must be supported by 1862 the opinion of two qualified professionalsof a psychiatrist and1863the second opinion of a clinical psychologist or another1864psychiatrist, both of whom have personally examined the patient 1865 within the preceding 72 hours, that the criteria for involuntary 1866 inpatient placement are met.However, in a county that has a1867population of fewer than 50,000, if the administrator certifies1868that a psychiatrist or clinical psychologist is not available to1869provide the second opinion, the second opinion may be provided1870by a licensed physician who has postgraduate training and1871experience in diagnosis and treatment of mental and nervous1872disorders or by a psychiatric nurse. Any second opinion1873authorized in this subsection may be conducted through a face1874to-face examination, in person or by electronic means.Such 1875 recommendation shall be entered on a petition foraninvoluntary 1876 inpatient placement certificate that authorizes thereceiving1877 facility to retain the patient pending transfer to a treatment 1878 facility or completion of a hearing. 1879 (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.— 1880 (a) The administrator of the facility shall file a petition 1881 for involuntary inpatient placement in the court in the county 1882 where the patient is located. Upon filing, the clerk of the 1883 court shall provide copies to the department, the patient, the 1884 patient’s guardian or representative, and the state attorney and 1885 public defender of the judicial circuit in which the patient is 1886 located. ANofee may notshallbe charged for the filing of a 1887 petition under this subsection. 1888 (b) A facility filing a petition under this subsection for 1889 involuntary inpatient placement shall send a copy of the 1890 petition to the managing entity in its area. 1891 (4) APPOINTMENT OF COUNSEL.—Within 1 court working day 1892 after the filing of a petition for involuntary inpatient 1893 placement, the court shall appoint the public defender to 1894 represent the person who is the subject of the petition, unless 1895 the person is otherwise represented by counsel. The clerk of the 1896 court shall immediately notify the public defender of such 1897 appointment. Any attorney representing the patient shall have 1898 access to the patient, witnesses, and records relevant to the 1899 presentation of the patient’s case and shall represent the 1900 interests of the patient, regardless of the source of payment to 1901 the attorney. 1902 (5) CONTINUANCE OF HEARING.—The patient is entitled, with 1903 the concurrence of the patient’s counsel, to at least one 1904 continuance of the hearing. The continuance shall befora1905periodofup to 4 weeks. 1906 (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.— 1907 (a)1. The court shall hold the hearing on involuntary 1908 inpatient placement within 5 court working days, unless a 1909 continuance is granted. 1910 2. Except for good cause documented in the court file, the 1911 hearing mustshallbe held in the county or the facility, as 1912 appropriate, where the patient is located, mustand shallbe as 1913 convenient to the patient as ismay beconsistent with orderly 1914 procedure, and shall be conducted in physical settings not 1915 likely to be injurious to the patient’s condition. If the court 1916 finds that the patient’s attendance at the hearing is not 1917 consistent with the best interests of the patient, and the 1918 patient’s counsel does not object, the court may waive the 1919 presence of the patient from all or any portion of the hearing. 1920 The state attorney for the circuit in which the patient is 1921 located shall represent the state, rather than the petitioning 1922 facility administrator, as the real party in interest in the 1923 proceeding. 1924 3.2.The court may appoint ageneral or specialmagistrate 1925 to preside at the hearing. One of the two professionals who 1926 executed the petition for involuntary inpatient placement 1927 certificate shall be a witness. The patient and the patient’s 1928 guardian or representative shall be informed by the court of the 1929 right to an independent expert examination. If the patient 1930 cannot afford such an examination, the court shall ensure that 1931 one is provided, as otherwise provided for by lawprovide for1932one. The independent expert’s report isshall beconfidential 1933 and not discoverable, unless the expert is to be called as a 1934 witness for the patient at the hearing. The testimony in the 1935 hearing must be given under oath, and the proceedings must be 1936 recorded. The patient may refuse to testify at the hearing. 1937 (b) If the court concludes that the patient meets the 1938 criteria for involuntary inpatient placement, it mayshallorder 1939 that the patient be transferred to a treatment facility or, if 1940 the patient is at a treatment facility, that the patient be 1941 retained there or be treated at any other appropriatereceiving1942or treatmentfacility, or that the patient receive services from 1943 such areceiving or treatmentfacility or service provider, on 1944 an involuntary basis, for a period of up to 90 days6 months. 1945 However, any order for involuntary mental health services in a 1946 treatment facility may be for up to 6 months. The order shall 1947 specify the nature and extent of the patient’s mental illness. 1948 The facility shall discharge a patient any time the patient no 1949 longer meets the criteria for involuntary inpatient placement, 1950 unless the patient has transferred to voluntary status. 1951 (c) If at any time beforeprior tothe conclusion of the 1952 hearing on involuntary inpatient placement it appears to the 1953 court that the person does not meet the criteria for involuntary 1954 inpatient placement under this section, but instead meets the 1955 criteria for involuntary outpatient servicesplacement, the 1956 court may order the person evaluated for involuntary outpatient 1957 servicesplacementpursuant to s. 394.4655. The petition and 1958 hearing procedures set forth in s. 394.4655 shall apply. If the 1959 person instead meets the criteria for involuntary assessment, 1960 protective custody, or involuntary admission pursuant to s. 1961 397.675, then the court may order the person to be admitted for 1962 involuntary assessment for a period of 5 days pursuant to s. 1963 397.6811. Thereafter, all proceedings areshall begoverned by 1964 chapter 397. 1965 (d) At the hearing on involuntary inpatient placement, the 1966 court shall consider testimony and evidence regarding the 1967 patient’s competence to consent to treatment. If the court finds 1968 that the patient is incompetent to consent to treatment, it 1969 shall appoint a guardian advocate as provided in s. 394.4598. 1970 (e) The administrator of the petitioningreceivingfacility 1971 shall provide a copy of the court order and adequate 1972 documentation of a patient’s mental illness to the administrator 1973 of a treatment facility if thewhenever apatient is ordered for 1974 involuntary inpatient placement, whether by civil or criminal 1975 court. The documentation mustshallinclude any advance 1976 directives made by the patient, a psychiatric evaluation of the 1977 patient, and any evaluations of the patient performed by a 1978 psychiatric nurse, clinical psychologist, a marriage and family 1979 therapist, a mental health counselor, or a clinical social 1980 worker. The administrator of a treatment facility may refuse 1981 admission to any patient directed to its facilities on an 1982 involuntary basis, whether by civil or criminal court order, who 1983 is not accompaniedat the same timeby adequate orders and 1984 documentation. 1985 (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT 1986 PLACEMENT.— 1987 (a) Hearings on petitions for continued involuntary 1988 inpatient placement of an individual placed at any treatment 1989 facility areshall beadministrative hearings and mustshallbe 1990 conducted in accordance withthe provisions ofs. 120.57(1), 1991 except that any order entered by the administrative law judge is 1992shall befinal and subject to judicial review in accordance with 1993 s. 120.68. Orders concerning patients committed after 1994 successfully pleading not guilty by reason of insanity areshall1995begoverned bythe provisions ofs. 916.15. 1996 (b) If the patient continues to meet the criteria for 1997 involuntary inpatient placement and is being treated at a 1998 treatment facility, the administrator shall, beforeprior tothe 1999 expiration of the periodduring whichthe treatment facility is 2000 authorized to retain the patient, file a petition requesting 2001 authorization for continued involuntary inpatient placement. The 2002 request mustshallbe accompanied by a statement from the 2003 patient’s physician, psychiatrist, psychiatric nurse, or 2004 clinical psychologist justifying the request, a brief 2005 description of the patient’s treatment during the time he or she 2006 was involuntarily placed, and an individualized plan of 2007 continued treatment. Notice of the hearing mustshallbe 2008 provided as providedset forthin s. 394.4599. If a patient’s 2009 attendance at the hearing is voluntarily waived, the 2010 administrative law judge must determine that the waiver is 2011 knowing and voluntary before waiving the presence of the patient 2012 from all or a portion of the hearing. Alternatively, if at the 2013 hearing the administrative law judge finds that attendance at 2014 the hearing is not consistent with the best interests of the 2015 patient, the administrative law judge may waive the presence of 2016 the patient from all or any portion of the hearing, unless the 2017 patient, through counsel, objects to the waiver of presence. The 2018 testimony in the hearing must be under oath, and the proceedings 2019 must be recorded. 2020 (c) Unless the patient is otherwise represented or is 2021 ineligible, he or she shall be represented at the hearing on the 2022 petition for continued involuntary inpatient placement by the 2023 public defender of the circuit in which the facility is located. 2024 (d) If at a hearing it is shown that the patient continues 2025 to meet the criteria for involuntary inpatient placement, the 2026 administrative law judge shall sign the order for continued 2027 involuntary inpatient placement for a period of up to 90 days 2028not to exceed 6 months. However, any order for involuntary 2029 mental health services in a treatment facility may be for up to 2030 6 months. The same procedure shall be repeated prior to the 2031 expiration of each additional period the patient is retained. 2032 (e) If continued involuntary inpatient placement is 2033 necessary for a patient admitted while serving a criminal 2034 sentence, but his or herwhosesentence is about to expire, or 2035 for a minorpatientinvoluntarily placed,while a minorbut who 2036 is about to reach the age of 18, the administrator shall 2037 petition the administrative law judge for an order authorizing 2038 continued involuntary inpatient placement. 2039 (f) If the patient has been previously found incompetent to 2040 consent to treatment, the administrative law judge shall 2041 consider testimony and evidence regarding the patient’s 2042 competence. If the administrative law judge finds evidence that 2043 the patient is now competent to consent to treatment, the 2044 administrative law judge may issue a recommended order to the 2045 court that found the patient incompetent to consent to treatment 2046 that the patient’s competence be restored and that any guardian 2047 advocate previously appointed be discharged. 2048 (g) If the patient has been ordered to undergo involuntary 2049 inpatient placement and has previously been found incompetent to 2050 consent to treatment, the court shall consider testimony and 2051 evidence regarding the patient’s incompetence. If the patient’s 2052 competency to consent to treatment is restored, the discharge of 2053 the guardian advocate shall be governed by the provisions of s. 2054 394.4598. 2055 2056 The procedure required in this subsection must be followed 2057 before the expiration of each additional period the patient is 2058 involuntarily receiving services. 2059 (8) RETURN TO FACILITYOF PATIENTS.—If a patient 2060 involuntarily heldWhena patientat a treatment facility under 2061 this part leaves the facility without the administrator’s 2062 authorization, the administrator may authorize a search for the 2063 patient and his or herthereturnof the patientto the 2064 facility. The administrator may request the assistance of a law 2065 enforcement agency in this regardthe search for and return of2066the patient. 2067 Section 14. Section 394.46715, Florida Statutes, is amended 2068 to read: 2069 394.46715 Rulemaking authority.—The department may adopt 2070 rules to administer this partDepartment of Children and2071Families shall have rulemaking authority to implement the2072provisions of ss. 394.455, 394.4598, 394.4615, 394.463,2073394.4655, and 394.467 as amended or created by this act. These2074rules shall be for the purpose of protecting the health, safety,2075and well-being of persons examined, treated, or placed under2076this act. 2077 Section 15. Section 394.656, Florida Statutes, is amended 2078 to read: 2079 394.656 Criminal Justice, Mental Health, and Substance 2080 Abuse Reinvestment Grant Program.— 2081 (1) There is created within the Department of Children and 2082 Families the Criminal Justice, Mental Health, and Substance 2083 Abuse Reinvestment Grant Program. The purpose of the program is 2084 to provide funding to countieswithwhich they may use tocan2085 plan, implement, or expand initiatives that increase public 2086 safety, avert increased spending on criminal justice, and 2087 improve the accessibility and effectiveness of treatment 2088 services for adults and juveniles who have a mental illness, 2089 substance abuse disorder, or co-occurring mental health and 2090 substance abuse disorders and who are in, or at risk of 2091 entering, the criminal or juvenile justice systems. 2092 (2) The department shall establish a Criminal Justice, 2093 Mental Health, and Substance Abuse Statewide Grant Review 2094 Committee. The committee shall include: 2095 (a) One representative of the Department of Children and 2096 Families; 2097 (b) One representative of the Department of Corrections; 2098 (c) One representative of the Department of Juvenile 2099 Justice; 2100 (d) One representative of the Department of Elderly 2101 Affairs;and2102 (e) One representative of the Office of the State Courts 2103 Administrator;.2104 (f) One representative of the Department of Veterans’ 2105 Affairs; 2106 (g) One representative of the Florida Sheriffs Association; 2107 (h) One representative of the Florida Police Chiefs 2108 Association; 2109 (i) One representative of the Florida Association of 2110 Counties; 2111 (j) One representative of the Florida Alcohol and Drug 2112 Abuse Association; 2113 (k) One representative of the Florida Association of 2114 Managing Entities; 2115 (l) One representative of the Florida Council for Community 2116 Mental Health; 2117 (m) One representative of the National Alliance of Mental 2118 Illness; 2119 (n) One representative of the Florida Prosecuting Attorneys 2120 Association; 2121 (o) One representative of the Florida Public Defender 2122 Association; and 2123 (p) One administrator of an assisted living facility that 2124 holds a limited mental health license. 2125 (3) The committee shall serve as the advisory body to 2126 review policy and funding issues that help reduce the impact of 2127 persons with mental illness and substance abuse disorders on 2128 communities, criminal justice agencies, and the court system. 2129 The committee shall advise the department in selecting 2130 priorities for grants and investing awarded grant moneys. 2131 (4) The committee must have experience in substance use and 2132 mental health disorders, community corrections, and law 2133 enforcement. To the extent possible, themembers of the2134 committee shall have expertise in grant reviewwriting, grant2135reviewing,and grant application scoring. 2136 (5)(a)(3)(a)A county, or a not-for-profit community 2137 provider or managing entity designated by the county planning 2138 council or committee, as described in s. 394.657, may apply for 2139 a 1-year planning grant or a 3-year implementation or expansion 2140 grant. The purpose of the grants is to demonstrate that 2141 investment in treatment efforts related to mental illness, 2142 substance abuse disorders, or co-occurring mental health and 2143 substance abuse disorders results in a reduced demand on the 2144 resources of the judicial, corrections, juvenile detention, and 2145 health and social services systems. 2146 (b) To be eligible to receive a 1-year planning grant or a 2147 3-year implementation or expansion grant:,2148 1. A county applicant must have acountyplanning council 2149 or committee that is in compliance with the membership 2150 requirements set forth in this section. 2151 2. A not-for-profit community provider or managing entity 2152 must be designated by the county planning council or committee 2153 and have written authorization to submit an application. A not 2154 for-profit community provider or managing entity must have 2155 written authorization for each submitted application. 2156 (c) The department may award a 3-year implementation or 2157 expansion grant to an applicant who has not received a 1-year 2158 planning grant. 2159 (d) The department may require an applicant to conduct 2160 sequential intercept mapping for a project. For purposes of this 2161 paragraph, the term “sequential intercept mapping” means a 2162 process for reviewing a local community’s mental health, 2163 substance abuse, criminal justice, and related systems and 2164 identifying points of interceptions where interventions may be 2165 made to prevent an individual with a substance abuse disorder or 2166 mental illness from deeper involvement in the criminal justice 2167 system. 2168 (6)(4)The grant review and selection committee shall 2169 select the grant recipients and notify the departmentof2170Children and Familiesin writing of the recipients’ namesof the2171applicants who have been selected by the committee to receive a2172grant. Contingent upon the availability of funds and upon 2173 notification by the grant review and selection committee of 2174 those applicants approved to receive planning, implementation, 2175 or expansion grants, the departmentof Children and Familiesmay 2176 transfer funds appropriated for the grant program to a selected 2177 grant recipientto any county awarded a grant. 2178 Section 16. Section 394.761, Florida Statutes, is created 2179 to read: 2180 394.761 Revenue maximization.—The department, in 2181 coordination with the Agency for Health Care Administration and 2182 the managing entities, shall compile detailed documentation of 2183 the cost and reimbursements for Medicaid covered services 2184 provided to Medicaid eligible individuals by providers of 2185 behavioral health services that are also funded for programs 2186 authorized by this chapter and chapter 397. The department’s 2187 documentation, along with a report of general revenue funds 2188 supporting behavioral health services that are not counted as 2189 maintenance of effort or match for any other federal program, 2190 will be submitted to the Agency for Health Care Administration 2191 by December 31, 2016. Copies of the report must also be provided 2192 to the Governor, the President of the Senate, and the Speaker of 2193 the House of Representatives. If this report presents clear 2194 evidence that Medicaid reimbursements are less than the costs of 2195 providing the services, the Agency for Health Care 2196 Administration and the Department of Children and Families shall 2197 prepare and submit any budget amendments necessary to use 2198 unmatched general revenue funds in the 2016-2017 fiscal year to 2199 draw additional federal funding to increase Medicaid funding to 2200 behavioral health service providers receiving the unmatched 2201 general revenue. Payments shall be made to providers in such 2202 manner as is allowed by federal law and regulations. 2203 Section 17. Subsection (11) is added to section 394.875, 2204 Florida Statutes, to read: 2205 394.875 Crisis stabilization units, residential treatment 2206 facilities, and residential treatment centers for children and 2207 adolescents; authorized services; license required.— 2208 (11) By January 1, 2017, the department and the agency 2209 shall modify licensure rules and procedures to create an option 2210 for a single, consolidated license for a provider who offers 2211 multiple types of mental health and substance abuse services 2212 regulated under this chapter and chapter 397. Providers eligible 2213 for a consolidated license shall operate these services through 2214 a single corporate entity and a unified management structure. 2215 Any provider serving adults and children must meet department 2216 standards for separate facilities and other requirements 2217 necessary to ensure children’s safety and promote therapeutic 2218 efficacy. 2219 Section 18. Section 394.9082, Florida Statutes, is amended 2220 to read: 2221 (Substantial rewording of section. See 2222 s. 394.9082, F.S., for present text.) 2223 394.9082 Behavioral health managing entities’ purpose; 2224 definitions; duties; contracting; accountability.— 2225 (1) PURPOSE.—The purpose of the behavioral health managing 2226 entities is to plan, coordinate and contract for the delivery of 2227 community mental health and substance abuse services, to improve 2228 access to care, to promote service continuity, to purchase 2229 services, and to support efficient and effective delivery of 2230 services. 2231 (2) DEFINITIONS.—As used in this section, the term: 2232 (a) “Behavioral health services” means mental health 2233 services and substance abuse prevention and treatment services 2234 as described in this chapter and chapter 397. 2235 (b) “Case management” means those direct services provided 2236 to a client in order to assess needs, plan or arrange services, 2237 coordinate service providers, monitor service delivery, and 2238 evaluate outcomes. 2239 (c) “Coordinated system of care” means the full array of 2240 behavioral health and related services in a region or a 2241 community offered by all service providers, whether 2242 participating under contract with the managing entity or through 2243 another method of community partnership or mutual agreement. 2244 (d) “Geographic area” means one or more contiguous 2245 counties, circuits, or regions as described in s. 409.966. 2246 (e) “High-need or high-utilization individual” means a 2247 recipient who meets one or more of the following criteria and 2248 may be eligible for intensive case management services: 2249 1. Has resided in a state mental health facility for at 2250 least 6 months in the last 36 months; 2251 2. Has had two or more admissions to a state mental health 2252 facility in the last 36 months; or 2253 3. Has had three or more admissions to a crisis 2254 stabilization unit, an addictions receiving facility, a short 2255 term residential detoxification facility, or an inpatient 2256 psychiatric unit within the last 12 months. 2257 (f) “Managed behavioral health organization” means a 2258 Medicaid managed care organization currently under contract with 2259 the statewide Medicaid managed medical assistance program in 2260 this state pursuant to part IV of chapter 409, including a 2261 managed care organization operating as a behavioral health 2262 specialty plan. 2263 (g) “Managing entity” means a corporation selected by and 2264 under contract with the department to manage the daily 2265 operational delivery of behavioral health services through a 2266 coordinated system of care. 2267 (h) “Provider network” means the group of direct service 2268 providers, facilities, and organizations under contract with a 2269 managing entity to provide a comprehensive array of emergency, 2270 acute care, residential, outpatient, recovery support, and 2271 consumer support services, including prevention services. 2272 (i) “Receiving facility” means any public or private 2273 facility designated by the department to receive and hold or to 2274 refer, as appropriate, involuntary patients under emergency 2275 conditions for mental health or substance abuse evaluation and 2276 to provide treatment or transportation to the appropriate 2277 service provider. County jails may not be used or designated as 2278 a receiving facility, a triage center, or an access center. 2279 (3) DEPARTMENT DUTIES.—The department shall: 2280 (a) Designate, with input from the managing entity, 2281 facilities that meet the definitions in s. 394.455(1), (2), 2282 (13), and (41) and the receiving system developed by one or more 2283 counties pursuant to s. 394.4573(2)(b). 2284 (b) Contract with organizations to serve as the managing 2285 entity in accordance with the requirements of this section. 2286 (c) Specify the geographic area served. 2287 (d) Specify data reporting and use of shared data systems. 2288 (e) Develop strategies to divert persons with mental 2289 illness or substance abuse disorders from the criminal and 2290 juvenile justice systems. 2291 (f) Support the development and implementation of a 2292 coordinated system of care by requiring each provider that 2293 receives state funds for behavioral health services through a 2294 direct contract with the department to work with the managing 2295 entity in the provider’s service area to coordinate the 2296 provision of behavioral health services, as part of the contract 2297 with the department. 2298 (g) Provide technical assistance to the managing entities. 2299 (h) Promote the integration of behavioral health care and 2300 primary care. 2301 (i) Facilitate the coordination between the managing entity 2302 and other payors of behavioral health care. 2303 (j) Develop and provide a unique identifier for clients 2304 receiving services under the managing entity to coordinate care. 2305 (k) Coordinate procedures for the referral and admission of 2306 patients to, and the discharge of patients from, state treatment 2307 facilities and their return to the community. 2308 (l) Ensure that managing entities comply with state and 2309 federal laws, rules, and regulations. 2310 (m) Develop rules for the operations of, and the 2311 requirements that must be met by, the managing entity, if 2312 necessary. 2313 (4) CONTRACTS FOR SERVICES.— 2314 (a) In contracting for services with managing entities 2315 under this section, the department must first attempt to 2316 contract with not-for-profit, community-based organizations that 2317 have competence in managing networks of providers serving 2318 persons with mental health and substance abuse disorders. 2319 (b) The department shall issue an invitation to negotiate 2320 under s. 287.057 to select an organization to serve as a 2321 managing entity. If the department receives fewer than two 2322 responsive bids to the solicitation, the department shall 2323 reissue the invitation to negotiate, in which case managed 2324 behavioral health organizations shall be eligible to bid and be 2325 awarded a contract. 2326 (c) If the managing entity is a not-for-profit, community 2327 based organization, it must have a governing board that is 2328 representative. At a minimum, the governing board must include 2329 consumers and their family members; representatives of local 2330 government, area law enforcement agencies, health care 2331 facilities, and community-based care lead agencies; business 2332 leaders; and providers of substance abuse and mental health 2333 services as defined in this chapter and chapter 397. 2334 (d) If the managing entity is a managed behavioral health 2335 organization, it must establish an advisory board that meets the 2336 same requirements specified in paragraph (c) for a governing 2337 board. 2338 (e) If the department issues an invitation to negotiate 2339 pursuant to paragraph (b), the department shall consider the 2340 advice and recommendations of the provider network and community 2341 stakeholders in determining the criteria and relative weight of 2342 the criteria that will be used in the solicitation of the new 2343 contractor. The department shall consider all of the following 2344 factors: 2345 1. Experience serving persons with mental health and 2346 substance abuse disorders. 2347 2. Establishment of community partnerships with behavioral 2348 health providers. 2349 3. Demonstrated organizational capabilities for network 2350 management functions. 2351 4. Capability to coordinate behavioral health with primary 2352 care services. 2353 (f) The department’s contracts with managing entities must 2354 support efficient and effective administration of the behavioral 2355 health system and ensure accountability for performance. 2356 (g) A contractor serving as a managing entity shall operate 2357 under the same data reporting, administrative, and 2358 administrative rate requirements, regardless of whether it is a 2359 for-profit or a not-for-profit entity. 2360 (h) The contract must designate the geographic area that 2361 will be served by the managing entity, which area must be of 2362 sufficient size in population, funding, and services to allow 2363 for flexibility and efficiency. 2364 (i) The contract must require that, when there is a change 2365 in the managing entity in a geographic area, a transition plan 2366 be developed and implemented by the department which ensures 2367 continuity of care for patients receiving behavioral health 2368 services. 2369 (j) By October 31, 2019, if all other contract requirements 2370 and performance standards are met and the department determines 2371 that the managing entity has made progress toward the 2372 implementation of a coordinated system of care in its geographic 2373 region, the department may continue its contract with the 2374 managing entity for up to, but not exceeding, 5 years, including 2375 any and all renewals and extensions. Thereafter, the department 2376 must issue a competitive solicitation pursuant to paragraph (b). 2377 (5) DUTIES OF MANAGING ENTITIES.—A managing entity shall: 2378 (a) Maintain a board of directors that is representative of 2379 the community and that, at a minimum, includes consumers and 2380 family members, community stakeholders and organizations, and 2381 providers of mental health and substance abuse services, 2382 including public and private receiving facilities. 2383 (b) Conduct a community behavioral health care needs 2384 assessment in the geographic area served by the managing entity. 2385 The needs assessment must be updated annually and provided to 2386 the department. The assessment must include, at a minimum, the 2387 information the department needs for its annual report to the 2388 Governor and Legislature pursuant to s. 394.4573. 2389 (c) Develop local resources by pursuing third-party 2390 payments for services, applying for grants, assisting providers 2391 in securing local matching funds and in-kind services, and any 2392 other methods needed to ensure services are available and 2393 accessible. 2394 (d) Provide assistance to counties to develop a designated 2395 receiving system pursuant to s. 394.4573(2)(b) and a 2396 transportation plan pursuant to s. 394.462. 2397 (e) Promote the development and effective implementation of 2398 a coordinated system of care pursuant to s. 394.4573. 2399 (f) Develop a comprehensive network of qualified providers 2400 to deliver behavioral health services. The managing entity is 2401 not required to competitively procure network providers, but 2402 must have a process in place to publicize opportunities to join 2403 the network and to evaluate providers in the network to 2404 determine if they can remain in the network. These processes 2405 must be published on the website of the managing entity. The 2406 managing entity must ensure continuity of care for clients if a 2407 provider ceases to provide a service or leaves the network. 2408 (g) Enter into cooperative agreements with local homeless 2409 councils and organizations to allow the sharing of available 2410 resource information, shared client information, client referral 2411 services, and any other data or information that may be useful 2412 in addressing the homelessness of persons suffering from a 2413 behavioral health crisis. All information sharing must comply 2414 with federal and state privacy and confidentiality laws, 2415 statutes and regulations. 2416 (h) Monitor network providers’ performance and their 2417 compliance with contract requirements and federal and state 2418 laws, rules, and regulations. 2419 (i) Provide or contract for case management services. 2420 (j) Manage and allocate funds for services to meet the 2421 requirements of law or rule. 2422 (k) Promote integration of behavioral health with primary 2423 care. 2424 (l) Implement shared data systems necessary for the 2425 delivery of coordinated care and integrated services, the 2426 assessment of managing entity performance and provider 2427 performance, and the reporting of outcomes and costs of 2428 services. 2429 (m) Operate in a transparent manner, providing public 2430 access to information, notice of meetings, and opportunities for 2431 public participation in managing entity decision-making. 2432 (n) Establish and maintain effective relationships with 2433 community stakeholders, including local governments and other 2434 organizations that serve individuals with behavioral health 2435 needs. 2436 (o) Collaborate with local criminal and juvenile justice 2437 systems to divert persons with mental illness or substance abuse 2438 disorders, or both, from the criminal and juvenile justice 2439 systems. 2440 (p) Collaborate with the local court system to develop 2441 procedures to maximize the use of involuntary outpatient 2442 services; reduce involuntary inpatient treatment; and increase 2443 diversion from the criminal and juvenile justice systems. 2444 (6) NETWORK ACCREDITATION AND SYSTEMS COORDINATION 2445 AGREEMENTS.— 2446 (a)1. The department shall identify acceptable 2447 accreditations which address coordination within a network and, 2448 if possible, between the network and major systems and programs 2449 with which the network interacts, such as the child welfare 2450 system, state courts system, and the Medicaid program. In 2451 identifying acceptable accreditations, the department shall 2452 consider whether the accreditation facilitates integrated 2453 strategic planning, resource coordination, technology 2454 integration, performance measurement, and increased value to 2455 consumers through choice of access to services, improved 2456 coordination of services, and effectiveness and efficiency of 2457 service delivery. 2458 2. All managing entities under contract as of July 1, 2016, 2459 shall earn accreditation deemed acceptable by the department 2460 pursuant to paragraph (a) by June 30, 2019. Managing entities 2461 whose initial contract with the state is executed after July 1, 2462 2016, shall earn network accreditation within 3 years after the 2463 contract execution date. Pursuant to paragraph (4)(j) above, the 2464 department may continue the contract of a managing entity that 2465 earns the network accreditation within the required timeframe 2466 and maintains it throughout the contract term. 2467 (b) If no accreditations are available or deemed acceptable 2468 which address coordination between the network and other major 2469 systems and programs, by July 1, 2017, for managing entities 2470 under contract as of July 1, 2016, and within one year after the 2471 contract execution date for managing entities initially under 2472 contract after that date, each managing entity shall enter into 2473 a memorandum of understanding detailing mechanisms for 2474 communication and coordination with any community-based care 2475 lead agencies, state court system, sheriff’s offices, public 2476 defenders, offices of regional conflict counsel Medicaid managed 2477 medical assistance plans, and homeless coalitions in its service 2478 area. Such entities shall cooperate with the managing entities 2479 in entering into such memoranda. 2480 (c) By February 1 of each year, beginning in 2018, each 2481 managing entity shall develop and submit to the department a 2482 plan for the enhancement of the behavioral health system of care 2483 of the managing entity’s service area, if appropriate, based on 2484 the assessed behavioral health care needs of the service area. 2485 Individual sections of the plan shall address: 2486 1. The designated receiving systems developed pursuant to 2487 s. 394.4573, and shall give consideration to evidence-based, 2488 evidence-informed, and innovative practices for diverting 2489 individuals from the acute behavioral health care system and 2490 addressing their needs once they are in the system in the most 2491 efficient and cost-effective manner. 2492 2. Treatment and recovery services, and shall emphasize the 2493 provision of care coordination and the use of recovery-oriented, 2494 peer-involved approaches. 2495 3. Coordination between the behavioral health system of 2496 care and other systems such as the child welfare system, state 2497 courts system and Medicaid program. 2498 (d) If the plan recommends additional funding, the plan 2499 shall describe, at a minimum, the specific needs that would be 2500 met, the specific services that would be purchased, the 2501 estimated benefits of the services, the projected costs, the 2502 projected number of individuals that would be served, and any 2503 other information indicating the estimated benefit to the 2504 community. The managing entity shall include consumers and their 2505 family members, local governments, law enforcement agencies, 2506 providers, community partners, and other stakeholders when 2507 developing the plan. 2508 (e) Subject to a specific appropriation by the Legislature, 2509 the department may award system improvement grants to managing 2510 entities based on the submission of the plans as described and 2511 required in paragraphs (c) and (d). 2512 (7) PERFORMANCE MEASUREMENT AND ACCOUNTABILITY.— 2513 (a) Managing entities shall collect and submit data to the 2514 department regarding persons served, outcomes of persons served, 2515 costs of services provided through the department’s contract, 2516 and other data as required by the department. 2517 (b) The department shall evaluate the managing entity’s 2518 performance and the overall progress made by the managing 2519 entity, together with other systems, in meeting the community’s 2520 behavioral health needs, based on consumer-centered outcome 2521 measures that reflect national standards, if possible, and that 2522 can dependably be measured. The department shall work with 2523 managing entities to establish performance standards related at 2524 a minimum to: 2525 1. The extent to which individuals in the community receive 2526 services. 2527 2. The improvement in the overall behavioral health of a 2528 community. 2529 3. The improvement in functioning or progress in the 2530 recovery of individuals served by the managing entity, as 2531 determined using person-centered measures tailored to the 2532 population. 2533 4. The success of strategies to divert admissions to acute 2534 levels of care, jails, prisons, and forensic facilities as 2535 measured by, at a minimum, the total number of percentage of 2536 clients who, during a specified period, experience multiple 2537 admissions to acute levels of care, jails, prisons, or forensic 2538 facilities. 2539 5. Consumer and family satisfaction. 2540 6. The satisfaction of key community constituencies such as 2541 law enforcement agencies, juvenile justice agencies, the state 2542 courts system, school districts, local government entities, 2543 hospitals, and others as appropriate for the geographical area 2544 of the managing entity. 2545 (8) FUNDING FOR MANAGING ENTITIES.— 2546 (a) A contract established between the department and a 2547 managing entity under this section must be funded by general 2548 revenue, other applicable state funds, or applicable federal 2549 funding sources. A managing entity may carry forward documented 2550 unexpended state funds from one fiscal year to the next, but the 2551 cumulative amount carried forward may not exceed 8 percent of 2552 the total value of the contract. Any unexpended state funds in 2553 excess of that percentage must be returned to the department. 2554 The funds carried forward may not be used in a way that would 2555 increase future recurring obligations or for any program or 2556 service that was not authorized as of July 1, 2016, under the 2557 existing contract with the department. Expenditures of funds 2558 carried forward must be separately reported to the department. 2559 Any unexpended funds that remain at the end of the contract 2560 period must be returned to the department. Funds carried forward 2561 may be retained through contract renewals and new contract 2562 procurements as long as the same managing entity is retained by 2563 the department. 2564 (b) The method of payment for a fixed-price contract with a 2565 managing entity must provide for a 2-month advance payment at 2566 the beginning of each fiscal year and equal monthly payments 2567 thereafter. 2568 (9) ACUTE CARE SERVICES UTILIZATION DATABASE.—The 2569 department shall develop, implement, and maintain standards 2570 under which a managing entity shall collect utilization data 2571 from all public receiving facilities situated within its 2572 geographic service area and all detoxification and addictions 2573 receiving facilities under contract with the managing entity. As 2574 used in this subsection, the term “public receiving facility” 2575 means an entity that meets the licensure requirements of, and is 2576 designated by, the department to operate as a public receiving 2577 facility under s. 394.875 and that is operating as a licensed 2578 crisis stabilization unit. 2579 (a) The department shall develop standards and protocols to 2580 be used for data collection, storage, transmittal, and analysis. 2581 The standards and protocols shall allow for compatibility of 2582 data and data transmittal between public receiving facilities, 2583 detoxification facilities, addiction receiving facilities, 2584 managing entities, and the department for the implement and 2585 requirements of this subsection. 2586 (b) A managing entity shall require providers specified in 2587 paragraph (1)(a) to submit data, in real time or at least daily, 2588 to the managing entity for: 2589 1. All admissions and discharges of clients receiving 2590 public receiving facility services who qualify as indigent, as 2591 defined in s. 394.4787; 2592 2. The current active census of total licensed beds, the 2593 number of beds purchased by the department, the number of 2594 clients qualifying as indigent who occupy those beds, and the 2595 total number of unoccupied licensed beds regardless of funding 2596 for each public receiving facility; 2597 3. All admissions and discharges of clients receiving 2598 substance abuse services in an addictions receiving facility or 2599 detoxification facility pursuant to parts IV and V of chapter 2600 397. 2601 (c) A managing entity shall require providers specified in 2602 paragraph (1)(a) to submit data, on a monthly basis, to the 2603 managing entity which aggregates the daily data submitted under 2604 paragraph (b). The managing entity shall reconcile the data in 2605 the monthly submission to the data received by the managing 2606 entity under paragraph (b) to check for consistency. If the 2607 monthly aggregate data submitted by a provider under this 2608 paragraph are inconsistent with the daily data submitted under 2609 paragraph (b), the managing entity shall consult with the 2610 provider to make corrections necessary to ensure accurate data. 2611 (d) A managing entity shall require providers specified in 2612 paragraph (1)(a)within its provider network to submit data, on 2613 an annual basis, to the managing entity which aggregates the 2614 data submitted and reconciled under paragraph (c). The managing 2615 entity shall reconcile the data in the annual submission to the 2616 data received and reconciled by the managing entity under 2617 paragraph (c) to check for consistency. If the annual aggregate 2618 data submitted by a provider under this paragraph are 2619 inconsistent with the data received and reconciled under 2620 paragraph (c), the managing entity shall consult with the 2621 provider to make corrections necessary to ensure accurate data. 2622 (e) After ensuring the accuracy of data pursuant to 2623 paragraphs (c) and (d), the managing entity shall submit the 2624 data to the department on a monthly and an annual basis. The 2625 department shall create a statewide database for the data 2626 described under paragraph (b) and submitted under this paragraph 2627 for the purpose of analyzing the payments for and the use of 2628 crisis stabilization services funded by the Baker Act and 2629 detoxification and addictions receiving services provided 2630 pursuant to parts IV and V of chapter 397 on a statewide basis 2631 and on an individual provider basis. 2632 Section 19. Present subsections (20) through (45) of 2633 section 397.311, Florida Statutes, are redesignated as 2634 subsections (22) through (47), respectively, new subsections 2635 (20) and (21) are added to that section, and present subsections 2636 (30) and (38) of that section are amended, to read: 2637 397.311 Definitions.—As used in this chapter, except part 2638 VIII, the term: 2639 (20) “Informed consent” means consent voluntarily given in 2640 writing by a competent person after sufficient explanation and 2641 disclosure of the subject matter involved to enable the person 2642 to make a knowing and willful decision without any element of 2643 force, fraud, deceit, duress, or other form of constraint or 2644 coercion. 2645 (21) “Involuntary services” means an array of behavioral 2646 health services that may be ordered by the court for persons 2647 with substance abuse or co-occurring mental health disorders. 2648 (32)(30)“Qualified professional” means a physician or a 2649 physician assistant licensed under chapter 458 or chapter 459; a 2650 professional licensed under chapter 490 or chapter 491; an 2651 advanced registered nurse practitionerhaving a specialty in2652psychiatrylicensed under part I of chapter 464; or a person who 2653 is certified through a department-recognized certification 2654 process for substance abuse treatment services and who holds, at 2655 a minimum, a bachelor’s degree. A person who is certified in 2656 substance abuse treatment services by a state-recognized 2657 certification process in another state at the time of employment 2658 with a licensed substance abuse provider in this state may 2659 perform the functions of a qualified professional as defined in 2660 this chapter but must meet certification requirements contained 2661 in this subsection no later than 1 year after his or her date of 2662 employment. 2663 (40)(38)“Service component” or “component” means a 2664 discrete operational entity within a service provider which is 2665 subject to licensing as defined by rule. Service components 2666 include prevention, intervention, and clinical treatment 2667 described in subsection (24)(22). 2668 Section 20. Section 397.675, Florida Statutes, is amended 2669 to read: 2670 397.675 Criteria for involuntary admissions, including 2671 protective custody, emergency admission, and other involuntary 2672 assessment, involuntary treatment, and alternative involuntary 2673 assessment for minors, for purposes of assessment and 2674 stabilization, and for involuntary treatment.—A person meets the 2675 criteria for involuntary admission if there is good faith reason 2676 to believe that the person has a substance abuse or co-occurring 2677 mental health disorderis substance abuse impairedand, because 2678 of such disorderimpairment: 2679 (1) Has lost the power of self-control with respect to 2680 substance abuseuse; andeither2681 (2)(a)Hasinflicted, or threatened or attempted to2682inflict, or unless admitted is likely to inflict, physical harm2683on himself or herself or another;or2684(b)Is in need of substance abuse services and, by reason 2685 of substance abuse impairment, his or her judgment has been so 2686 impaired that he or shethe personis incapable of appreciating 2687 his or her need for such services and of making a rational 2688 decision in that regard, althoughthereto; however,mere refusal 2689 to receive such services does not constitute evidence of lack of 2690 judgment with respect to his or her need for such services. 2691 (b) Without care or treatment, is likely to suffer from 2692 neglect or to refuse to care for himself or herself, that such 2693 neglect or refusal poses a real and present threat of 2694 substantial harm to his or her well-being and that it is not 2695 apparent that such harm may be avoided through the help of 2696 willing family members or friends or the provision of other 2697 services, or there is substantial likelihood that the person has 2698 inflicted, or threatened to or attempted to inflict, or, unless 2699 admitted, is likely to inflict, physical harm on himself, 2700 herself, or another. 2701 Section 21. Section 397.679, Florida Statutes, is amended 2702 to read: 2703 397.679 Emergency admission; circumstances justifying.—A 2704 person who meets the criteria for involuntary admission in s. 2705 397.675 may be admitted to a hospital or to a licensed 2706 detoxification facility or addictions receiving facility for 2707 emergency assessment and stabilization, or to a less intensive 2708 component of a licensed service provider for assessment only, 2709 upon receipt by the facility of athephysician’scertificate by 2710 a physician, an advanced registered nurse practitioner, a 2711 clinical psychologist, a licensed clinical social worker, a 2712 licensed marriage and family therapist, a licensed mental health 2713 counselor, a physician assistant working under the scope of 2714 practice of the supervising physician, or a master’s-level 2715 certified addictions professional, if the certificate is 2716 specific to substance abuse disorders, and the completion of an 2717 application for emergency admission. 2718 Section 22. Section 397.6791, Florida Statutes, is amended 2719 to read: 2720 397.6791 Emergency admission; persons who may initiate.—The 2721 following professionalspersonsmay request a certificate foran2722 emergency assessment or admission: 2723 (1) In the case of an adult, physicians, advanced 2724 registered nurse practitioners, clinical psychologists, licensed 2725 clinical social workers, licensed marriage and family 2726 therapists, licensed mental health counselors, physician 2727 assistants working under the scope of practice of the 2728 supervising physician, and a master’s-level-certified addictions 2729 professional, if the certificate is specific to substance abuse 2730 disordersthe certifying physician, the person’s spouse or legal 2731 guardian, any relative of the person, or any other responsible 2732 adult who has personal knowledge of the person’s substance abuse 2733 impairment. 2734 (2) In the case of a minor, the minor’s parent, legal 2735 guardian, or legal custodian. 2736 Section 23. Section 397.6793, Florida Statutes, is amended 2737 to read: 2738 397.6793 Professional’sPhysician’scertificate for 2739 emergency admission.— 2740 (1) The professional’sphysician’scertificate must include 2741 the name of the person to be admitted, the relationship between 2742 the person and the professional executing the certificate 2743physician, the relationship between the applicant and the 2744 professionalphysician, any relationship between the 2745 professionalphysicianand the licensed service provider,anda 2746 statement that the person has been examined and assessed within 2747 the preceding 5 days of the application date, andmust include2748 factual allegations with respect to the need for emergency 2749 admission, including: 2750 (a) The reason for thephysician’sbelief that the person 2751 is substance abuse impaired; and 2752 (b) The reason for thephysician’sbelief that because of 2753 such impairment the person has lost the power of self-control 2754 with respect to substance abuse; andeither2755 (c)1. The reason for the beliefphysicianbelievesthat, 2756 without care or treatment, the person is likely to suffer from 2757 neglect or refuse to care for himself or herself; that such 2758 neglect or refusal poses a real and present threat of 2759 substantial harm to his or her well-being; and that it is not 2760 apparent that such harm may be avoided through the help of 2761 willing family members or friends or the provision of other 2762 services or there is substantial likelihood that the person has 2763 inflicted or is likely to inflict physical harm on himself or 2764 herself or others unless admitted; or 2765 2. The reason for the beliefphysician believesthat the 2766 person’s refusal to voluntarily receive care is based on 2767 judgment so impaired by reason of substance abuse that the 2768 person is incapable of appreciating his or her need for care and 2769 of making a rational decision regarding his or her need for 2770 care. 2771 (2) The professional’sphysician’scertificate must 2772 recommend the least restrictive type of service that is 2773 appropriate for the person. The certificate must be signed by 2774 the professionalphysician. If other less restrictive means are 2775 not available, such as voluntary appearance for outpatient 2776 evaluation, a law enforcement officer shall take the person 2777 named in the certificate into custody and deliver him or her to 2778 the appropriate facility for involuntary examination. 2779 (3) A signed copy of the professional’sphysician’s2780 certificate shall accompany the person,and shall be made a part 2781 of the person’s clinical record, together with a signed copy of 2782 the application. The application and the professional’s 2783physician’scertificate authorize the involuntary admission of 2784 the person pursuant to, and subject to the provisions of, ss. 2785 397.679-397.6797. 2786 (4) The professional’s certificate is valid for 7 days 2787 after issuance. 2788 (5) The professional’sphysician’scertificate must 2789 indicate whether the person requires transportation assistance 2790 for delivery for emergency admission and specify, pursuant to s. 2791 397.6795, the type of transportation assistance necessary. 2792 Section 24. Section 397.6795, Florida Statutes, is amended 2793 to read: 2794 397.6795 Transportation-assisted delivery of persons for 2795 emergency assessment.—An applicant for a person’s emergency 2796 admission,orthe person’s spouse or guardian, or a law 2797 enforcement officer,or a health officermay deliver a person 2798 named in the professional’sphysician’scertificate for 2799 emergency admission to a hospital or a licensed detoxification 2800 facility or addictions receiving facility for emergency 2801 assessment and stabilization. 2802 Section 25. Subsection (1) of section 397.681, Florida 2803 Statutes, is amended to read: 2804 397.681 Involuntary petitions; general provisions; court 2805 jurisdiction and right to counsel.— 2806 (1) JURISDICTION.—The courts have jurisdiction of 2807 involuntary assessment and stabilization petitions and 2808 involuntary treatment petitions for substance abuse impaired 2809 persons, and such petitions must be filed with the clerk of the 2810 court in the county where the person is located. The clerk of 2811 the court may not charge a fee for the filing of a petition 2812 under this section. The chief judge may appoint a general or 2813 special magistrate to preside over all or part of the 2814 proceedings. The alleged impaired person is named as the 2815 respondent. 2816 Section 26. Subsection (1) of section 397.6811, Florida 2817 Statutes, is amended to read: 2818 397.6811 Involuntary assessment and stabilization.—A person 2819 determined by the court to appear to meet the criteria for 2820 involuntary admission under s. 397.675 may be admitted for a 2821 period of 5 days to a hospital or to a licensed detoxification 2822 facility or addictions receiving facility, for involuntary 2823 assessment and stabilization or to a less restrictive component 2824 of a licensed service provider for assessment only upon entry of 2825 a court order or upon receipt by the licensed service provider 2826 of a petition. Involuntary assessment and stabilization may be 2827 initiated by the submission of a petition to the court. 2828 (1) If the person upon whose behalf the petition is being 2829 filed is an adult, a petition for involuntary assessment and 2830 stabilization may be filed by the respondent’s spouse,orlegal 2831 guardian, any relative, a private practitioner, the director of 2832 a licensed service provider or the director’s designee, or any 2833 individualthree adultswho has directhavepersonal knowledge 2834 of the respondent’s substance abuse impairment. 2835 Section 27. Section 397.6814, Florida Statutes, is amended 2836 to read: 2837 397.6814 Involuntary assessment and stabilization; contents 2838 of petition.—A petition for involuntary assessment and 2839 stabilization must contain the name of the respondent,;the name 2840 of the applicant or applicants,;the relationship between the 2841 respondent and the applicant, and;the name of the respondent’s 2842 attorney, if known,and a statement of the respondent’s ability2843to afford an attorney;and must state facts to support the need 2844 for involuntary assessment and stabilization, including: 2845 (1) The reason for the petitioner’s belief that the 2846 respondent is substance abuse impaired;and2847 (2) The reason for the petitioner’s belief that because of 2848 such impairment the respondent has lost the power of self 2849 control with respect to substance abuse; andeither2850 (3)(a) The reason the petitioner believes that the 2851 respondent has inflicted or is likely to inflict physical harm 2852 on himself or herself or others unless admitted; or 2853 (b) The reason the petitioner believes that the 2854 respondent’s refusal to voluntarily receive care is based on 2855 judgment so impaired by reason of substance abuse that the 2856 respondent is incapable of appreciating his or her need for care 2857 and of making a rational decision regarding that need for care. 2858 If the respondent has refused to submit to an assessment, such 2859 refusal must be alleged in the petition. 2860 2861 A fee may not be charged for the filing of a petition pursuant 2862 to this section. 2863 Section 28. Section 397.6819, Florida Statutes, is amended 2864 to read: 2865 397.6819 Involuntary assessment and stabilization; 2866 responsibility of licensed service provider.— 2867 (1) A licensed service provider may admit an individual for 2868 involuntary assessment and stabilization for a period not to 2869 exceed 5 days unless a petition has been filed pursuant to s. 2870 397.6821 or s. 397.6822. The individual must be assessed within 2871 72 hourswithout unnecessary delayby a qualified professional. 2872 If an assessment is performed by a qualified professional who is 2873 not a physician, the assessment must be reviewed by a physician 2874 before the end of the assessment period. 2875 (2) The managing entity must be notified of the 2876 recommendation for involuntary services so that it may assist in 2877 locating and providing the requested services, if such services 2878 are available. The managing entity shall document its efforts to 2879 obtain the recommended services. 2880 Section 29. Section 397.695, Florida Statutes, is amended 2881 to read: 2882 397.695 Involuntary servicestreatment; persons who may 2883 petition.— 2884 (1)(a) If the respondent is an adult, a petition for 2885 involuntary servicestreatmentmay be filed by the respondent’s 2886 spouse or legal guardian, any relative, a service provider, or 2887 any individualthree adultswho has directhavepersonal 2888 knowledge of the respondent’s substance abuse impairment and his 2889 or her prior course of assessment and treatment. 2890 (2) If the respondent is a minor, a petition for 2891 involuntary treatment may be filed by a parent, legal guardian, 2892 or service provider. 2893 Section 30. Section 397.6951, Florida Statutes, is amended 2894 to read: 2895 397.6951 Contents of petition for involuntary services 2896treatment.—A petition for involuntary servicestreatmentmust 2897 contain the name of the respondentto be admitted; the name of 2898 the petitioner or petitioners; the relationship between the 2899 respondent and the petitioner; the name of the respondent’s 2900 attorney, if known, and a statement of the petitioner’s2901knowledge of the respondent’s ability to afford an attorney; the 2902 findings and recommendations of the assessment performed by the 2903 qualified professional; and the factual allegations presented by 2904 the petitioner establishing the need for involuntary outpatient 2905 services. The factual allegations must demonstratetreatment,2906including: 2907 (1) The reason for the petitioner’s belief that the 2908 respondent is substance abuse impaired;and2909 (2) The reason for the petitioner’s belief that because of 2910 such impairment the respondent has lost the power of self 2911 control with respect to substance abuse; and either 2912 (3)(a) The reason the petitioner believes that the 2913 respondent has inflicted or is likely to inflict physical harm 2914 on himself or herself or others unless the court orders the 2915 involuntary servicesadmitted; or 2916 (b) The reason the petitioner believes that the 2917 respondent’s refusal to voluntarily receive care is based on 2918 judgment so impaired by reason of substance abuse that the 2919 respondent is incapable of appreciating his or her need for care 2920 and of making a rational decision regarding that need for care. 2921 Section 31. Section 397.6955, Florida Statutes, is amended 2922 to read: 2923 397.6955 Duties of court upon filing of petition for 2924 involuntary servicestreatment.— 2925 (1) Upon the filing of a petition fortheinvoluntary 2926 services fortreatmentofa substance abuse impaired person with 2927 the clerk of the court, the court shall immediately determine 2928 whether the respondent is represented by an attorney or whether 2929 the appointment of counsel for the respondent is appropriate. If 2930 the court appoints counsel for the person, the clerk of the 2931 court shall immediately notify the regional conflict counsel, 2932 created pursuant to s. 27.511, of the appointment. The regional 2933 conflict counsel shall represent the person until the petition 2934 is dismissed, the court order expires, or the person is 2935 discharged from involuntary services. An attorney that 2936 represents the person named in the petition shall have access to 2937 the person, witnesses, and records relevant to the presentation 2938 of the person’s case and shall represent the interests of the 2939 person, regardless of the source of payment to the attorney. 2940 (2) The court shall schedule a hearing to be held on the 2941 petition within 510days unless a continuance is granted. The 2942 court may appoint a magistrate to preside at the hearing. 2943 (3) A copy of the petition and notice of the hearing must 2944 be provided to the respondent; the respondent’s parent, 2945 guardian, or legal custodian, in the case of a minor; the 2946 respondent’s attorney, if known; the petitioner; the 2947 respondent’s spouse or guardian, if applicable; and such other 2948 persons as the court may direct. If the respondent is a minor, a 2949 copy of the petition and notice of the hearing must beand have2950such petition and orderpersonally delivered to the respondent 2951if he or she is a minor. The court shall also issue a summons to 2952 the person whose admission is sought. 2953 Section 32. Section 397.6957, Florida Statutes, is amended 2954 to read: 2955 397.6957 Hearing on petition for involuntary services 2956treatment.— 2957 (1) At a hearing on a petition for involuntary services 2958treatment, the court shall hear and review all relevant 2959 evidence, including the review of results of the assessment 2960 completed by the qualified professional in connection with the 2961 respondent’s protective custody, emergency admission, 2962 involuntary assessment, or alternative involuntary admission. 2963 The respondent must be present unless the court finds that his 2964 or her presence is likely to be injurious to himself or herself 2965 or others, in which event the court must appoint a guardian 2966 advocate to act in behalf of the respondent throughout the 2967 proceedings. 2968 (2) The petitioner has the burden of proving by clear and 2969 convincing evidence that: 2970 (a) The respondent is substance abuse impaired and has a 2971 history of lack of compliance with treatment for substance 2972 abuse;,and 2973 (b) Because of such impairment the respondent is unlikely 2974 to voluntarily participate in the recommended services or is 2975 unable to determine for himself or herself whether services are 2976 necessarythe respondent has lost the power of self-control with2977respect to substance abuse;and:either2978 1. Without services, the respondent is likely to suffer 2979 from neglect or to refuse to care for himself or herself; that 2980 such neglect or refusal poses a real and present threat of 2981 substantial harm to his or her well-being; and that there is a 2982 substantial likelihood that without services the respondent will 2983 cause serious bodily harm to himself or herself or others in the 2984 near future, as evidenced by recent behaviorThe respondent has2985inflicted or is likely to inflict physical harm on himself or2986herself or others unless admitted; or 2987 2. The respondent’s refusal to voluntarily receive care is 2988 based on judgment so impaired by reason of substance abuse that 2989 the respondent is incapable of appreciating his or her need for 2990 care and of making a rational decision regarding that need for 2991 care. 2992 (3) One of the qualified professionals who executed the 2993 involuntary services certificate must be a witness. The court 2994 shall allow testimony from individuals, including family 2995 members, deemed by the court to be relevant under state law, 2996 regarding the respondent’s prior history and how that prior 2997 history relates to the person’s current condition. The testimony 2998 in the hearing must be under oath, and the proceedings must be 2999 recorded. The patient may refuse to testify at the hearing. 3000 (4)(3)At the conclusion of the hearing the court shall 3001eitherdismiss the petition or order the respondent to receive 3002undergoinvoluntary services from his or hersubstance abuse3003treatment, with the respondent’schosen licensed service 3004 provider ifto deliver the involuntarysubstance abuse treatment3005wherepossible and appropriate. 3006 Section 33. Section 397.697, Florida Statutes, is amended 3007 to read: 3008 397.697 Court determination; effect of court order for 3009 involuntary servicessubstance abuse treatment.— 3010 (1) When the court finds that the conditions for 3011 involuntary servicessubstance abuse treatmenthave been proved 3012 by clear and convincing evidence, it may order the respondent to 3013 receiveundergoinvoluntary services fromtreatmentbya 3014 licensed service provider for a period not to exceed 9060days. 3015 The court may order a respondent to undergo treatment through a 3016 privately funded licensed service provider if the respondent has 3017 the ability to pay for the treatment, or if any person on the 3018 respondent’s behalf voluntarily demonstrates a willingness and 3019 an ability to pay for the treatment. If the court finds it 3020 necessary, it may direct the sheriff to take the respondent into 3021 custody and deliver him or her to the licensed service provider 3022 specified in the court order, or to the nearest appropriate 3023 licensed service provider, for involuntary servicestreatment. 3024 When the conditions justifying involuntary servicestreatmentno 3025 longer exist, the individual must be released as provided in s. 3026 397.6971. When the conditions justifying involuntary services 3027treatmentare expected to exist after 9060days of services 3028treatment, a renewal of the involuntary servicestreatmentorder 3029 may be requested pursuant to s. 397.6975 beforeprior tothe end 3030 of the 9060-day period. 3031 (2) In all cases resulting in an order for involuntary 3032 servicessubstance abuse treatment, the court shall retain 3033 jurisdiction over the case and the parties for the entry of such 3034 further orders as the circumstances may require. The court’s 3035 requirements for notification of proposed release must be 3036 included in the originaltreatmentorder. 3037 (3) An involuntary servicestreatmentorder authorizes the 3038 licensed service provider to require the individual to receive 3039 services thatundergo such treatment aswill benefit him or her, 3040 including servicestreatmentat any licensable service component 3041 of a licensed service provider. 3042 (4) If the court orders involuntary services, a copy of the 3043 order must be sent to the managing entity within 1 working day 3044 after it is received from the court. Documents may be submitted 3045 electronically though existing data systems, if applicable. 3046 Section 34. Section 397.6971, Florida Statutes, is amended 3047 to read: 3048 397.6971 Early release from involuntary servicessubstance3049abuse treatment.— 3050 (1) At any time beforeprior tothe end of the 9060-day 3051 involuntary servicestreatmentperiod, orprior tothe end of 3052 any extension granted pursuant to s. 397.6975, an individual 3053 receivingadmitted forinvoluntary servicestreatmentmay be 3054 determined eligible for discharge to the most appropriate 3055 referral or disposition for the individual when any of the 3056 following apply: 3057 (a) The individual no longer meets the criteria for 3058 involuntary admission and has given his or her informed consent 3059 to be transferred to voluntary treatment status.;3060 (b) If the individual was admitted on the grounds of 3061 likelihood of infliction of physical harm upon himself or 3062 herself or others, such likelihood no longer exists.; or3063 (c) If the individual was admitted on the grounds of need 3064 for assessment and stabilization or treatment, accompanied by 3065 inability to make a determination respecting such need, either: 3066 1. Such inability no longer exists; or 3067 2. It is evident that further treatment will not bring 3068 about further significant improvements in the individual’s 3069 condition.;3070 (d) The individual is no longer in need of services.; or3071 (e) The director of the service provider determines that 3072 the individual is beyond the safe management capabilities of the 3073 provider. 3074 (2) Whenever a qualified professional determines that an 3075 individual admitted for involuntary services qualifiestreatment3076is readyfor early release underfor any of the reasons listed3077insubsection (1), the service provider shall immediately 3078 discharge the individual,and must notify all persons specified 3079 by the court in the original treatment order. 3080 Section 35. Section 397.6975, Florida Statutes, is amended 3081 to read: 3082 397.6975 Extension of involuntary servicessubstance abuse3083treatmentperiod.— 3084 (1) Whenever a service provider believes that an individual 3085 who is nearing the scheduled date of his or her release from 3086 involuntary servicestreatmentcontinues to meet the criteria 3087 for involuntary servicestreatmentin s. 397.693, a petition for 3088 renewal of the involuntary servicestreatmentorder may be filed 3089 with the court at least 10 days before the expiration of the 3090 court-ordered servicestreatmentperiod. The court shall 3091 immediately schedule a hearing to be held not more than 15 days 3092 after filing of the petition. The court shall provide the copy 3093 of the petition for renewal and the notice of the hearing to all 3094 parties to the proceeding. The hearing is conducted pursuant to 3095 s. 397.6957. 3096 (2) If the court finds that the petition for renewal of the 3097 involuntary servicestreatmentorder should be granted, it may 3098 order the respondent to receiveundergoinvoluntary services 3099treatmentfor a period not to exceed an additional 90 days. When 3100 the conditions justifying involuntary servicestreatmentno 3101 longer exist, the individual must be released as provided in s. 3102 397.6971. When the conditions justifying involuntary services 3103treatmentcontinue to exist after an additional 90 days of 3104 serviceadditional treatment, a new petition requesting renewal 3105 of the involuntary servicestreatmentorder may be filed 3106 pursuant to this section. 3107 (3) Within 1 court working day after the filing of a 3108 petition for continued involuntary services, the court shall 3109 appoint the regional conflict counsel to represent the 3110 respondent, unless the respondent is otherwise represented by 3111 counsel. The clerk of the court shall immediately notify the 3112 regional conflict counsel of such appointment. The regional 3113 conflict counsel shall represent the respondent until the 3114 petition is dismissed or the court order expires or the 3115 respondent is discharged from involuntary services. Any attorney 3116 representing the respondent shall have access to the respondent, 3117 witnesses, and records relevant to the presentation of the 3118 respondent’s case and shall represent the interests of the 3119 respondent, regardless of the source of payment to the attorney. 3120 (4) Hearings on petitions for continued involuntary 3121 services shall be before the circuit court. The court may 3122 appoint a magistrate to preside at the hearing. The procedures 3123 for obtaining an order pursuant to this section shall be in 3124 accordance with s. 397.697. 3125 (5) Notice of hearing shall be provided to the respondent 3126 or his or her counsel. The respondent and the respondent’s 3127 counsel may agree to a period of continued involuntary services 3128 without a court hearing. 3129 (6) The same procedure shall be repeated before the 3130 expiration of each additional period of involuntary services. 3131 (7) If the respondent has previously been found incompetent 3132 to consent to treatment, the court shall consider testimony and 3133 evidence regarding the respondent’s competence. 3134 Section 36. Section 397.6977, Florida Statutes, is amended 3135 to read: 3136 397.6977 Disposition of individual upon completion of 3137 involuntary servicessubstance abuse treatment.—At the 3138 conclusion of the 9060-day period of court-ordered involuntary 3139 servicestreatment, the respondentindividualis automatically 3140 discharged unless a motion for renewal of the involuntary 3141 servicestreatmentorder has been filed with the court pursuant 3142 to s. 397.6975. 3143 Section 37. Section 397.6978, Florida Statutes, is created 3144 to read: 3145 397.6978 Guardian advocate; patient incompetent to consent; 3146 substance abuse disorder.— 3147 (1) The administrator of a receiving facility or addictions 3148 receiving facility may petition the court for the appointment of 3149 a guardian advocate based upon the opinion of a qualified 3150 professional that the patient is incompetent to consent to 3151 treatment. If the court finds that a patient is incompetent to 3152 consent to treatment and has not been adjudicated incapacitated 3153 and that a guardian with the authority to consent to mental 3154 health treatment has not been appointed, it may appoint a 3155 guardian advocate. The patient has the right to have an attorney 3156 represent him or her at the hearing. If the person is indigent, 3157 the court shall appoint the office of the regional conflict 3158 counsel to represent him or her at the hearing. The patient has 3159 the right to testify, cross-examine witnesses, and present 3160 witnesses. The proceeding shall be recorded electronically or 3161 stenographically, and testimony must be provided under oath. One 3162 of the qualified professionals authorized to give an opinion in 3163 support of a petition for involuntary placement, as described in 3164 s. 397.675 or s. 397.6981, must testify. A guardian advocate 3165 must meet the qualifications of a guardian contained in part IV 3166 of chapter 744. The person who is appointed as a guardian 3167 advocate must agree to the appointment. 3168 (2) The following persons are prohibited from appointment 3169 as a patient’s guardian advocate: 3170 (a) A professional providing clinical services to the 3171 individual under this part. 3172 (b) The qualified professional who initiated the 3173 involuntary examination of the individual, if the examination 3174 was initiated by a qualified professional’s certificate. 3175 (c) An employee, an administrator, or a board member of the 3176 facility providing the examination of the individual. 3177 (d) An employee, an administrator, or a board member of the 3178 treatment facility providing treatment of the individual. 3179 (e) A person providing any substantial professional 3180 services, excluding public guardians or professional guardians, 3181 to the individual, including clinical services. 3182 (f) A creditor of the individual. 3183 (g) A person subject to an injunction for protection 3184 against domestic violence under s. 741.30, whether the order of 3185 injunction is temporary or final, and for which the individual 3186 was the petitioner. 3187 (h) A person subject to an injunction for protection 3188 against repeat violence, stalking, sexual violence, or dating 3189 violence under s. 784.046, whether the order of injunction is 3190 temporary or final, and for which the individual was the 3191 petitioner. 3192 (3) A facility requesting appointment of a guardian 3193 advocate must, before the appointment, provide the prospective 3194 guardian advocate with information about the duties and 3195 responsibilities of guardian advocates, including information 3196 about the ethics of medical decision-making. Before asking a 3197 guardian advocate to give consent to treatment for a patient, 3198 the facility must provide to the guardian advocate sufficient 3199 information so that the guardian advocate can decide whether to 3200 give express and informed consent to the treatment. Such 3201 information must include information that demonstrates that the 3202 treatment is essential to the care of the patient and does not 3203 present an unreasonable risk of serious, hazardous, or 3204 irreversible side effects. If possible, before giving consent to 3205 treatment, the guardian advocate must personally meet and talk 3206 with the patient and the patient’s physician. If that is not 3207 possible, the discussion may be conducted by telephone. The 3208 decision of the guardian advocate may be reviewed by the court, 3209 upon petition of the patient’s attorney, the patient’s family, 3210 or the facility administrator. 3211 (4) In lieu of the training required for guardians 3212 appointed pursuant to chapter 744, a guardian advocate shall 3213 attend at least a 4-hour training course approved by the court 3214 before exercising his or her authority. At a minimum, the 3215 training course must include information about patient rights, 3216 the diagnosis of substance abuse disorders, the ethics of 3217 medical decision-making, and the duties of guardian advocates. 3218 (5) The required training course and the information to be 3219 supplied to prospective guardian advocates before their 3220 appointment must be developed by the department, approved by the 3221 chief judge of the circuit court, and taught by a court-approved 3222 organization, which may include, but need not be limited to, a 3223 community college, a guardianship organization, a local bar 3224 association, or The Florida Bar. The training course may be web 3225 based, provided in video format, or other electronic means but 3226 must be capable of ensuring the identity and participation of 3227 the prospective guardian advocate. The court may waive some or 3228 all of the training requirements for guardian advocates or 3229 impose additional requirements. The court shall make its 3230 decision on a case-by-case basis and, in making its decision, 3231 shall consider the experience and education of the guardian 3232 advocate, the duties assigned to the guardian advocate, and the 3233 needs of the patient. 3234 (6) In selecting a guardian advocate, the court shall give 3235 preference to the patient’s health care surrogate, if one has 3236 already been designated by the patient. If the patient has not 3237 previously designated a health care surrogate, the selection 3238 shall be made, except for good cause documented in the court 3239 record, from among the following persons, listed in order of 3240 priority: 3241 (a) The patient’s spouse. 3242 (b) An adult child of the patient. 3243 (c) A parent of the patient. 3244 (d) The adult next of kin of the patient. 3245 (e) An adult friend of the patient. 3246 (f) An adult trained and willing to serve as the guardian 3247 advocate for the patient. 3248 (7) If a guardian with the authority to consent to medical 3249 treatment has not already been appointed, or if the patient has 3250 not already designated a health care surrogate, the court may 3251 authorize the guardian advocate to consent to medical treatment 3252 as well as substance abuse disorder treatment. Unless otherwise 3253 limited by the court, a guardian advocate with authority to 3254 consent to medical treatment has the same authority to make 3255 health care decisions and is subject to the same restrictions as 3256 a proxy appointed under part IV of chapter 765. Unless the 3257 guardian advocate has sought and received express court approval 3258 in a proceeding separate from the proceeding to determine the 3259 competence of the patient to consent to medical treatment, the 3260 guardian advocate may not consent to: 3261 (a) Abortion. 3262 (b) Sterilization. 3263 (c) Electroshock therapy. 3264 (d) Psychosurgery. 3265 (e) Experimental treatments that have not been approved by 3266 a federally approved institutional review board in accordance 3267 with 45 C.F.R. part 46 or 21 C.F.R. part 56. 3268 3269 The court must base its authorization on evidence that the 3270 treatment or procedure is essential to the care of the patient 3271 and that the treatment does not present an unreasonable risk of 3272 serious, hazardous, or irreversible side effects. In complying 3273 with this subsection, the court shall follow the procedures set 3274 forth in subsection (1). 3275 (8) The guardian advocate shall be discharged when the 3276 patient is discharged from an order for involuntary services or 3277 when the patient is transferred from involuntary to voluntary 3278 status. The court or a hearing officer shall consider the 3279 competence of the patient as provided in subsection (1) and may 3280 consider an involuntarily placed patient’s competence to consent 3281 to services at any hearing. Upon sufficient evidence, the court 3282 may restore, or the magistrate may recommend that the court 3283 restore, the patient’s competence. A copy of the order restoring 3284 competence or the certificate of discharge containing the 3285 restoration of competence shall be provided to the patient and 3286 the guardian advocate. 3287 Section 38. Present paragraphs (d) through (m) of 3288 subsection (2) of section 409.967, are redesignated as 3289 paragraphs (e) through (n), respectively, and a new paragraph 3290 (d) is added to that subsection, to read: 3291 409.967 Managed care plan accountability.— 3292 (2) The agency shall establish such contract requirements 3293 as are necessary for the operation of the statewide managed care 3294 program. In addition to any other provisions the agency may deem 3295 necessary, the contract must require: 3296 (d) Quality care.—Managed care plans shall provide, or 3297 contract for the provision of, care coordination to facilitate 3298 the appropriate delivery of behavioral health care services in 3299 the least restrictive setting with treatment and recovery 3300 capabilities that address the needs of the patient. Services 3301 shall be provided in a manner that integrates behavioral health 3302 services and primary care. Plans shall be required to achieve 3303 specific behavioral health outcome standards, established by the 3304 agency in consultation with the department. 3305 Section 39. Subsection (5) is added to section 409.973, 3306 Florida Statutes, to read: 3307 409.973 Benefits.— 3308 (5) INTEGRATED BEHAVIORAL HEALTH INITIATIVE.—Each plan 3309 operating in the managed medical assistance program shall work 3310 with the managing entity in its service area to establish 3311 specific organizational supports and protocols that enhance the 3312 integration and coordination of primary care and behavioral 3313 health services for Medicaid recipients. Progress in this 3314 initiative shall be measured using the integration framework and 3315 core measures developed by the Agency for Healthcare Research 3316 and Quality. 3317 Section 40. Section 491.0045, Florida Statutes, is amended 3318 to read: 3319 491.0045 Intern registration; requirements.— 3320 (1)Effective January 1, 1998,An individual who has not 3321 satisfiedintends to practice in Florida to satisfythe 3322 postgraduate or post-master’s level experience requirements, as 3323 specified in s. 491.005(1)(c), (3)(c), or (4)(c), must register 3324 as an intern in the profession for which he or she is seeking 3325 licensure prior to commencing the post-master’s experience 3326 requirement or an individual who intends to satisfy part of the 3327 required graduate-level practicum, internship, or field 3328 experience, outside the academic arena for any profession, must 3329 register as an intern in the profession for which he or she is 3330 seeking licensure prior to commencing the practicum, internship, 3331 or field experience. 3332 (2) The department shall register as a clinical social 3333 worker intern, marriage and family therapist intern, or mental 3334 health counselor intern each applicant who the board certifies 3335 has: 3336 (a) Completed the application form and remitted a 3337 nonrefundable application fee not to exceed $200, as set by 3338 board rule; 3339 (b)1. Completed the education requirements as specified in 3340 s. 491.005(1)(c), (3)(c), or (4)(c) for the profession for which 3341 he or she is applying for licensure, if needed; and 3342 2. Submitted an acceptable supervision plan, as determined 3343 by the board, for meeting the practicum, internship, or field 3344 work required for licensure that was not satisfied in his or her 3345 graduate program. 3346 (c) Identified a qualified supervisor. 3347 (3) An individual registered under this section must remain 3348 under supervision while practicing under registered intern 3349 statusuntil he or she is in receipt of a license or a letter3350from the department stating that he or she is licensed to3351practice the profession for which he or she applied. 3352(4) An individual who has applied for intern registration3353on or before December 31, 2001, and has satisfied the education3354requirements of s. 491.005 that are in effect through December335531, 2000, will have met the educational requirements for3356licensure for the profession for which he or she has applied.3357 (4)(5)An individual who failsIndividuals who have3358commenced the experience requirement as specified in s.3359491.005(1)(c), (3)(c), or (4)(c) but failed to register as3360required by subsection (1) shall register with the department3361before January 1, 2000. Individuals who failto comply with this 3362 section maysubsection shallnot be granted a license under this 3363 chapter, and any time spent by the individual completing the 3364 experience requirement as specified in s. 491.005(1)(c), (3)(c), 3365 or (4)(c) beforeprior toregistering as an intern doesshall3366 not count toward completion of thesuchrequirement. 3367 (5) An intern registration is valid for 5 years. 3368 (6) A registration issued on or before March 31, 2017, 3369 expires March 31, 2022, and may not be renewed or reissued. Any 3370 registration issued after March 31, 2017, expires 60 months 3371 after the date it is issued. A subsequent intern registration 3372 may not be issued unless the candidate has passed the theory and 3373 practice examination described in s. 491.005(1)(d), (3)(d), and 3374 (4)(d). 3375 (7) An individual who has held a provisional license issued 3376 by the board may not apply for an intern registration in the 3377 same profession. 3378 Section 41. Section 394.4674, Florida Statutes, is 3379 repealed. 3380 Section 42. Section 394.4985, Florida Statutes, is 3381 repealed. 3382 Section 43. Section 394.745, Florida Statutes, is repealed. 3383 Section 44. Section 397.331, Florida Statutes, is repealed. 3384 Section 45. Section 397.801, Florida Statutes, is repealed. 3385 Section 46. Section 397.811, Florida Statutes, is repealed. 3386 Section 47. Section 397.821, Florida Statutes, is repealed. 3387 Section 48. Section 397.901, Florida Statutes, is repealed. 3388 Section 49. Section 397.93, Florida Statutes, is repealed. 3389 Section 50. Section 397.94, Florida Statutes, is repealed. 3390 Section 51. Section 397.951, Florida Statutes, is repealed. 3391 Section 52. Section 397.97, Florida Statutes, is repealed. 3392 Section 53. Section 397.98, Florida Statutes, is repealed. 3393 Section 54. Paragraph (a) of subsection (3) of section 3394 39.407, Florida Statutes, is amended to read: 3395 39.407 Medical, psychiatric, and psychological examination 3396 and treatment of child; physical, mental, or substance abuse 3397 examination of person with or requesting child custody.— 3398 (3)(a)1. Except as otherwise provided in subparagraph (b)1. 3399 or paragraph (e), before the department provides psychotropic 3400 medications to a child in its custody, the prescribing physician 3401 shall attempt to obtain express and informed consent, as defined 3402 in s. 394.455(16)s. 394.455(9)and as described in s. 3403 394.459(3)(a), from the child’s parent or legal guardian. The 3404 department must take steps necessary to facilitate the inclusion 3405 of the parent in the child’s consultation with the physician. 3406 However, if the parental rights of the parent have been 3407 terminated, the parent’s location or identity is unknown or 3408 cannot reasonably be ascertained, or the parent declines to give 3409 express and informed consent, the department may, after 3410 consultation with the prescribing physician, seek court 3411 authorization to provide the psychotropic medications to the 3412 child. Unless parental rights have been terminated and if it is 3413 possible to do so, the department shall continue to involve the 3414 parent in the decisionmaking process regarding the provision of 3415 psychotropic medications. If, at any time, a parent whose 3416 parental rights have not been terminated provides express and 3417 informed consent to the provision of a psychotropic medication, 3418 the requirements of this section that the department seek court 3419 authorization do not apply to that medication until such time as 3420 the parent no longer consents. 3421 2. Any time the department seeks a medical evaluation to 3422 determine the need to initiate or continue a psychotropic 3423 medication for a child, the department must provide to the 3424 evaluating physician all pertinent medical information known to 3425 the department concerning that child. 3426 Section 55. Paragraph (e) of subsection (5) of section 3427 212.055, Florida Statutes, is amended to read: 3428 212.055 Discretionary sales surtaxes; legislative intent; 3429 authorization and use of proceeds.—It is the legislative intent 3430 that any authorization for imposition of a discretionary sales 3431 surtax shall be published in the Florida Statutes as a 3432 subsection of this section, irrespective of the duration of the 3433 levy. Each enactment shall specify the types of counties 3434 authorized to levy; the rate or rates which may be imposed; the 3435 maximum length of time the surtax may be imposed, if any; the 3436 procedure which must be followed to secure voter approval, if 3437 required; the purpose for which the proceeds may be expended; 3438 and such other requirements as the Legislature may provide. 3439 Taxable transactions and administrative procedures shall be as 3440 provided in s. 212.054. 3441 (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in 3442 s. 125.011(1) may levy the surtax authorized in this subsection 3443 pursuant to an ordinance either approved by extraordinary vote 3444 of the county commission or conditioned to take effect only upon 3445 approval by a majority vote of the electors of the county voting 3446 in a referendum. In a county as defined in s. 125.011(1), for 3447 the purposes of this subsection, “county public general 3448 hospital” means a general hospital as defined in s. 395.002 3449 which is owned, operated, maintained, or governed by the county 3450 or its agency, authority, or public health trust. 3451 (e) A governing board, agency, or authority shall be 3452 chartered by the county commission upon this act becoming law. 3453 The governing board, agency, or authority shall adopt and 3454 implement a health care plan for indigent health care services. 3455 The governing board, agency, or authority shall consist of no 3456 more than seven and no fewer than five members appointed by the 3457 county commission. The members of the governing board, agency, 3458 or authority shall be at least 18 years of age and residents of 3459 the county. No member may be employed by or affiliated with a 3460 health care provider or the public health trust, agency, or 3461 authority responsible for the county public general hospital. 3462 The following community organizations shall each appoint a 3463 representative to a nominating committee: the South Florida 3464 Hospital and Healthcare Association, the Miami-Dade County 3465 Public Health Trust, the Dade County Medical Association, the 3466 Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade 3467 County. This committee shall nominate between 10 and 14 county 3468 citizens for the governing board, agency, or authority. The 3469 slate shall be presented to the county commission and the county 3470 commission shall confirm the top five to seven nominees, 3471 depending on the size of the governing board. Until such time as 3472 the governing board, agency, or authority is created, the funds 3473 provided for in subparagraph (d)2. shall be placed in a 3474 restricted account set aside from other county funds and not 3475 disbursed by the county for any other purpose. 3476 1. The plan shall divide the county into a minimum of four 3477 and maximum of six service areas, with no more than one 3478 participant hospital per service area. The county public general 3479 hospital shall be designated as the provider for one of the 3480 service areas. Services shall be provided through participants’ 3481 primary acute care facilities. 3482 2. The plan and subsequent amendments to it shall fund a 3483 defined range of health care services for both indigent persons 3484 and the medically poor, including primary care, preventive care, 3485 hospital emergency room care, and hospital care necessary to 3486 stabilize the patient. For the purposes of this section, 3487 “stabilization” means stabilization as defined in s. 397.311(43) 3488s. 397.311(41). Where consistent with these objectives, the plan 3489 may include services rendered by physicians, clinics, community 3490 hospitals, and alternative delivery sites, as well as at least 3491 one regional referral hospital per service area. The plan shall 3492 provide that agreements negotiated between the governing board, 3493 agency, or authority and providers shall recognize hospitals 3494 that render a disproportionate share of indigent care, provide 3495 other incentives to promote the delivery of charity care to draw 3496 down federal funds where appropriate, and require cost 3497 containment, including, but not limited to, case management. 3498 From the funds specified in subparagraphs (d)1. and 2. for 3499 indigent health care services, service providers shall receive 3500 reimbursement at a Medicaid rate to be determined by the 3501 governing board, agency, or authority created pursuant to this 3502 paragraph for the initial emergency room visit, and a per-member 3503 per-month fee or capitation for those members enrolled in their 3504 service area, as compensation for the services rendered 3505 following the initial emergency visit. Except for provisions of 3506 emergency services, upon determination of eligibility, 3507 enrollment shall be deemed to have occurred at the time services 3508 were rendered. The provisions for specific reimbursement of 3509 emergency services shall be repealed on July 1, 2001, unless 3510 otherwise reenacted by the Legislature. The capitation amount or 3511 rate shall be determined beforeprior toprogram implementation 3512 by an independent actuarial consultant. In no event shall such 3513 reimbursement rates exceed the Medicaid rate. The plan must also 3514 provide that any hospitals owned and operated by government 3515 entities on or after the effective date of this act must, as a 3516 condition of receiving funds under this subsection, afford 3517 public access equal to that provided under s. 286.011 as to any 3518 meeting of the governing board, agency, or authority the subject 3519 of which is budgeting resources for the retention of charity 3520 care, as that term is defined in the rules of the Agency for 3521 Health Care Administration. The plan shall also include 3522 innovative health care programs that provide cost-effective 3523 alternatives to traditional methods of service and delivery 3524 funding. 3525 3. The plan’s benefits shall be made available to all 3526 county residents currently eligible to receive health care 3527 services as indigents or medically poor as defined in paragraph 3528 (4)(d). 3529 4. Eligible residents who participate in the health care 3530 plan shall receive coverage for a period of 12 months or the 3531 period extending from the time of enrollment to the end of the 3532 current fiscal year, per enrollment period, whichever is less. 3533 5. At the end of each fiscal year, the governing board, 3534 agency, or authority shall prepare an audit that reviews the 3535 budget of the plan, delivery of services, and quality of 3536 services, and makes recommendations to increase the plan’s 3537 efficiency. The audit shall take into account participant 3538 hospital satisfaction with the plan and assess the amount of 3539 poststabilization patient transfers requested, and accepted or 3540 denied, by the county public general hospital. 3541 Section 56. Paragraph (c) of subsection (2) of section 3542 394.4599, Florida Statutes, is amended to read: 3543 394.4599 Notice.— 3544 (2) INVOLUNTARY ADMISSION.— 3545 (c)1. A receiving facility shall give notice of the 3546 whereabouts of a minor who is being involuntarily held for 3547 examination pursuant to s. 394.463 to the minor’s parent, 3548 guardian, caregiver, or guardian advocate, in person or by 3549 telephone or other form of electronic communication, immediately 3550 after the minor’s arrival at the facility. The facility may 3551 delay notification for no more than 24 hours after the minor’s 3552 arrival if the facility has submitted a report to the central 3553 abuse hotline, pursuant to s. 39.201, based upon knowledge or 3554 suspicion of abuse, abandonment, or neglect and if the facility 3555 deems a delay in notification to be in the minor’s best 3556 interest. 3557 2. The receiving facility shall attempt to notify the 3558 minor’s parent, guardian, caregiver, or guardian advocate until 3559 the receiving facility receives confirmation from the parent, 3560 guardian, caregiver, or guardian advocate, verbally, by 3561 telephone or other form of electronic communication, or by 3562 recorded message, that notification has been received. Attempts 3563 to notify the parent, guardian, caregiver, or guardian advocate 3564 must be repeated at least once every hour during the first 12 3565 hours after the minor’s arrival and once every 24 hours 3566 thereafter and must continue until such confirmation is 3567 received, unless the minor is released at the end of the 72-hour 3568 examination period, or until a petition for involuntary services 3569placementis filed with the court pursuant to s. 394.463(2)(g) 3570s. 394.463(2)(i). The receiving facility may seek assistance 3571 from a law enforcement agency to notify the minor’s parent, 3572 guardian, caregiver, or guardian advocate if the facility has 3573 not received within the first 24 hours after the minor’s arrival 3574 a confirmation by the parent, guardian, caregiver, or guardian 3575 advocate that notification has been received. The receiving 3576 facility must document notification attempts in the minor’s 3577 clinical record. 3578 Section 57. Subsection (3) of section 394.495, Florida 3579 Statutes, is amended to read: 3580 394.495 Child and adolescent mental health system of care; 3581 programs and services.— 3582 (3) Assessments must be performed by: 3583 (a) A professional as defined in s. 394.455(6), (8), (34), 3584 (37), or (38)s. 394.455(2), (4), (21), (23), or (24); 3585 (b) A professional licensed under chapter 491; or 3586 (c) A person who is under the direct supervision of a 3587 professional as defined in s. 394.455(6), (8), (34), (37), or 3588 (38)s. 394.455(2), (4), (21), (23), or (24)or a professional 3589 licensed under chapter 491. 3590 Section 58. Subsection (5) of section 394.496, Florida 3591 Statutes, is amended to read: 3592 394.496 Service planning.— 3593 (5) A professional as defined in s. 394.455(6), (8), (34), 3594 (37), or (38)s. 394.455(2), (4), (21), (23), or (24)or a 3595 professional licensed under chapter 491 must be included among 3596 those persons developing the services plan. 3597 Section 59. Subsection (6) of section 394.9085, Florida 3598 Statutes, is amended to read: 3599 394.9085 Behavioral provider liability.— 3600 (6) For purposes of this section, the terms “detoxification 3601 services,” “addictions receiving facility,” and “receiving 3602 facility” have the same meanings as those provided in ss. 3603 397.311(24)(a)4., 397.311(24)(a)1., and 394.455(41)ss.3604397.311(22)(a)4., 397.311(22)(a)1., and 394.455(26), 3605 respectively. 3606 Section 60. Subsection (15) of section 397.321, Florida 3607 Statutes, is amended, and subsections (16) through (20) of that 3608 section are redesignated as subsections (15) through (19), 3609 respectively, to read: 3610 397.321 Duties of the department.—The department shall: 3611(15) Appoint a substance abuse impairment coordinator to3612represent the department in efforts initiated by the statewide3613substance abuse impairment prevention and treatment coordinator3614established in s. 397.801 and to assist the statewide3615coordinator in fulfilling the responsibilities of that position.3616 Section 61. Subsection (8) of section 397.405, Florida 3617 Statutes, is amended to read: 3618 397.405 Exemptions from licensure.—The following are exempt 3619 from the licensing provisions of this chapter: 3620 (8) A legally cognizable church or nonprofit religious 3621 organization or denomination providing substance abuse services, 3622 including prevention services, which are solely religious, 3623 spiritual, or ecclesiastical in nature. A church or nonprofit 3624 religious organization or denomination providing any of the 3625 licensed service components itemized under s. 397.311(24)s.3626397.311(22)is not exempt from substance abuse licensure but 3627 retains its exemption with respect to all services which are 3628 solely religious, spiritual, or ecclesiastical in nature. 3629 3630 The exemptions from licensure in this section do not apply to 3631 any service provider that receives an appropriation, grant, or 3632 contract from the state to operate as a service provider as 3633 defined in this chapter or to any substance abuse program 3634 regulated pursuant to s. 397.406. Furthermore, this chapter may 3635 not be construed to limit the practice of a physician or 3636 physician assistant licensed under chapter 458 or chapter 459, a 3637 psychologist licensed under chapter 490, a psychotherapist 3638 licensed under chapter 491, or an advanced registered nurse 3639 practitioner licensed under part I of chapter 464, who provides 3640 substance abuse treatment, so long as the physician, physician 3641 assistant, psychologist, psychotherapist, or advanced registered 3642 nurse practitioner does not represent to the public that he or 3643 she is a licensed service provider and does not provide services 3644 to individuals pursuant to part V of this chapter. Failure to 3645 comply with any requirement necessary to maintain an exempt 3646 status under this section is a misdemeanor of the first degree, 3647 punishable as provided in s. 775.082 or s. 775.083. 3648 Section 62. Subsections (1) and (5) of section 397.407, 3649 Florida Statutes, are amended to read: 3650 397.407 Licensure process; fees.— 3651 (1) The department shall establish the licensure process to 3652 include fees and categories of licenses and must prescribe a fee 3653 range that is based, at least in part, on the number and 3654 complexity of programs listed in s. 397.311(24)s. 397.311(22)3655 which are operated by a licensee. The fees from the licensure of 3656 service components are sufficient to cover at least 50 percent 3657 of the costs of regulating the service components. The 3658 department shall specify a fee range for public and privately 3659 funded licensed service providers. Fees for privately funded 3660 licensed service providers must exceed the fees for publicly 3661 funded licensed service providers. 3662 (5) The department may issue probationary, regular, and 3663 interim licenses. The department shall issue one license for 3664 each service component that is operated by a service provider 3665 and defined pursuant to s. 397.311(24)s. 397.311(22). The 3666 license is valid only for the specific service components listed 3667 for each specific location identified on the license. The 3668 licensed service provider shall apply for a new license at least 3669 60 days before the addition of any service components or 30 days 3670 before the relocation of any of its service sites. Provision of 3671 service components or delivery of services at a location not 3672 identified on the license may be considered an unlicensed 3673 operation that authorizes the department to seek an injunction 3674 against operation as provided in s. 397.401, in addition to 3675 other sanctions authorized by s. 397.415. Probationary and 3676 regular licenses may be issued only after all required 3677 information has been submitted. A license may not be 3678 transferred. As used in this subsection, the term “transfer” 3679 includes, but is not limited to, the transfer of a majority of 3680 the ownership interest in the licensed entity or transfer of 3681 responsibilities under the license to another entity by 3682 contractual arrangement. 3683 Section 63. Section 397.416, Florida Statutes, is amended 3684 to read: 3685 397.416 Substance abuse treatment services; qualified 3686 professional.—Notwithstanding any other provision of law, a 3687 person who was certified through a certification process 3688 recognized by the former Department of Health and Rehabilitative 3689 Services before January 1, 1995, may perform the duties of a 3690 qualified professional with respect to substance abuse treatment 3691 services as defined in this chapter, and need not meet the 3692 certification requirements contained in s. 397.311(32)s.3693397.311(30). 3694 Section 64. Subsection (2) of section 397.4871, Florida 3695 Statutes, is amended to read: 3696 397.4871 Recovery residence administrator certification.— 3697 (2) The department shall approve at least one credentialing 3698 entity by December 1, 2015, for the purpose of developing and 3699 administering a voluntary credentialing program for 3700 administrators. The department shall approve any credentialing 3701 entity that the department endorses pursuant to s. 397.321(15) 3702s. 397.321(16)if the credentialing entity also meets the 3703 requirements of this section. The approved credentialing entity 3704 shall: 3705 (a) Establish recovery residence administrator core 3706 competencies, certification requirements, testing instruments, 3707 and recertification requirements. 3708 (b) Establish a process to administer the certification 3709 application, award, and maintenance processes. 3710 (c) Develop and administer: 3711 1. A code of ethics and disciplinary process. 3712 2. Biennial continuing education requirements and annual 3713 certification renewal requirements. 3714 3. An education provider program to approve training 3715 entities that are qualified to provide precertification training 3716 to applicants and continuing education opportunities to 3717 certified persons. 3718 Section 65. Paragraph (e) of subsection (3) of section 3719 409.966, Florida Statutes, is amended to read: 3720 409.966 Eligible plans; selection.— 3721 (3) QUALITY SELECTION CRITERIA.— 3722 (e) To ensure managed care plan participation in Regions 1 3723 and 2, the agency shall award an additional contract to each 3724 plan with a contract award in Region 1 or Region 2. Such 3725 contract shall be in any other region in which the plan 3726 submitted a responsive bid and negotiates a rate acceptable to 3727 the agency. If a plan that is awarded an additional contract 3728 pursuant to this paragraph is subject to penalties pursuant to 3729 s. 409.967(2)(i)s. 409.967(2)(h)for activities in Region 1 or 3730 Region 2, the additional contract is automatically terminated 3731 180 days after the imposition of the penalties. The plan must 3732 reimburse the agency for the cost of enrollment changes and 3733 other transition activities. 3734 Section 66. Paragraph (b) of subsection (1) of section 3735 409.972, Florida Statutes, is amended to read: 3736 409.972 Mandatory and voluntary enrollment.— 3737 (1) The following Medicaid-eligible persons are exempt from 3738 mandatory managed care enrollment required by s. 409.965, and 3739 may voluntarily choose to participate in the managed medical 3740 assistance program: 3741 (b) Medicaid recipients residing in residential commitment 3742 facilities operated through the Department of Juvenile Justice 3743 or amental healthtreatment facilityfacilitiesas defined in 3744 s. 394.455(50)bys. 394.455(32). 3745 Section 67. Paragraphs (d) and (g) of subsection (1) of 3746 section 440.102, Florida Statutes, are amended to read: 3747 440.102 Drug-free workplace program requirements.—The 3748 following provisions apply to a drug-free workplace program 3749 implemented pursuant to law or to rules adopted by the Agency 3750 for Health Care Administration: 3751 (1) DEFINITIONS.—Except where the context otherwise 3752 requires, as used in this act: 3753 (d) “Drug rehabilitation program” means a service provider, 3754 established pursuant to s. 397.311(41)s. 397.311(39), that 3755 provides confidential, timely, and expert identification, 3756 assessment, and resolution of employee drug abuse. 3757 (g) “Employee assistance program” means an established 3758 program capable of providing expert assessment of employee 3759 personal concerns; confidential and timely identification 3760 services with regard to employee drug abuse; referrals of 3761 employees for appropriate diagnosis, treatment, and assistance; 3762 and followup services for employees who participate in the 3763 program or require monitoring after returning to work. If, in 3764 addition to the above activities, an employee assistance program 3765 provides diagnostic and treatment services, these services shall 3766 in all cases be provided by service providers pursuant to s. 3767 397.311(41)s. 397.311(39). 3768 Section 68. Subsection (7) of section 744.704, Florida 3769 Statutes, is amended to read: 3770 744.704 Powers and duties.— 3771 (7) A public guardian mayshallnot commit a ward to a 3772mental healthtreatment facility, as defined in s. 394.455(50) 3773s. 394.455(32), without an involuntary placement proceeding as 3774 provided by law. 3775 Section 69. Paragraph (a) of subsection (2) of section 3776 790.065, Florida Statutes, is amended to read: 3777 790.065 Sale and delivery of firearms.— 3778 (2) Upon receipt of a request for a criminal history record 3779 check, the Department of Law Enforcement shall, during the 3780 licensee’s call or by return call, forthwith: 3781 (a) Review any records available to determine if the 3782 potential buyer or transferee: 3783 1. Has been convicted of a felony and is prohibited from 3784 receipt or possession of a firearm pursuant to s. 790.23; 3785 2. Has been convicted of a misdemeanor crime of domestic 3786 violence, and therefore is prohibited from purchasing a firearm; 3787 3. Has had adjudication of guilt withheld or imposition of 3788 sentence suspended on any felony or misdemeanor crime of 3789 domestic violence unless 3 years have elapsed since probation or 3790 any other conditions set by the court have been fulfilled or 3791 expunction has occurred; or 3792 4. Has been adjudicated mentally defective or has been 3793 committed to a mental institution by a court or as provided in 3794 sub-sub-subparagraph b.(II), and as a result is prohibited by 3795 state or federal law from purchasing a firearm. 3796 a. As used in this subparagraph, “adjudicated mentally 3797 defective” means a determination by a court that a person, as a 3798 result of marked subnormal intelligence, or mental illness, 3799 incompetency, condition, or disease, is a danger to himself or 3800 herself or to others or lacks the mental capacity to contract or 3801 manage his or her own affairs. The phrase includes a judicial 3802 finding of incapacity under s. 744.331(6)(a), an acquittal by 3803 reason of insanity of a person charged with a criminal offense, 3804 and a judicial finding that a criminal defendant is not 3805 competent to stand trial. 3806 b. As used in this subparagraph, “committed to a mental 3807 institution” means: 3808 (I) Involuntary commitment, commitment for mental 3809 defectiveness or mental illness, and commitment for substance 3810 abuse. The phrase includes involuntary inpatient placement as 3811 defined in s. 394.467, involuntary outpatient servicesplacement3812 as defined in s. 394.4655, involuntary assessment and 3813 stabilization under s. 397.6818, and involuntary substance abuse 3814 treatment under s. 397.6957, but does not include a person in a 3815 mental institution for observation or discharged from a mental 3816 institution based upon the initial review by the physician or a 3817 voluntary admission to a mental institution; or 3818 (II) Notwithstanding sub-sub-subparagraph (I), voluntary 3819 admission to a mental institution for outpatient or inpatient 3820 treatment of a person who had an involuntary examination under 3821 s. 394.463, where each of the following conditions have been 3822 met: 3823 (A) An examining physician found that the person is an 3824 imminent danger to himself or herself or others. 3825 (B) The examining physician certified that if the person 3826 did not agree to voluntary treatment, a petition for involuntary 3827 outpatient or inpatient servicestreatmentwould have been filed 3828 under s. 394.463(2)(g)s. 394.463(2)(i)4., or the examining 3829 physician certified that a petition was filed and the person 3830 subsequently agreed to voluntary treatment beforeprior toa 3831 court hearing on the petition. 3832 (C) Before agreeing to voluntary treatment, the person 3833 received written notice of that finding and certification, and 3834 written notice that as a result of such finding, he or she may 3835 be prohibited from purchasing a firearm, and may not be eligible 3836 to apply for or retain a concealed weapon or firearms license 3837 under s. 790.06 and the person acknowledged such notice in 3838 writing, in substantially the following form: 3839 3840 “I understand that the doctor who examined me believes 3841 I am a danger to myself or to others. I understand 3842 that if I do not agree to voluntary treatment, a 3843 petition will be filed in court to require me to 3844 receive involuntary treatment. I understand that if 3845 that petition is filed, I have the right to contest 3846 it. In the event a petition has been filed, I 3847 understand that I can subsequently agree to voluntary 3848 treatment prior to a court hearing. I understand that 3849 by agreeing to voluntary treatment in either of these 3850 situations, I may be prohibited from buying firearms 3851 and from applying for or retaining a concealed weapons 3852 or firearms license until I apply for and receive 3853 relief from that restriction under Florida law.” 3854 3855 (D) A judge or a magistrate has, pursuant to sub-sub 3856 subparagraph c.(II), reviewed the record of the finding, 3857 certification, notice, and written acknowledgment classifying 3858 the person as an imminent danger to himself or herself or 3859 others, and ordered that such record be submitted to the 3860 department. 3861 c. In order to check for these conditions, the department 3862 shall compile and maintain an automated database of persons who 3863 are prohibited from purchasing a firearm based on court records 3864 of adjudications of mental defectiveness or commitments to 3865 mental institutions. 3866 (I) Except as provided in sub-sub-subparagraph (II), clerks 3867 of court shall submit these records to the department within 1 3868 month after the rendition of the adjudication or commitment. 3869 Reports shall be submitted in an automated format. The reports 3870 must, at a minimum, include the name, along with any known alias 3871 or former name, the sex, and the date of birth of the subject. 3872 (II) For persons committed to a mental institution pursuant 3873 to sub-sub-subparagraph b.(II), within 24 hours after the 3874 person’s agreement to voluntary admission, a record of the 3875 finding, certification, notice, and written acknowledgment must 3876 be filed by the administrator of the receiving or treatment 3877 facility, as defined in s. 394.455, with the clerk of the court 3878 for the county in which the involuntary examination under s. 3879 394.463 occurred. No fee shall be charged for the filing under 3880 this sub-sub-subparagraph. The clerk must present the records to 3881 a judge or magistrate within 24 hours after receipt of the 3882 records. A judge or magistrate is required and has the lawful 3883 authority to review the records ex parte and, if the judge or 3884 magistrate determines that the record supports the classifying 3885 of the person as an imminent danger to himself or herself or 3886 others, to order that the record be submitted to the department. 3887 If a judge or magistrate orders the submittal of the record to 3888 the department, the record must be submitted to the department 3889 within 24 hours. 3890 d. A person who has been adjudicated mentally defective or 3891 committed to a mental institution, as those terms are defined in 3892 this paragraph, may petition the circuit court that made the 3893 adjudication or commitment, or the court that ordered that the 3894 record be submitted to the department pursuant to sub-sub 3895 subparagraph c.(II), for relief from the firearm disabilities 3896 imposed by such adjudication or commitment. A copy of the 3897 petition shall be served on the state attorney for the county in 3898 which the person was adjudicated or committed. The state 3899 attorney may object to and present evidence relevant to the 3900 relief sought by the petition. The hearing on the petition may 3901 be open or closed as the petitioner may choose. The petitioner 3902 may present evidence and subpoena witnesses to appear at the 3903 hearing on the petition. The petitioner may confront and cross 3904 examine witnesses called by the state attorney. A record of the 3905 hearing shall be made by a certified court reporter or by court 3906 approved electronic means. The court shall make written findings 3907 of fact and conclusions of law on the issues before it and issue 3908 a final order. The court shall grant the relief requested in the 3909 petition if the court finds, based on the evidence presented 3910 with respect to the petitioner’s reputation, the petitioner’s 3911 mental health record and, if applicable, criminal history 3912 record, the circumstances surrounding the firearm disability, 3913 and any other evidence in the record, that the petitioner will 3914 not be likely to act in a manner that is dangerous to public 3915 safety and that granting the relief would not be contrary to the 3916 public interest. If the final order denies relief, the 3917 petitioner may not petition again for relief from firearm 3918 disabilities until 1 year after the date of the final order. The 3919 petitioner may seek judicial review of a final order denying 3920 relief in the district court of appeal having jurisdiction over 3921 the court that issued the order. The review shall be conducted 3922 de novo. Relief from a firearm disability granted under this 3923 sub-subparagraph has no effect on the loss of civil rights, 3924 including firearm rights, for any reason other than the 3925 particular adjudication of mental defectiveness or commitment to 3926 a mental institution from which relief is granted. 3927 e. Upon receipt of proper notice of relief from firearm 3928 disabilities granted under sub-subparagraph d., the department 3929 shall delete any mental health record of the person granted 3930 relief from the automated database of persons who are prohibited 3931 from purchasing a firearm based on court records of 3932 adjudications of mental defectiveness or commitments to mental 3933 institutions. 3934 f. The department is authorized to disclose data collected 3935 pursuant to this subparagraph to agencies of the Federal 3936 Government and other states for use exclusively in determining 3937 the lawfulness of a firearm sale or transfer. The department is 3938 also authorized to disclose this data to the Department of 3939 Agriculture and Consumer Services for purposes of determining 3940 eligibility for issuance of a concealed weapons or concealed 3941 firearms license and for determining whether a basis exists for 3942 revoking or suspending a previously issued license pursuant to 3943 s. 790.06(10). When a potential buyer or transferee appeals a 3944 nonapproval based on these records, the clerks of court and 3945 mental institutions shall, upon request by the department, 3946 provide information to help determine whether the potential 3947 buyer or transferee is the same person as the subject of the 3948 record. Photographs and any other data that could confirm or 3949 negate identity must be made available to the department for 3950 such purposes, notwithstanding any other provision of state law 3951 to the contrary. Any such information that is made confidential 3952 or exempt from disclosure by law shall retain such confidential 3953 or exempt status when transferred to the department. 3954 Section 70. The Secretary of the Department of Children and 3955 Families will appoint a workgroup to consider the feasibility of 3956 individuals using advance directives to express the treatment 3957 wishes for substance use disorders. The workgroup shall be 3958 composed of individuals with expertise in the treatment of 3959 substance use disorders. The workgroup must review the use of 3960 advance directives in mental health, the use of advance 3961 directives for substance use disorders in other states, and the 3962 use of similar legal instruments to express the treatment wishes 3963 of individuals suffering from substance use disorder. The 3964 workgroup will provide a report to the Governor, President of 3965 the Senate, and Speaker of the House by January 1, 2017. The 3966 report must include recommendations on the feasibility of using 3967 advance directives for individuals with substance use disorders 3968 and recommendations for any law changes or changes in agency 3969 rules. The members of the workgroup are not entitled to 3970 reimbursement from the Department of Children and Families for 3971 travel for workgroup meetings unless they are employees of the 3972 department. This section expires May 6, 2017. 3973 Section 71. This act shall take effect July 1, 2016.