Bill Summary – FastDemocracy

       Florida Senate - 2024                                     SB 960
       
       
        
       By Senator Berman
       
       
       
       
       
       26-01544-24                                            2024960__
                      A bill to be entitled                      
       An act relating to outpatient mental health services;
       amending s. 394.455, F.S.; revising and providing
       definitions; amending s. 394.4655, F.S.; authorizing a
       court to order a respondent into outpatient treatment
       for a specified amount of time under certain
       circumstances; providing criteria for involuntary
       outpatient treatment; requiring monitoring of the
       respondent for the duration of his or her treatment;
       requiring the court to retain jurisdiction over the
       case and parties under certain circumstances;
       authorizing a certain court exercising original
       jurisdiction to order certain respondents into
       involuntary outpatient services; prohibiting such
       court from using incarceration as a sanction for
       noncompliance with the outpatient treatment plan;
       amending s. 394.467, F.S.; revising criteria for
       involuntary inpatient placement; amending ss.
       394.4599, 394.4615, 394.463, 394.467, 394.495,
       394.496, 394.9085, 409.972, 464.012, 744.2007, and
       790.065, F.S.; conforming provisions and cross
       references to changes made by the act; providing an
       effective date.
        
Be It Enacted by the Legislature of the State of Florida:

       Section 1. Subsections (32) through (39) and (40) through
(50) of section 394.455, Florida Statutes, are redesignated as
subsections (33) through (40) and (42) through (52),
respectively, subsection (23) is amended, and new subsections
(32) and (41) are added to that section, to read:
       394.455 Definitions.—As used in this part, the term:
       (23) “Involuntary examination” means an examination
performed under s. 394.463, s. 397.6772, s. 397.679, s.
397.6798, or s. 397.6957 s. 397.6811 to determine whether a
person qualifies for involuntary services.
       (32) “Neglect or refuse to care for himself or herself”
means a refusal to accept treatment and includes, but is not
limited to, evidence that a person:
       (a) Is, for a reason other than indigence, unable to
satisfy basic needs for nourishment, clothing, medical care,
shelter, or safety, thereby creating a substantial probability
of imminent death, serious physical debilitation, or disease; or
       (b) Is substantially unable to make an informed treatment
choice, after an explanation of the advantages and disadvantages
of, and alternatives to, treatment, and needs care or treatment
to prevent deterioration. However, the following do not
constitute a refusal to accept treatment:
       1. A willingness to take medication appropriate for the
person’s condition, but a reasonable disagreement about type or
dosage;
       2. A good faith effort to follow a reasonable treatment
plan;
       3. An inability to obtain access to appropriate treatment
because of inadequate health care coverage or an insurer’s
refusal or delay in providing coverage for treatment; or
       4. An inability to obtain access to needed services because
the provider has no available treatment beds or qualified
professionals, the provider only accepts patients under court
order, or the provider gives persons under court order priority
over voluntary patients in obtaining treatment and services.
       (41) “Real and present threat of substantial harm”
includes, but is not limited to, evidence of a substantial
probability that the untreated person will:
       (a) Lack, refuse, or not receive services for health and
safety which are actually available in the community; or
       (b) Suffer severe mental, emotional, or physical harm that
will result in the loss of his or her ability to function in the
community or in the loss of cognitive or volitional control over
his or her thoughts or actions.
       Section 2. Section 394.4655, Florida Statutes, is amended
to read:
       (Substantial rewording of section. See
       s. 394.4655, F.S., for present text.)
       394.4655 Involuntary outpatient services.—
       (1)(a) A court may order a respondent into outpatient
treatment for up to 6 months if, during the initial hearing
under s. 394.467 or a subsequent hearing before a respondent’s
anticipated discharge from inpatient placement, at the request
of the facility, and providing at least 1 week’s notice to the
court and the parties of its belief that the respondent would
benefit from involuntary outpatient services, it is established
that the respondent meets the involuntary placement criteria and
all of the following:
       1. The respondent has been incarcerated, has been
involuntarily admitted to a receiving facility or treatment
facility as defined in s. 394.455, or has received mental health
services in a forensic or correctional facility at least twice
during the previous 36 months.
       2. The outpatient treatment is provided and available in
the county in which the respondent resides or will reside if he
or she is being placed from a state treatment facility.
       3. The respondent’s treating physician certifies, within a
reasonable degree of medical probability, that the respondent:
       a. May be appropriately treated on an outpatient basis.
       b. Is able to follow and benefit from the prescribed
treatment plan.
       (b) For the duration of his or her treatment, the
respondent must be monitored by a social worker or case manager
of the outpatient treatment provider, or a willing, able, and
responsible individual appointed by the court who must inform
the court, state attorney, and respondent’s counsel of any
failure by the respondent to comply with his or her outpatient
program.
       (2) The court shall, if required, retain jurisdiction over
the case and parties for the entry of further orders after a
hearing. Such jurisdiction includes, but is not limited to,
ordering inpatient treatment to stabilize a respondent who
decompensates while under court-ordered treatment and meets the
commitment criteria of s. 394.467(1), and extending, modifying,
or ending outpatient services. For a court to extend, modify, or
end outpatient services, the appropriate motion must be filed
with the court before the operating order expires, and the court
shall schedule a hearing as soon as practicable to determine
whether the respondent still meets the commitment criteria and
assess the appropriateness of any treatment modification.
       (3) A criminal county court exercising its original
jurisdiction in a misdemeanor case under s. 34.01 may order into
involuntary outpatient services a respondent who meets the
commitment criteria. The court may not use incarceration as a
sanction for noncompliance with the outpatient treatment plan,
but it may order an evaluation for possible inpatient placement
if there is significant, or multiple instances of,
noncompliance.
       Section 3. Paragraph (a) of subsection (1) of section
394.467, Florida Statutes, is amended to read:
       394.467 Involuntary inpatient placement.—
       (1) CRITERIA.—A person may be ordered for involuntary
inpatient placement for treatment upon a finding of the court by
clear and convincing evidence that:
       (a) He or she has a mental illness and because of his or
her mental illness:
       1.a. He or she has refused voluntary inpatient placement
for treatment after sufficient and conscientious explanation and
disclosure of the purpose of inpatient placement for treatment;
or
       b. He or she is unable to determine for himself or herself
whether inpatient placement is necessary; and
       2.a. He or she is incapable of surviving alone or with the
help of willing and responsible family or friends, including
available alternative services, and, without treatment, is
likely to suffer from neglect or refuse to care for himself or
herself, and such neglect or refusal poses a real and present
threat of substantial harm to his or her well-being; or
       b. There is substantial likelihood that in the near future,
and without services, he or she will inflict serious bodily harm
to on self or others, as evidenced by recent acts, omissions, or
behavior causing, attempting, or threatening such harm,
including, but not limited to, significant property damage; and
       Section 4. Paragraph (d) of subsection (2) of section
394.4599, Florida Statutes, is amended to read:
       394.4599 Notice.—
       (2) INVOLUNTARY ADMISSION.—
       (d) The written notice of the filing of the petition for
involuntary services for an individual being held must contain
the following:
       1. Notice that the petition for:
       a. Involuntary inpatient treatment pursuant to s. 394.467
has been filed with the circuit court in the county in which the
individual is hospitalized and the address of such court; or
       b. Involuntary outpatient services pursuant to s. 394.4655
has been filed with the criminal county court, as provided under
s. 394.4655 defined in s. 394.4655(1), or the circuit court, as
applicable, in the county in which the individual is
hospitalized and the address of such court.
       2. Notice that the office of the public defender has been
appointed to represent the individual in the proceeding, if the
individual is not otherwise represented by counsel.
       3. The date, time, and place of the hearing and the name of
each examining expert and every other person expected to testify
in support of continued detention.
       4. Notice that the individual, the individual’s guardian,
guardian advocate, health care surrogate or proxy, or
representative, or the administrator may apply for a change of
venue for the convenience of the parties or witnesses or because
of the condition of the individual.
       5. Notice that the individual is entitled to an independent
expert examination and, if the individual cannot afford such an
examination, that the court will provide for one.
       Section 5. Subsection (3) of section 394.4615, Florida
Statutes, is amended to read:
       394.4615 Clinical records; confidentiality.—
       (3) Information from the clinical record may be released in
the following circumstances:
       (a) When a patient has communicated to a service provider a
specific threat to cause serious bodily injury or death to an
identified or a readily available person, if the service
provider reasonably believes, or should reasonably believe
according to the standards of his or her profession, that the
patient has the apparent intent and ability to imminently or
immediately carry out such threat. When such communication has
been made, the administrator may authorize the release of
sufficient information to provide adequate warning to the person
threatened with harm by the patient.
       (b) When the administrator of the facility or secretary of
the department deems release to a qualified researcher as
defined in administrative rule, an aftercare treatment provider,
or an employee or agent of the department is necessary for
treatment of the patient, maintenance of adequate records,
compilation of treatment data, aftercare planning, or evaluation
of programs.

For the purpose of determining whether a person meets the
criteria for involuntary outpatient placement or for preparing
the proposed treatment plan pursuant to s. 394.4655, the
clinical record may be released to the state attorney, the
public defender or the patient’s private legal counsel, the
court, and to the appropriate mental health professionals,
including the service provider identified in s.
394.4655(7)(b)2., in accordance with state and federal law.
       Section 6. Paragraph (g) of subsection (2) of section
394.463, Florida Statutes, is amended to read:
       394.463 Involuntary examination.—
       (2) INVOLUNTARY EXAMINATION.—
       (g) The examination period must be for up to 72 hours. For
a minor, the examination shall be initiated within 12 hours
after the patient’s arrival at the facility. Within the
examination period, one of the following actions must be taken,
based on the individual needs of the patient:
       1. The patient shall be released, unless he or she is
charged with a crime, in which case the patient shall be
returned to the custody of a law enforcement officer;
       2. The patient shall be released, subject to subparagraph
1., for voluntary outpatient treatment;
       3. The patient, unless he or she is charged with a crime,
shall be asked to give express and informed consent to placement
as a voluntary patient and, if such consent is given, the
patient shall be admitted as a voluntary patient; or
       4. A petition for involuntary services shall be filed in
the circuit court if inpatient treatment is deemed necessary or
with the criminal county court, as defined in s. 394.4655(1), as
applicable. When inpatient treatment is deemed necessary, the
least restrictive treatment consistent with the optimum
improvement of the patient’s condition shall be made available.
When a petition is to be filed for involuntary outpatient
placement, it shall be filed by one of the petitioners specified
in s. 394.4655(4)(a). A petition for involuntary inpatient
placement shall be filed by the facility administrator. If a
patient’s 72-hour examination period ends on a weekend or
holiday, and the receiving facility:
       a. Intends to file a petition for involuntary services,
such patient may be held at a receiving facility through the
next working day thereafter and such petition for involuntary
services must be filed no later than such date. If the receiving
facility fails to file a petition for involuntary services at
the close of the next working day, the patient shall be released
from the receiving facility following approval pursuant to
paragraph (f).
       b. Does not intend to file a petition for involuntary
services, a receiving facility may postpone release of a patient
until the next working day thereafter only if a qualified
professional documents that adequate discharge planning and
procedures in accordance with s. 394.468, and approval pursuant
to paragraph (f), are not possible until the next working day.
       Section 7. Paragraph (c) of subsection (6) of section
394.467, Florida Statutes, is amended to read:
       394.467 Involuntary inpatient placement.—
       (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.—
       (c) If at any time before the conclusion of the hearing on
involuntary inpatient placement it appears to the court that the
person does not meet the criteria for involuntary inpatient
placement under this section, but instead meets the criteria for
involuntary outpatient services, the court may order the person
evaluated for involuntary outpatient services pursuant to s.
394.4655. The petition and hearing procedures set forth in s.
394.4655 shall apply. If the person instead meets the criteria
for involuntary assessment, protective custody, or involuntary
admission pursuant to s. 397.675, then the court may order the
person to be admitted for involuntary assessment for a period of
5 days pursuant to s. 397.6811. Thereafter, all proceedings are
governed by chapter 397.
       Section 8. Paragraphs (a) and (c) of subsection (3) of
section 394.495, Florida Statutes, are amended to read:
       394.495 Child and adolescent mental health system of care;
programs and services.—
       (3) Assessments must be performed by:
       (a) A professional as defined in s. 394.455(5), (7), (34)
(33), (37) (36), or (38) (37);
       (c) A person who is under the direct supervision of a
qualified professional as defined in s. 394.455(5), (7), (34)
(33), (37) (36), or (38) (37) or a professional licensed under
chapter 491.
       Section 9. Subsection (5) of section 394.496, Florida
Statutes, is amended to read:
       394.496 Service planning.—
       (5) A professional as defined in s. 394.455(5), (7), (34)
(33), (37) (36), or (38) (37) or a professional licensed under
chapter 491 must be included among those pers