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 Appropriations Committee on Criminal and Civil Justice
BILL: SB 1284
INTRODUCER: Senator Martin
SUBJECT: Health Care for Inmates
DATE: February 12, 2024 REVISED: 2/14/24
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Wyant Stokes CJ Favorable
2. Atchley Harkness ACJ Favorable
3. FP
I. Summary:
SB 1284 revises ss. 945.40-945.49, F.S., the Corrections Mental Health Act to provide updated,
clarifying, or technical language, as well as, provide substantial changes to the procedure for
placement and treatment of inmates.
The bill amends s. 945.41, F.S., to revise legislative intent by clarifying technical language in
regards to inmates who have a mental illness and provide that services received by those inmates
are offered as outpatient and inpatient mental health treatment and services. The Department of
Corrections (DOC) is authorized to purchase treatment materials and equipment for specified
purposes and to contract with entities, persons, or agencies qualified to provide mental health
treatment and services. The bill requires inmates in the custody of the DOC to be offered the
opportunity to participate in the development of a written individualized treatment plan.
A mentally competent inmate must give his or her express and informed consent for mental
health treatment, and any consent given for treatment may be revoked orally or in writing before
or during the treatment by the inmate or a person legally authorized to make such decisions.
Inmates who are incompetent to consent must receive treatment deemed necessary for their
appropriate care and for the safety of the inmate or others.
The bill authorizes nonpsychiatric, emergency surgical treatment, and routine medical treatment
for an inmate placed in a mental health treatment facility under certain circumstances.
The bill amends s. 945.42, F.S., to define the terms “chief,” “express and informed consent,”
“gravely disabled,” “incompetent to consent to treatment,” “involuntary examination,”
“likelihood of serious harm,” and “treatment,” and revises current terms.
The bill substantially rewords s. 945.43, F.S., to provide a process for involuntary examination.
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The bill substantially rewords s. 945.44, F.S., to provide the criteria, hearing procedures for
petitions, orders for treatment, status hearings, copies of orders, and dismissal of petitions
relating to the placement and treatment of an inmate in a mental health treatment facility.
The bill repeals s. 945.45, F.S., relating to the continued placement of inmates in mental health
facilities. Language related to continued placement is described in s. 945.44, F.S, under the bill.
The bill amends s. 945.46, F.S., to provide the process for involuntary placement court
proceedings when an inmate continues to be mentally ill and in need of care and treatment but is
scheduled for release from custody. The bill adds language to ensure a fee may not be charged
for the filing of the petition.
The bill amends s. 945.47, F.S., to specify that any time that an inmate who has received mental
health treatment while in the custody of the DOC becomes eligible for release, a record of the
treatment may be provided to the Florida Commission on Offender Review and the Department
of Children and Families for the purpose of arranging post release aftercare placement and to
prospective recipient inpatient health care or residential facilities upon request.
The bill substantially rewords s. 945.48, F.S., to authorize the DOC to involuntary administer
psychotropic medication to an inmate on an emergency basis without following the procedure
outlined in s. 945.43, F.S. The use of force is permitted when and to the extent that it reasonably
appears necessary to effectuate the treatment of an inmate, to effectuate clinically necessary
hygiene of an inmate, for the application of physical restraint, or pursuant to a valid court order.
Such force must be in accordance with requirements described in s. 944.35, F.S.
The bill creates s. 945.485, F.S., to provide procedures for when an inmate is engaging in active
or ongoing self-injurious behavior and has refused to provide express and informed consent. If
an inmate is incompetent to consent, the inmate’s treating physician must proceed as set forth in
s. 945.6042, F.S. The bill provides proceedings for when an inmate is competent, refusing
necessary surgical or medical treatment, and engaging in active or ongoing self-injurious
behavior that presents a threat to the safety of the DOC staff or other inmates or the security,
internal order, or discipline of the institution.
The bill amends s. 945.49, F.S., to remove the requirement for the DOC to work in cooperation
with the Mental Health Program Office of the Department of Children and Families to adopt
rules necessary to administer sections under the Corrections Mental Health Act.
The bill creates s. 945.6042, F.S., to provide the DOC must offer inmates the opportunity to
execute an advance directive as defined in s. 765.101, F.S. The bill provides definitions for
“health care facility”, “incapacity,” “informed consent,” “inmate,” “ombudsman,” “proxy,” and
“proxy review team.” The bill provides procedure relating to the capacity of an inmate. The bill
creates a process for a DOC ombudsman to serve as a proxy for an inmate that has not executed
an advance directive. The bill authorizes the use of force and provides immunity from liability.
The bill does not have a fiscal impact on the DOC. See Section V, Fiscal Impact Statement.
The bill is effective July 1, 2024.
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II. Present Situation:
Under the Corrections Mental Health Act, ss. 945.40-945.49, F.S., it is the intent of the
Legislature for mentally ill inmates in the custody of the DOC to receive an evaluation and
appropriate treatment for their mental illness through a continuum of services. The DOC must
provide mental health services to inmates committed to the DOC and may contract with entities,
persons, or agencies qualified to provide such services.1 Mental health treatment facilities are
required to be secure, adequately equipped and staffed, and provide services in the least
restrictive manner consistent with optimum improvement of the inmate’s condition.2
The Corrections Mental Health Act provides key terminology necessary in determining criteria is
met for crisis stabilization care3 such as: defining mentally ill,4 an inmate in immediate need of
care and treatment,5 in need of care and treatment,6 and transitional mental health care.7
1
Section 945.41(1), F.S.
2
Section 945.41(2), F.S.
3
“Crisis Stabilization Care” means a level of care that is less restrictive and intense than care provided in a mental health
treatment facility, that includes a broad range of evaluation and treatment services provided within a highly structured setting
or locked residential setting, and that is intended for inmates who are experiencing acute emotional distress and who cannot
be adequately evaluated and treated in a transitional care unit and is devoted principally toward rapid stabilization of acute
symptoms and conditions. Section 945.42(2), F.S.
4
“Mentally ill” means an impairment of the mental or emotional processes that exercise conscious control of one’s actions or
the ability to perceive or understand reality, which impairment substantially interferes with the person’s ability to meet the
ordinary demands of living. However, for the purposes of transferring an inmate to a mental health treatment facility, the
term does not include a developmental disability as defined in s. 393.063, F.S., simple intoxication, or conditions manifested
only by antisocial behavior or substance abuse addiction. However, an individual who is developmentally disabled may also
have a mental illness. Section 945.42(9), F.S.
5
“In immediate need of care and treatment” means that an inmate is apparently mentally ill and is not able to be
appropriately cared for in the institution where he or she is confined and that, but for being isolated in a more restrictive and
secure housing environment, because of the apparent mental illness: the inmate is demonstrating a refusal to care for himself
or herself and without immediate treatment intervention is likely to continue to refuse to care for himself or herself, and such
refusal poses an immediate, real, and present threat of substantial harm to his or her well-being; or there is an immediate, real,
and present threat that the inmate will inflict serious bodily harm on himself or herself or another person, as evidenced by
recent behavior involving causing, attempting, or threatening such harm; the inmate is unable to determine for himself or
herself whether placement is necessary; and all available less restrictive treatment alternatives that would offer an opportunity
for improvement of the inmate’s condition have been clinically determined to be inappropriate. Section 945.42(5), F.S.
6
“In need of care and treatment” means that an inmate has a mental illness for which inpatient services in a mental health
treatment facility are necessary and that, but for being isolated in a more restrictive and secure housing environment, because
of the mental illness: the inmate is demonstrating a refusal to care for himself or herself and without treatment is likely to
continue to refuse to care for himself or herself, and such refusal poses a real and present threat of substantial harm to his or
her well-being; or there is a substantial likelihood that in the near future the inmate will inflict serious bodily harm on himself
or herself or another person, as evidenced by recent behavior causing, attempting, or threatening such harm; The inmate is
unable to determine for himself or herself whether placement is necessary; and all available less restrictive treatment
alternatives that would offer an opportunity for improvement of the inmate's condition have been clinically determined to be
inappropriate. Section 945.42(6), F.S.
7
“Transitional mental health care” means a level of care that is more intensive than outpatient care, but less intensive than
crisis stabilization care, and is characterized by the provision of traditional mental health treatments such as group and
individual therapy, activity therapy, recreational therapy, and psychotropic medications in the context of a structured
residential setting. Transitional mental health care is indicated for a person with chronic or residual symptomatology who
does not require crisis stabilization care or acute psychiatric care, but whose impairment in functioning nevertheless renders
him or her incapable of adjusting satisfactorily within the general inmate population. Section 945.42(13), F.S.
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The DOC is authorized to contract with appropriate entities to provide health services. The DOC
is required to work in cooperation with the Mental Health Program Office of the Department of
Children and Families to adopt rules necessary for administration of ss. 945.40-945.49, F.S.
Correctional officers employed by a mental health treatment facility must receive specialized
training above and beyond basic certification.
An inmate receiving mental health treatment shall be subject to the same standards applied to
other inmates in the department, including, but not limited to, consideration for parole, release by
reason of gain-time allowances, and release by expiration of sentence.8
Procedure for Placement
If an inmate is deemed mentally ill and in need of care and treatment, he or she may be placed in
a mental health treatment facility after notice and hearing, and upon recommendation of the
warden. The procedure for placement in a mental health treatment facility is as follows:9
 The warden files a petition with the court in the county where the inmate is housed. The
petition must include the warden’s recommendation supported by the expert opinion of a
psychiatrist and the second opinion of a psychiatrist or psychological professional.
 A copy of the petition must be served to the inmate, accompanied by a written notice that an
inmate may apply to have an attorney appointed if the inmate cannot afford one. The attorney
must have access to the inmate and any records that are relevant to the representation of the
inmate.
 The hearing must be held in the same county and one of the inmate’s physicians at the
facility must appear as a witness at the hearing.
 If the inmate is found mentally ill and in need of care, the court must order the inmate be
placed in a mental health treatment facility or, if the inmate is at a mental health treatment
facility, that he or she be retained there. The court must authorize the facility to retain the
inmate for up to six months. If continued placement is necessary, the warden shall apply to
the Division of Administrative Hearings, for an order authorizing continued placement.
The current procedure for a hearing on the placement of an inmate in a mental health treatment
facility provides:10
 The court must serve notice on the warden of the facility where the inmate is confined and
serve the allegedly mentally ill inmate. The notice must specify the date, time, and place of
the hearing; the basis for the allegation of mental illness; and the names of the examining
experts. The hearing shall be held within 5 days, and the court may appoint a general or
special magistrate to preside. One of the experts whose opinion supported the petition for
placement must be present at the hearing.
 If, at the hearing, the court finds that the inmate is mentally ill and in need of care and
treatment, the court must order that he or she be placed in a mental health treatment facility.
The court must provide a copy of the order and all supporting documentation relating to the
8
Section 945.49, F.S.
9
Section 945.43(2), F.S.
10
Section 945.43(3), F.S.
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inmate’s condition to the warden of the treatment facility. If the court finds that the inmate is
not mentally ill, the petition for placement is dismissed.
The court may waive the presence of the inmate at the hearing if it is in the best interests of the
inmate and the inmate’s counsel does not object. The department may transport the inmate to the
location of the hearing if it is not conducted at the facility or electronically.11 The warden of an
institution in which a mental health treatment facility is located may refuse to place any inmate
in that treatment facility who is not accompanied by adequate court orders and documentation, as
required in these sections.12
Procedure for Emergency Placement
An inmate may be placed in a mental health treatment facility on an emergency basis if he or she
is mentally ill and in immediate need of care and treatment. If such care and treatment cannot be
provided at the institution where the inmate is confined, he or she may be placed immediately in
a mental health treatment facility accompanied by the recommendation of the warden of the
institution where the inmate is confined. The recommendation must state the need for the
emergency placement and include a written opinion of a physician verifying the need. Upon
placement, the inmate shall be evaluated, if the inmate is determined to be in need of treatment
or care, the warden initiates proceedings for placement.13
Procedure for Continued Placement
An inmate may be retained in a mental health treatment facility if he or she is mentally ill and
continues to be in need of care and treatment. The procedure for continued placement is as
follows:
 Prior to expiration of the period in which the inmate is being housed in a mental health
treatment facility, the warden must file a petition with the Division of Administrative
Hearings accompanied by a statement from the inmate’s physician justifying the petition and
providing a summary of the inmate’s treatment and the individualized plan for the inmate.14
 Notification is mailed to the inmate, along with a waiver-of-hearing form and the completed
petition, requesting the inmate’s signature. The waiver-of-hearing form shall require express
and informed consent and shall state the inmate is entitled to be represented by an attorney.15
 The hearing is an administrative hearing and conducted in accordance with ch. 120, F.S.,16
except that an order entered by the administrative law judge is final and subject t