The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Committee on Fiscal Policy
BILL: CS/SB 1412
INTRODUCER: Children, Families, and Elder Affairs Committee; Senator Bradley and others
SUBJECT: Mental Health
DATE: April 24, 2023 REVISED:
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Delia Cox CF Fav/CS
2. Barr Money AHS Favorable
3. Delia Yeatman FP Favorable
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
CS/SB 1412 authorizes the Department of Children and Families (DCF) to issue conditional
designations for Baker Act receiving and treatment facilities as an alternative to the suspension
or withdrawal of a standard facility designation.
The bill also modifies ch. 916, F.S., regarding competency determination, treatment options, and
restoration:
 Requires local sheriffs or the DCF to administer psychotropic medications to forensic clients
in jails if clinically indicated prior to their admission to forensic facilities if clinically
indicated;
 Requires expert evaluators and courts to consider alternative, community-based treatment
options before ordering the placement of a defendant to a forensic facility;
 Requires administrators of forensic facilities to provide notification to courts no more than 60
days, rather than six months as in current law, from the time a defendant is competent to
proceed or no longer meets commitment criteria;
 Reduces the maximum amount of time patients may wait to be transported from a forensic
facility to the committing jurisdiction once they are competent to proceed or no longer meet
commitment criteria, from 30 days to 7 days;
 Requires competency determinations to be made at a competency hearing within 30 days of
notification from forensic facilities that patients have gained competency or no longer meet
commitment criteria;
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 Requires forensic facilities to transfer defendants back to the committing jurisdiction with up
to 30 days of medication and assist in discharge planning with medical teams at the receiving
county jail; and
 Reenacts and makes conforming changes to several existing sections of statute.
The DCF anticipates the bill will have no fiscal impact on state government. See Section V. of
this analysis.
The bill takes effect on July 1, 2023.
II. Present Situation:
Receiving and Treatment Facilities
The Department of Children and Families (DCF) is authorized to designate and monitor
receiving facilities, treatment facilities, and receiving systems and may suspend or withdraw
such designations for failure to comply with Florida law.1 A receiving facility is a public or
private facility that provides emergency screening, evaluation, and short-term stabilization for
mental health or substance abuse disorders.2 A treatment facility is a state-owned, state-operated,
or state-supported hospital, center, or clinic providing extended treatment and hospitalization of
persons who have a mental illness.3 Unless specifically designated by the DCF, facilities are not
permitted to hold or treat involuntary patients experiencing a mental health or substance use
disorder crisis.4
There are currently 126 public and private designated receiving facilities in Florida.5
The DCF is also statutorily authorized to adopt rules relating to a number of issues surrounding
receiving and treatment facilities, including:
 Procedures and criteria for receiving and evaluating facility applications for designation,
which may include onsite facility inspection and evaluation of an applicant’s licensing status
and performance history, as well as consideration of local service needs;
 Minimum standards that a facility must meet and maintain in order to be designated as a
receiving or treatment facility and procedures for monitoring continued adherence to such
standards;
 Procedures and criteria for designating receiving systems which may include consideration of
the adequacy of services provided by facilities within the receiving system to meet the needs
of the geographic area using available resources;
 Procedures for receiving complaints against a designated facility or designated receiving
system and for initiating inspections and investigations of facilities or receiving systems
alleged to have violated regulatory laws or rules; and
1
Section 394.461, F.S.
2
Section 394.455(13), F.S.
3
Section 394.455(49), F.S.
4
Section 394.461, F.S.
5
The Department of Children and Families, SB 1412 Bill Analysis, March 10, 2023, at p. 2. (on file with the Senate
Appropriations Committee on Health and Human Services) (hereinafter cited as, “The DCF Analysis”).
BILL: CS/SB 1412 Page 3
 Procedures and criteria for the suspension or withdrawal of designation as a receiving facility
or receiving system.6
The DCF does not have a licensing mechanism to allow facilities that have outstanding
inspection findings or are the subject of an investigation to temporarily operate while under a
corrective action plan. Current law only provides the DCF with the authority to suspend or
withdraw designations. In circumstances where a provider is the only available public receiving
facility in a geographic area, suspending or withdrawing the designation would result in reducing
access to crisis care services.7
Competency Restoration Treatment and Forensic Facilities
Chapter 916, F.S., governs the state forensic system, which is a network of state facilities and
community services for persons who are involved with the criminal justice system and who have
mental health issues, an intellectual disability, or autism. Offenders who are charged with a
felony and adjudicated incompetent to proceed8 and offenders who are adjudicated not guilty by
reason of insanity may be involuntarily committed to state civil and forensic treatment facilities
by the circuit court,9 or in lieu of such commitment, may be released on conditional release10 by
the circuit court if the person is not serving a prison sentence.11 The committing court retains
jurisdiction over the defendant while the defendant is under involuntary commitment or
conditional release, and a defendant may not be released from either commitment or conditional
release except by order of the committing court.12
Sections 916.13 and 916.15, F.S., set forth the criteria under which a court may involuntarily
commit a defendant charged with a felony who has been adjudicated incompetent to proceed or
who has been found not guilty by reason of insanity. Florida law provides for the ability to
commit a person under either basis; however, the goals for the commitment are different for each
basis of the commitment. Persons committed under s. 916.13, F.S., after an adjudication of
incompetency to proceed have a primary goal of restoration of competency; whereas persons
who have been found not guilty by reason of insanity who are committed have a primary goal of
stabilization and post-hospital planning.
A civil facility is, in part, a mental health facility established within the DCF, or by contract with
the DCF, to serve individuals committed pursuant to ch. 394, F.S., and defendants pursuant to ch.
916, F.S., who do not require the security provided in a forensic facility.13
A forensic facility is a separate and secure facility established within the DCF or the Agency for
Persons with Disabilities (APD) to serve forensic clients committed pursuant to ch. 916, F.S. A
6
Section 394.461(6), F.S.
7
The DCF Analysis at p. 2.
8
“Incompetent to proceed” means “the defendant does not have sufficient present ability to consult with her or his lawyer
with a reasonable degree of rational understanding” or “the defendant has no rational, as well as factual, understanding of the
proceedings against her or him.” Section 916.12(1), F.S.
9
Sections 916.13, 916.15, and 916.302, F.S.
10
Conditional release is release into the community accompanied by outpatient care and treatment. Section 916.17, F.S.
11
Section 916.17(1), F.S.
12
Section 916.16(1), F.S.
13
Section 916.106(4), F.S.
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separate and secure facility means a security-grade building for the purposes of separately
housing individuals with mental illness from persons who have intellectual disabilities or autism
and separately housing persons who have been involuntarily committed from non-forensic
residents.14
Determination of Incompetency
If a defendant is suspected of being incompetent, the court, counsel for the defendant, or the state
may file a motion for examination to have the defendant’s cognitive state assessed.15 If the
motion is well-founded, the court will appoint experts to evaluate the defendant’s cognitive state.
The defendant’s competency is then determined by the judge in a subsequent hearing.16 If the
defendant is found to be competent, the criminal proceeding resumes.17 If the defendant is found
to be incompetent to proceed, the proceeding may not resume unless competency is restored.18
Judicial Determination of Incompetency, Expert Evaluations, and Commitment
A defendant is deemed incompetent to proceed if the defendant does not have sufficient present
ability to consult with her or his lawyer with a reasonable degree of rational understanding or if
the defendant has no rational, as well as factual, understanding of the proceedings against her or
him.19 A defendant who, because of psychotropic medication,20 is able to understand the nature
of proceedings and assist in the defendant’s own defense must not automatically be deemed
incompetent to proceed simply because the defendant’s satisfactory mental functioning is
dependent upon such medication.21
Section 916.115, F.S., requires courts to appoint no more than three expert evaluators to
determine the mental condition of a defendant in a criminal case, including competency to
proceed, insanity, involuntary placement, and treatment.22 Mental health experts must first
determine whether the defendant has a mental illness and, if so, consider the factors related to the
issue of whether the defendant meets the criteria for competence to proceed.23 A defendant must
be evaluated by no fewer than two experts before the court commits the defendant or takes other
action, except if one expert finds that the defendant is incompetent to proceed and the parties
stipulate to that finding. The court may commit the defendant or take other action without further
evaluation or hearing, or the court may appoint no more than two additional experts to evaluate
the defendant.24 Notwithstanding any stipulation by the state and the defendant, the court may
14
Section 916.106(10), F.S.
15
Rule 3.210, Fla.R.Crim.P.
16
Id.
17
Rule 3.212, Fla.R.Crim.P.
18
Id.
19
Section 916.12(1), F.S.
20
“Psychotropic medication” is defined to mean any drug or compound used to treat mental or emotional disorders affecting
the mind, behavior, intellectual functions, perception, moods, or emotions and includes antipsychotic, antidepressant,
antimanic, and antianxiety drugs. Section 916.12(5), F.S.
21
Section 916.12(5), F.S.
22
Section 916.115(1), F.S.
23
Section 916.12(2), F.S.
24
Id.
BILL: CS/SB 1412 Page 5
require a hearing with testimony from the expert or experts before ordering the commitment of a
defendant.25
In considering the issue of competence to proceed, an examining expert must first consider and
specifically include in his or her report the defendant’s capacity to:
 Appreciate the charges or allegations against the defendant;
 Appreciate the range and nature of possible penalties, if applicable, that may be imposed in
the proceedings against the defendant;
 Understand the adversarial nature of the legal process;
 Disclose to counsel facts pertinent to the proceedings at issue;
 Manifest appropriate courtroom behavior; and
 Testify relevantly.26
In addition, an examining expert must consider and include in his or her report any other factor
deemed relevant by the expert.27
If an expert finds that the defendant is incompetent to proceed, the expert must report on any
recommended treatment for the defendant to attain competence to proceed.28 In considering the
issues relating to treatment, the examining expert must specifically report on:
 The mental illness causing the incompetence;
 The treatment or treatments appropriate for the mental illness of the defendant and an
explanation of each of the possible treatment alternatives in order of choices;
 The availability of acceptable treatment and, if treatment is available in the community, the
expert shall so state in the report;
 The likelihood of the defendant’s attaining competence under the treatment recommended;
 An assessment of the probable duration of the treatment required to restore competence; and
 The probability that the defendant will attain competence to proceed in the foreseeable
future.29
The statute does not specify the alternative community-based treatment options that should be
considered. For Fiscal Year 2022-2023, the DCF reports that it is funding 299 community-based
beds for defendants with lesser felony offenses, low symptom acuity, and those who require
limited resources. Of those beds, 278 are currently filled. In addition, the DCF reports that it is
increasing the number of community-based diversion options to meet anticipated future
demand.30
When expert evaluators determine that a person does not meet the established criteria to proceed
to trial, and alternative options are not appropriate, a court may commit the defendant to a secure
setting to receive intensive behavioral health services, with the goal of competency restoration.31
25
Id.
26
Section 916.12(3), F.S.
27
Id.
28
Section 916.12(4), F.S.
29
Id.
30
The DCF Analysis at p. 3
31
The DCF Analysis at p. 3.
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If a person is committed pursuant to either statute, the administrator at the commitment facility
must submit a report to the court:
 No later than six months after a defendant’s admission date and at the end of any period of
extended commitment; or
 At any time the administrator has determined that the defendant has regained competency or
no longer meets the criteria for involuntary commitment.32
Judicial Procedure for Release and Transportation Back to Committing Jurisdiction
Current law also requires that a competency hearing must be held within 30 days after the court
receives notification that a defendant is competent to proceed or no longer meets the criteria for
continued commitment.33 However, many defendants are not being transported back to the
committing jurisdiction in a timely manner.34 While patients await transportation back to the
county with jurisdiction, they remain at a treatment facility.35 On an average day, there are
between 80 and 100 competent individuals in treatment facilities awaiting transportation back to
the committing jurisdiction.36 As a result, the waitlist for state mental health services is longer as
defendants awaiting transportation are left in state facilities and are occupying beds that could be
used by those awaiting treatment.37
While s. 916.13, F.S., requires that a competency hearing be held within 30 days of receiving a
competency notification, there are instances in which courts do not make a determination of
competency during an initial hearing, resulting in a defendant remaining at a treatment facility
for longer than the maximum 30 days required by current law.38 Additionally, in some instances
individuals that are transported back to the committing jurisdiction decompensate39 before a
determination of competency can be made.