HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 1349 Mental Health Treatment
SPONSOR(S): Melo and other
TIED BILLS: IDEN./SIM. BILLS: CS/SB 1412
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Children, Families & Seniors Subcommittee 16 Y, 0 N Curry Brazzell
2) Appropriations Committee 27 Y, 0 N Fontaine Pridgeon
3) Health & Human Services Committee 19 Y, 0 N Curry Calamas
SUMMARY ANALYSIS
Chapter 916, F.S., governs the state forensic system, which is a network of state facilities and community services
for persons who have mental health issues, an intellectual disability, or autism and who are involved with the
criminal justice system. Offenders who are charged with a felony and adjudicated incompetent to proceed due to
mental illness 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, or in lieu of such commitment, may be released on
conditional release by the circuit court if the person is not serving a prison sentence. The committing court retains
jurisdiction over the defendant while the defendant is under involuntary commitment or conditional release.
The Department of Children and Families (DCF) designates and monitors mental health receiving and treatment
facilities. DCF may suspend or withdraw receiving facility designations for noncompliance with agency rules. A
facility may not hold or treat involuntary patients unless it is designated by the agency.
The bill authorizes DCF to issue a conditional designation, for up to 60 days, to allow the agency time to work with
facilities to address inspection and minor compliance issues without DCF having to suspend or withdraw the
designation. This gives facilities time to address inspection issues without having to suspend services or reapply for
a designation.
The bill revises the statutory procedures for criminal defendants found incompetent to proceed, as follows:
 Requires expert evaluators and the courts to consider alternative treatment options before ordering a
defendant into a treatment facility;
 Requires the administrator of the treatment facility to notify the court within 60 days, instead of 6 months ,
when the administrator determines that the defendant has regained competency or no longer meets the
criteria for involuntary commitment;
 Reduces the maximum time defendants may wait to be transported out of a treatment facility from 30 days
to 7 days, once they are competent to proceed or no longer meet the criteria for continued commitment , and
requires the courts to conduct a hearing to make a determination of competency wi thin 30 days of
notification;
 Requires the sheriffs to either administer or permit DCF to administer psychotropic medication therapy to
forensic clients who are held in jail awaiting admission to a state mental health treatment facility before the
client is admitted into the facility;
 Requires the referring treatment facility to transfer the defendant with up to 30 days of medication and to
assist in discharge planning with medical teams at the receiving jail.
This bill has no fiscal impact on state or local government.
The bill provides an effective date of July 1, 2023.
This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives .
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 FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Baker Act
The Baker Act was enacted in 1971 to revise the state’s mental health commitment laws. 1 The Act
provides legal procedures for mental health examination and treatment, including voluntary and
involuntary examinations and treatment. It additionally protects the rights of all individuals examined or
treated for mental illness in Florida.2
An involuntary examination is required if there is reason to believe that the person has a mental illness
and has, because of his or her mental illness, refused involuntary examination, and is likely to refuse to
care for him or herself or cause harm to him or herself or others in the near future.3
Involuntary patients must be taken to either a public or a private facility that has been designated by the
Department of Children and Families (DCF) as a Baker Act receiving facility. The purpose of receiving
facilities is to receive and hold or refer, as appropriate, involuntary patients for mental health or
substance abuse evaluation and to provide treatment or transportation to the appropriate service
provider.4
Designation of Receiving and Treatment Facilities and Receiving Systems
DCF is authorized to designate and monitor receiving facilities, 5 treatment facilities,6 and receiving
systems.7 The agency is also authorized to adopt rules establishing the procedures, criteria, and
standards for obtaining and maintaining status as a designated facility8 and may suspend or withdraw
such designation for noncompliance.9 A facility may not hold or treat involuntary patients unless it is
designated by the agency.
Designated receiving facilities include public or private hospitals, crisis stabilization units (CSU),10 or
addictions receiving facilities that provide, at a minimum, emergency screening, evaluation, and short-
term stabilization for mental health or substance abuse disorders, and which may have an agreement
with a corresponding facility for transportation and services. 11
Treatment facilities are state-owned, state-operated, or state-supported hospitals, centers, or clinics
designated by DCF for extended treatment and hospitalization, beyond that provided for by a receiving
facility, of persons who have a mental illness. This includes federal and private facilities designated by
the department to provide such services.12
A public facility is a facility that has contracted with DCF and receives state funds to provide mental
health services to all persons, regardless of the ability to pay. 13 A private facility is a hospital or facility
1 Sections 394.451-394.47892, F.S.
2 Section 394.459, F.S.
3
S. 394.463(1), F.S.
4 S. 394.455(39), F.S. This term does not include a county jail.
5 S. 394.455(13), F.S.
6 S. 394.455(49), F.S.
7 Ss. 394.461 and 394.4573, F.S.
8 S. 394.461(6), F.S.
9 S. 394.461, F.S.
10 A crisis stabilization unit is a program that provides an alternative to inpatient hospitalization and that provides brief, i ntensive
services 24 hours a day, 7 days a week, for mentally ill individuals who are in an acutely disturbed s tate. See s. 394.67, F.S.
11 S. 394.455(13), F.S.
12 S. 394.455(49), F.S. Patients treated in facilities of the United States Government shall be solely those whose care is the
responsibility of the United States Department of Veterans Affairs.
13 S. 394.455(38), F.S.
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 operated by a for-profit or not-for-profit corporation or association which provides mental health or
substance abuse services.14 Private facilities do not receive state funds. There are currently 126 public
and private designated receiving facilities in Florida. 15
Receiving Facility Application Process
To be eligible to apply for designation as a receiving facility, the facility must be a hospital licensed
under chapter 395 or a substance abuse or mental health facility licensed under chapter 394, Part IV. 16
All designated facilities are required to provide emergency services, consistent with their facility’s
licensure to persons regardless of age, unless statutory or regulatory exceptions apply for specific
circumstances for designation.17
To apply for designation, each applicant must complete and submit an application and provide the
required supporting documentation, which includes:18
 A copy of the facility’s license issued pursuant to Chapter 394 or 395, F.S., evidencing its
eligibility to apply for designation;
 A current certificate of good standing for the applicant organization issued by the Florida
Secretary of State;
 Documentation of the applicant’s governing authority action authorizing the application for
designation;
 Description of proposed psychiatric services including any distinct programs to be provided to
each of the following consumer age groups, and the projected numbers of persons to be served
in each following group:
o Minors below 10 years of age,
o Minors between the ages of 10 to 17 years,
o Adults,
o Persons 60 or more years of age; and,
o Other specific populations.
 The corresponding street address for each reception and treatment location providing services.
Designation is limited to only the locations specified in the application and approved by the
department;
 Documentation of community need for maintaining or expanding the present level of designated
facilities’ services to meet the existing need, and why the applicant is best suited to meet this
need;
 Documentation of key facility protocols to assure all involved practitioners and staff are
knowledgeable of, and implement, persons’ legal rights, psychiatric care, records standards,
complaint reporting, investigation and reviews to maintain a consistently high level of
compliance with applicable Baker Act laws, ethical principles, and rights protections;
 Description of how the facility’s physical structure, staffing and policies offer frequent, if not
daily, opportunity for persons to have exercise, fresh air and sunshine, except as individually
restricted and documented in the person’s clinical record and within the physical limitations of
the facility;
 Description of how the facility’s discharge planning policies provide for continuity of psychotropic
medication availability until post-discharge follow-up services are scheduled; and
 For general hospitals, a description of the means utilized to create or approximate a distinct
psychiatric emergency reception and triage area that minimizes individuals’ exposure to undue
and exacerbating environmental stresses while awaiting or receiving services.
Designation as a receiving facility is valid for three years and may be renewed by submitting a renewal
application along with the required documentation at least 90 days prior to the expiration of the existing
designation.19
14 S. 394.455(35), F.S.
15 DCF, Agency Bill Analysis HB 1349 (2023), p. 2 (on file with the House Children, Families, & Seniors Subcommittee).
16 Rule 65E-5.350, F.A.C.
17 Id.
18 Id.
19 Id.
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 Standards for Designated Receiving Facilities
Designated receiving facilities must comply with the following minimum standards:20
 Have policies and procedures that prescribe, monitor and enforce all applicable regulatory
requirements;
 Assure that the facility’s reception, screening, and inpatient services are fully operational 24-
hours-per-day, 7-days-per-week;
 Have a compliance program that monitors facility and professional compliance with Chapter
394, Part I, F.S. Every such program shall specifically monitor the adequacy of and the
timeframes involved in the facility procedures utilized to expedite obtaining informed consent for
treatment. This program may be integrated with other activities; and
 Ensure the centralized provision and coordination of acute care services for eligible individuals
with an acute mental illness, if a public receiving facility that is affiliated with a publicly funded
community mental health center.
Any facility designated as a receiving facility that fails to comply with the statutory and regulatory
requirements may have its designation suspended or withdrawn for noncompliance. 21
Under current law, DCF is only authorized to suspend or withdraw a facility’s designation for
compliance violations. As a result, a facility’s designation may be suspended or withdrawn while the
facility works to correct inspection violations or other issues that generally are not serious threats to
health and safety such as lack of and deficiencies in staff training, outdated policies and procedures,
and documentation deficiencies. In circumstances where a provider is the only available public
receiving facility in a county or geographic area, “suspending” or “withdrawing” the designation based
on an inspection violation or a minor infraction is not a viable option because either of these actions
would result in reducing access to crisis care services.
State Forensic System
Criminal Defendants and Competency to Stand Trial
The Due Process Clause of the 14th Amendment prohibits the states from trying and convicting
defendants who are incompetent to stand trial.22 The states must have procedures in place that
adequately protect the defendant’s right to a fair trial, which includes his or her participation in all
material stages of the process.23 Defendants must be able to appreciate the range and nature of the
charges and penalties that may be imposed, understand the adversarial nature of the legal process,
and disclose to counsel facts pertinent to the proceedings. Defendants also must manifest appropriate
courtroom behavior and be able to testify relevantly.24
Involuntary Commitment of Defendant Adjudicated Incompetent
Chapter 916, F.S., governs the state forensic system, which is a network of state facilities and
community services for persons who have mental health issues, an intellectual disability, or autism and
who are involved with the criminal justice system. Offenders who are charged with a felony and
adjudicated incompetent to proceed due to mental illness 25 and offenders who are adjudicated not
20 Rule 65E-5.352, F.A.C
21 Id.
22 Pate v. Rob inson, 383 U.S. 375, 86 S.Ct. 836, 15 L.Ed. 815 (1966); Bishop v. U.S., 350 U.S.961, 76 S.Ct. 440, 100 L.Ed. 835 (1956);
Jones v. State, 740 So.2d 520 (Fla. 1999).
23 Id. See also Rule 3.210(a)(1), Fla.R.Crim.P.
24 Id. See also s. 916.12, 916.3012, and 985.19, F.S.
25 “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 proc eedings
against her or him.” s. 916.12(1), F.S.
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 guilty by reason of insanity may be involuntarily committed to state civil26 and forensic 27 treatment
facilities by the circuit court,28 or in lieu of such commitment, may be released on conditional release 29
by the circuit court if the person is not serving a prison sentence. 30 The committing court retains
jurisdiction over the defendant while the defendant is under involuntary commitment or conditional
release.31 In Fiscal Year (FY) 2021-2022 there were a total 3,349 adults served by DCF in forensic
commitment and 1,654 in civil commitment.32
A civil facility is, in part, a mental health facility established within DCF or by contract with 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.33
A forensic facility is a separate and secure facility established within DCF or the Agency for Persons
with Disabilities (APD) to service forensic clients committed pursuant to ch. 916, F.S. 34 A separate and
secure facility means a security-grade building for the purpose 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.35
If a defendant is suspected of being mentally incompetent, the court, counsel for the defendant, or the
state may file a motion for examination to have the defendant’s cognitive state assessed. 36 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. 37 If the defendant is
found to be mentally competent, the criminal proceeding resumes. 38 If the defendant is found to be
mentally incompetent to proceed, the proceeding may not resume unless competency is restored. 39
Mental Competence Evaluation
A defendant is considered incompe