Bill Text: FL S1418 | 2019 | Regular Session | Enrolled


Bill Title: Mental Health

Spectrum: Slight Partisan Bill (? 2-1)

Status: (Enrolled) 2019-05-01 - Ordered enrolled [S1418 Detail]

Download: Florida-2019-S1418-Enrolled.html
       ENROLLED
       2019 Legislature                           CS for CS for SB 1418
       
       
       
       
       
       
                                                             20191418er
    1  
    2         An act relating to mental health; amending s.
    3         394.4615, F.S.; requiring service providers to
    4         disclose information from a clinical record under
    5         certain circumstances relating to threats to cause
    6         serious bodily injury or death; requiring a law
    7         enforcement agency that receives notification of a
    8         specific threat to take appropriate action; providing
    9         immunity for service providers for certain actions;
   10         amending s. 394.463, F.S.; revising deadlines for
   11         submission of documentation regarding involuntary
   12         examinations; requiring that additional information be
   13         included in reports to the department; requiring the
   14         department to report to the Governor and Legislature
   15         on data collected from such reports; amending s.
   16         394.917, F.S.; revising the purpose of civil
   17         commitment of sexually violent predators to the
   18         department after completion of their criminal
   19         incarceration sentences; amending s. 456.059, F.S.;
   20         requiring psychiatrists to disclose certain patient
   21         communications for purposes of notifying law
   22         enforcement agencies of certain threats; requiring the
   23         notified law enforcement agency to take appropriate
   24         action to prevent the risk of harm to the victim;
   25         providing psychiatrists with immunity from specified
   26         liability and actions under certain circumstances;
   27         amending s. 490.0147, F.S.; requiring psychologists to
   28         disclose certain patient or client communications for
   29         purposes of notifying law enforcement agencies of
   30         certain threats; requiring the notified law
   31         enforcement agency to take appropriate action to
   32         prevent the risk of harm to the victim; providing
   33         psychologists with immunity from specified liability
   34         and actions under certain circumstances; amending s.
   35         491.0147, F.S.; requiring certain license holders and
   36         certificate holders to disclose certain patient or
   37         client communications for purposes of notifying law
   38         enforcement agencies of certain threats; requiring the
   39         notified law enforcement agency to take appropriate
   40         action to prevent the risk of harm to the victim;
   41         providing such persons with immunity from specified
   42         liability and actions; amending s. 1012.583, F.S.;
   43         revising responsibilities of the Department of
   44         Education and the Statewide Office for Suicide
   45         Prevention; revising criteria for designation as a
   46         Suicide Prevention Certified School; requiring that
   47         the department, schools, and school districts post
   48         certain information regarding such schools be posted
   49         on their respective websites; reenacting ss. 490.009
   50         and 491.009, F.S., relating to discipline of
   51         psychologists and other licensed therapists, to
   52         incorporate amendments made by the act; providing an
   53         effective date.
   54          
   55  Be It Enacted by the Legislature of the State of Florida:
   56  
   57         Section 1. Present subsections (4) through (11) of section
   58  394.4615, Florida Statutes, are renumbered as subsections (5)
   59  through (12), respectively, paragraph (a) of subsection (3) is
   60  amended, and a new subsection (4) is added to that section, to
   61  read:
   62         394.4615 Clinical records; confidentiality.—
   63         (3) Information from the clinical record may be released in
   64  the following circumstances:
   65         (a) When a patient has communicated to a service provider a
   66  specific threat to cause serious bodily injury or death to an
   67  identified or a readily available person, if the service
   68  provider reasonably believes, or should reasonably believe
   69  according to the standards of his or her profession, that the
   70  patient has the apparent intent and ability to imminently or
   71  immediately carry out such threat declared an intention to harm
   72  other persons. When such communication declaration has been
   73  made, the administrator may authorize the release of sufficient
   74  information to provide adequate warning to the person threatened
   75  with harm by the patient.
   76  
   77  For the purpose of determining whether a person meets the
   78  criteria for involuntary outpatient placement or for preparing
   79  the proposed treatment plan pursuant to s. 394.4655, the
   80  clinical record may be released to the state attorney, the
   81  public defender or the patient’s private legal counsel, the
   82  court, and to the appropriate mental health professionals,
   83  including the service provider identified in s.
   84  394.4655(7)(b)2., in accordance with state and federal law.
   85         (4)Information from the clinical record must be released
   86  when a patient has communicated to a service provider a specific
   87  threat to cause serious bodily injury or death to an identified
   88  or a readily available person, if the service provider
   89  reasonably believes, or should reasonably believe according to
   90  the standards of his or her profession, that the patient has the
   91  apparent intent and ability to imminently or immediately carry
   92  out such threat. When such communication has been made, the
   93  administrator must authorize the release of sufficient
   94  information to communicate the threat to law enforcement. A law
   95  enforcement agency that receives notification of a specific
   96  threat under this subsection must take appropriate action to
   97  prevent the risk of harm, including, but not limited to,
   98  notifying the intended victim of such threat or initiating a
   99  risk protection order. A service provider’s authorization to
  100  release information from a clinical record when communicating a
  101  threat pursuant to this section may not be the basis of any
  102  legal action or criminal or civil liability against the service
  103  provider.
  104         Section 2. Paragraph (a) of subsection (2) of section
  105  394.463, Florida Statutes, is amended, and subsection (4) is
  106  added to that section, to read:
  107         394.463 Involuntary examination.—
  108         (2) INVOLUNTARY EXAMINATION.—
  109         (a) An involuntary examination may be initiated by any one
  110  of the following means:
  111         1. A circuit or county court may enter an ex parte order
  112  stating that a person appears to meet the criteria for
  113  involuntary examination and specifying the findings on which
  114  that conclusion is based. The ex parte order for involuntary
  115  examination must be based on written or oral sworn testimony
  116  that includes specific facts that support the findings. If other
  117  less restrictive means are not available, such as voluntary
  118  appearance for outpatient evaluation, a law enforcement officer,
  119  or other designated agent of the court, shall take the person
  120  into custody and deliver him or her to an appropriate, or the
  121  nearest, facility within the designated receiving system
  122  pursuant to s. 394.462 for involuntary examination. The order of
  123  the court shall be made a part of the patient’s clinical record.
  124  A fee may not be charged for the filing of an order under this
  125  subsection. A facility accepting the patient based on this order
  126  must send a copy of the order to the department within 5 the
  127  next working days day. The order may be submitted electronically
  128  through existing data systems, if available. The order shall be
  129  valid only until the person is delivered to the facility or for
  130  the period specified in the order itself, whichever comes first.
  131  If no time limit is specified in the order, the order shall be
  132  valid for 7 days after the date that the order was signed.
  133         2. A law enforcement officer shall take a person who
  134  appears to meet the criteria for involuntary examination into
  135  custody and deliver the person or have him or her delivered to
  136  an appropriate, or the nearest, facility within the designated
  137  receiving system pursuant to s. 394.462 for examination. The
  138  officer shall execute a written report detailing the
  139  circumstances under which the person was taken into custody,
  140  which must be made a part of the patient’s clinical record. Any
  141  facility accepting the patient based on this report must send a
  142  copy of the report to the department within 5 the next working
  143  days day.
  144         3. A physician, clinical psychologist, psychiatric nurse,
  145  mental health counselor, marriage and family therapist, or
  146  clinical social worker may execute a certificate stating that he
  147  or she has examined a person within the preceding 48 hours and
  148  finds that the person appears to meet the criteria for
  149  involuntary examination and stating the observations upon which
  150  that conclusion is based. If other less restrictive means, such
  151  as voluntary appearance for outpatient evaluation, are not
  152  available, a law enforcement officer shall take into custody the
  153  person named in the certificate and deliver him or her to the
  154  appropriate, or nearest, facility within the designated
  155  receiving system pursuant to s. 394.462 for involuntary
  156  examination. The law enforcement officer shall execute a written
  157  report detailing the circumstances under which the person was
  158  taken into custody. The report and certificate shall be made a
  159  part of the patient’s clinical record. Any facility accepting
  160  the patient based on this certificate must send a copy of the
  161  certificate to the department within 5 the next working days
  162  day. The document may be submitted electronically through
  163  existing data systems, if applicable.
  164  
  165  When sending the order, report, or certificate to the
  166  department, a facility shall at a minimum provide information
  167  about which action was taken regarding the patient under
  168  paragraph (g), which information shall also be made a part of
  169  the patient’s clinical record.
  170         (4)DATA ANALYSIS.—Using data collected under paragraph
  171  (2)(a), the department shall, at a minimum, analyze data on the
  172  initiation of involuntary examinations of children, identify any
  173  patterns or trends and cases in which involuntary examinations
  174  are repeatedly initiated on the same child, study root causes
  175  for such patterns, trends, or repeated involuntary examinations,
  176  and make recommendations for encouraging alternatives to and
  177  eliminating inappropriate initiations of such examinations. The
  178  department shall submit a report on its findings and
  179  recommendations to the Governor, the President of the Senate,
  180  and the Speaker of the House of Representatives by November 1 of
  181  each odd numbered year.
  182         Section 3. Subsection (2) of section 394.917, Florida
  183  Statutes, is amended to read:
  184         394.917 Determination; commitment procedure; mistrials;
  185  housing; counsel and costs in indigent appellate cases.—
  186         (2) If the court or jury determines that the person is a
  187  sexually violent predator, upon the expiration of the
  188  incarcerative portion of all criminal sentences and disposition
  189  of any detainers, the person shall be committed to the custody
  190  of the Department of Children and Families for control, care,
  191  and treatment, and rehabilitation of criminal offenders, until
  192  such time as the person’s mental abnormality or personality
  193  disorder has so changed that it is safe for the person to be at
  194  large. At all times, persons who are detained or committed under
  195  this part shall be kept in a secure facility segregated from
  196  patients of the department who are not detained or committed
  197  under this part.
  198         Section 4. Section 456.059, Florida Statutes, is amended to
  199  read:
  200         456.059 Communications confidential; exceptions.
  201  Communications between a patient and a psychiatrist, as defined
  202  in s. 394.455, shall be held confidential and may shall not be
  203  disclosed except upon the request of the patient or the
  204  patient’s legal representative. Provision of psychiatric records
  205  and reports are shall be governed by s. 456.057. Notwithstanding
  206  any other provision of this section or s. 90.503, when where:
  207         (1) A patient is engaged in a treatment relationship with a
  208  psychiatrist;
  209         (2) Such patient has communicated to the psychiatrist a
  210  specific threat to cause serious bodily injury or death to an
  211  identified or a readily available person made an actual threat
  212  to physically harm an identifiable victim or victims; and
  213         (3) The treating psychiatrist makes a clinical judgment
  214  that the patient has the apparent intent and ability to
  215  imminently or immediately carry out such threat capability to
  216  commit such an act and that it is more likely than not that in
  217  the near future the patient will carry out that threat,
  218  
  219  the psychiatrist may disclose patient communications to the
  220  extent necessary to warn any potential victim or and must
  221  disclose patient communications to the extent necessary to
  222  communicate the threat to a law enforcement agency. A law
  223  enforcement agency that receives notification of a specific
  224  threat under this subsection must take appropriate action to
  225  prevent the risk of harm, including, but not limited to,
  226  notifying the intended victim of such threat or initiating a
  227  risk protection order. A psychiatrist’s disclosure of
  228  confidential communications when communicating a threat pursuant
  229  to this section may not be the basis of any legal action or
  230  criminal or civil liability against the psychiatrist No civil or
  231  criminal action shall be instituted, and there shall be no
  232  liability on account of disclosure of otherwise confidential
  233  communications by a psychiatrist in disclosing a threat pursuant
  234  to this section.
  235         Section 5. Section 490.0147, Florida Statutes, is amended
  236  to read:
  237         490.0147 Confidentiality and privileged communications.—
  238         (1) Any communication between a psychologist any person
  239  licensed under this chapter and her or his patient or client is
  240  shall be confidential. This privilege may be waived under the
  241  following conditions:
  242         (a)(1) When the psychologist person licensed under this
  243  chapter is a party defendant to a civil, criminal, or
  244  disciplinary action arising from a complaint filed by the
  245  patient or client, in which case the waiver shall be limited to
  246  that action.;
  247         (b)(2) When the patient or client agrees to the waiver, in
  248  writing, or when more than one person in a family is receiving
  249  therapy, when each family member agrees to the waiver, in
  250  writing.; or
  251         (c)(3) When a patient or client has communicated to the
  252  psychologist a specific threat to cause serious bodily injury or
  253  death to an identified or readily available person, and the
  254  psychologist makes a clinical judgment that the patient or
  255  client has the apparent intent and ability to imminently or
  256  immediately carry out such threat and the psychologist there is
  257  a clear and immediate probability of physical harm to the
  258  patient or client, to other individuals, or to society and the
  259  person licensed under this chapter communicates the information
  260  only to the potential victim, appropriate family member, or law
  261  enforcement or other appropriate authorities. A disclosure of
  262  confidential communications by a psychologist when communicating
  263  a threat pursuant to this subsection may not be the basis of any
  264  legal action or criminal or civil liability against the
  265  psychologist.
  266         (2)Such privilege must be waived, and the psychologist
  267  shall disclose patient or client communications to the extent
  268  necessary to communicate the threat to a law enforcement agency,
  269  if a patient or client has communicated to the psychologist a
  270  specific threat to cause serious bodily injury or death to an
  271  identified or readily available person, and the psychologist
  272  makes a clinical judgment that the patient or client has the
  273  apparent intent and ability to imminently or immediately carry
  274  out such threat. A law enforcement agency that receives
  275  notification of a specific threat under this subsection must
  276  take appropriate action to prevent the risk of harm, including,
  277  but not limited to, notifying the intended victim of such threat
  278  or initiating a risk protection order. A psychologist’s
  279  disclosure of confidential communications when communicating a
  280  threat pursuant to this subsection may not be the basis of any
  281  legal action or criminal or civil liability against the
  282  psychologist.
  283         Section 6. Section 491.0147, Florida Statutes, is amended
  284  to read:
  285         491.0147 Confidentiality and privileged communications.—Any
  286  communication between any person licensed or certified under
  287  this chapter and her or his patient or client is shall be
  288  confidential.
  289         (1) This privilege secrecy may be waived under the
  290  following conditions:
  291         (a)(1) When the person licensed or certified under this
  292  chapter is a party defendant to a civil, criminal, or
  293  disciplinary action arising from a complaint filed by the
  294  patient or client, in which case the waiver shall be limited to
  295  that action.
  296         (b)(2) When the patient or client agrees to the waiver, in
  297  writing, or, when more than one person in a family is receiving
  298  therapy, when each family member agrees to the waiver, in
  299  writing.
  300         (c)(3) When a patient or client has communicated to the
  301  person licensed or certified under this chapter a specific
  302  threat to cause serious bodily injury or death to an identified
  303  or readily available person, and the person licensed or
  304  certified under this chapter makes a clinical judgment that the
  305  patient or client has the apparent intent and ability to
  306  imminently or immediately carry out such threat, in the clinical
  307  judgment of the person licensed or certified under this chapter,
  308  there is a clear and immediate probability of physical harm to
  309  the patient or client, to other individuals, or to society and
  310  the person licensed or certified under this chapter communicates
  311  the information only to the potential victim, appropriate family
  312  member, or law enforcement or other appropriate authorities.
  313  There shall be no liability on the part of, and no cause of
  314  action of any nature shall arise against, a person licensed or
  315  certified under this chapter for the disclosure of otherwise
  316  confidential communications under this subsection. A disclosure
  317  of confidential communications by a person licensed or certified
  318  under this chapter when communicating a threat pursuant to this
  319  subsection may not be the basis of any legal action or criminal
  320  or civil liability against such person.
  321         (2)This privilege must be waived, and the person licensed
  322  or certified under this chapter shall disclose patient or client
  323  communications to the extent necessary to communicate the threat
  324  to a law enforcement agency, if a patient or client has
  325  communicated to such person a specific threat to cause serious
  326  bodily injury or death to an identified or readily available
  327  person, and the person licensed or certified under this chapter
  328  makes a clinical judgment that the patient or client has the
  329  apparent intent and ability to imminently or immediately carry
  330  out such threat. A law enforcement agency that receives
  331  notification of a specific threat under this subsection must
  332  take appropriate action to prevent the risk of harm, including,
  333  but not limited to, notifying the intended victim of such threat
  334  or initiating a risk protection order. A disclosure of
  335  confidential communications by a person licensed or certified
  336  under this chapter when communicating a threat pursuant to this
  337  subsection may not be the basis of any legal action or criminal
  338  or civil liability against such person.
  339         Section 7. Section 1012.583, Florida Statutes, is amended
  340  to read:
  341         1012.583 Continuing education and inservice training for
  342  youth suicide awareness and prevention.—
  343         (1) By July 1, 2019 Beginning with the 2016-2017 school
  344  year, the Department of Education, in consultation with the
  345  Statewide Office for Suicide Prevention and suicide prevention
  346  experts, shall develop a list of approved youth suicide
  347  awareness and prevention training materials and suicide
  348  screening instruments that may be used for training in youth
  349  suicide awareness, suicide and prevention, and suicide screening
  350  for instructional personnel in elementary school, middle school,
  351  and high school. The approved list of materials:
  352         (a)Must identify available standardized suicide screening
  353  instruments appropriate for use with a school-age population and
  354  which have validity and reliability and include information
  355  about obtaining instruction in the administration and use of
  356  such instruments.
  357         (b)(a) Must include training on how to identify appropriate
  358  mental health services and how to refer youth and their families
  359  to those services.
  360         (c)(b) May include materials currently being used by a
  361  school district if such materials meet any criteria established
  362  by the department.
  363         (d)(c) May include programs that instructional personnel
  364  can complete through a self-review of approved youth suicide
  365  awareness and prevention materials.
  366         (2) A school that chooses to incorporate 2 hours of
  367  training offered pursuant to this section shall be considered a
  368  “Suicide Prevention Certified School.if it:
  369         (a)Incorporates 2 hours of training offered pursuant to
  370  this section. The training must be included in the existing
  371  continuing education or inservice training requirements for
  372  instructional personnel and may not add to the total hours
  373  currently required by the department. A school that chooses to
  374  participate in the training must require all instructional
  375  personnel to participate.
  376         (b)Has at least two school-based staff members certified
  377  or otherwise deemed competent in the use of a suicide screening
  378  instrument approved under subsection (1) and has a policy to use
  379  such suicide risk screening instrument to evaluate a student’s
  380  suicide risk before requesting the initiation of, or initiating,
  381  an involuntary examination due to concerns about that student’s
  382  suicide risk.
  383         (3) A school that meets the criteria in subsection (2)
  384  participates in the suicide awareness and prevention training
  385  pursuant to this section must report its compliance
  386  participation to the department. The department shall keep an
  387  updated record of all Suicide Prevention Certified Schools and
  388  shall post the list of these schools on the department’s
  389  website. Each school shall also post on its own website whether
  390  it is a Suicide Prevention Certified School, and each school
  391  district shall post on its district website a list of the
  392  Suicide Prevention Certified Schools in that district.
  393         (4) A person has no cause of action for any loss or damage
  394  caused by an act or omission resulting from the implementation
  395  of this section or resulting from any training required by this
  396  section unless the loss or damage was caused by willful or
  397  wanton misconduct. This section does not create any new duty of
  398  care or basis of liability.
  399         (5) The State Board of Education may adopt rules to
  400  implement this section.
  401         Section 8. For the purpose of incorporating the amendment
  402  made by this act to section 490.0147, Florida Statutes, in a
  403  reference thereto, paragraph (u) of subsection (1) of section
  404  490.009, Florida Statutes, is reenacted to read:
  405         490.009 Discipline.—
  406         (1) The following acts constitute grounds for denial of a
  407  license or disciplinary action, as specified in s. 456.072(2):
  408         (u) Failing to maintain in confidence a communication made
  409  by a patient or client in the context of such services, except
  410  as provided in s. 490.0147.
  411         Section 9. For the purpose of incorporating the amendment
  412  made by this act to section 491.0147, Florida Statutes, in a
  413  reference thereto, paragraph (u) of subsection (1) of section
  414  491.009, Florida Statutes, is reenacted to read:
  415         491.009 Discipline.—
  416         (1) The following acts constitute grounds for denial of a
  417  license or disciplinary action, as specified in s. 456.072(2):
  418         (u) Failure of the licensee, registered intern, or
  419  certificateholder to maintain in confidence a communication made
  420  by a patient or client in the context of such services, except
  421  as provided in s. 491.0147.
  422         Section 10. This act shall take effect July 1, 2019.

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