65E-5.285. Involuntary Outpatient Placement

(1) Petition for Involuntary Outpatient Placement.

(a) Each criterion alleged must be substantiated by evidence, as follows:

1. Evidence of age must be substantiated, whenever there is any question as to whether the person may be age 18 or older.

2. A diagnosis of mental illness shall be substantiated by 2 professionals as provided in Section 394.4655(2)(a), F.S., who have recently examined the person and whose observations of the person’s condition are consistent with the statutory definition of mental illness, pursuant to Section 394.455(18), F.S., and the clinical description of that diagnosis as described in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, American Psychiatric Association, which is incorporated by reference and may be obtained from the American Psychiatric Association, 1000 Wilson Boulevard, Arlington, VA 22209-3901.

3. The clinical determination that a person is unlikely to survive safely in the community without supervision must be substantiated by evidence of current or past behaviors.

4. The person’s history of lack of compliance with treatment for mental illness must be substantiated by evidence showing specific previous incidents in which the person was non-compliant with treatment, including time periods in which the person was non-compliant with treatment.

5. The person’s involuntarily admission to a receiving or treatment facility or the mental health services in a forensic or correctional facility at least twice in the preceding 36 months, or the person’s acts of serious violent behavior toward self or others or attempted serious bodily harm to self or others at least once during the preceding 36 months, shall be substantiated by evidence.

6. Evidence of the unlikelihood of the person to voluntarily participate in the recommended treatment plan, and either his or her refusal of voluntary placement or inability to determine whether placement is necessary must be substantiated by behaviors, events, and statements by the person supporting this finding.

7. Evidence of the person’s treatment history and current behavior must be presented, including time periods of such treatment to substantiate the conclusion that the person needs involuntary placement in order to prevent a relapse or deterioration that would be likely to result in serious bodily harm to self or others or a substantial harm to his or her well-being.

8. Evidence must be presented to substantiate the likelihood of how the person will benefit from involuntary outpatient placement.

9. Evidence must be presented to substantiate each less restrictive alternative that was examined that would have offered an opportunity for the improvement of the person’s condition.

(b) Petition Filed by Receiving Facility Administrator.

1. If a person is retained involuntarily in a receiving facility, a petition for involuntary outpatient placement must be filed with the circuit court by the facility administrator within the 72-hour examination period, or if the 72 hours ends on a weekend or legal holiday, the petition shall be filed no later than the next court working day thereafter. Recommended form CF-MH 3130, Feb. 05, “Petition for Involuntary Outpatient Placement,” as referenced in subparagraph 65E-5.170(1)(d)2., F.A.C., may be used for this purpose. A copy of the completed petition shall be retained in the person’s clinical record.

2. A petition filed by a receiving facility administrator shall be filed in the county where the facility is located.

3. The administrator of the receiving facility or a designated department representative shall identify the service provider that will have the responsibility of developing a treatment plan and primary responsibility for service provision under an order for involuntary outpatient placement, unless the person is otherwise participating in outpatient psychiatric treatment and is not in need of public financing for that treatment. Recommended form CF-MH 3140, Sept. 06, “Designation of Service Provider for Involuntary Outpatient Placement,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter may be used for this purpose.

4. A treatment plan, complying with the requirements of Section 394.4655, F.S., and this rule, shall be attached to the petition, along with a certification from the service provider that:

a. The proposed services are available in the person’s local community;

b. There is space available in the program or service for the person;

c. Funding is available for the program or service;

d. The service provider agrees to provide those services; and

e. Proposed services have been deemed to be clinically appropriate by a physician, clinical psychologist, clinical social worker, mental health counselor, marriage and family therapist, or psychiatric nurse, as defined in Section 394.455, F.S., who consults with, is employed by, or has a contract with the service provider.

5. Recommended form CF-MH 3145, Sept. 06, “Proposed Individualized Treatment Plan for Involuntary Outpatient Placement and Continued Involuntary Outpatient Placement”, which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter may be used for the development of a treatment plan.

6. If the service provider developing a treatment plan, pursuant to involuntary outpatient placement determines the person is in need of services that cannot be proposed due to non-availability of services, funding, a willing provider, or other reason, it shall submit a completed recommended form CF-MH 3150, Feb. 05, “Notice to Department of Children and Families of Non-Filing of Petition for Involuntary Outpatient Placement or Diminished Treatment Plan Due to Non-Availability of Services or Funding,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter.

7. A copy of the petition for involuntary outpatient placement and the proposed treatment plan shall be provided within 1 working day after filing by the clerk of the court to the respondent, department, guardian or representative, state attorney, and counsel for the respondent. A notice of filing of the petition shall be provided by the clerk of court using recommended form CF-MH 3021, Feb. 05, “Notice of Petition for Involuntary Placement,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter, or other form adopted by the court.

(c) Petition Filed by Treatment Facility Administrator.

1. A petition for involuntary outpatient placement filed by a treatment facility administrator shall be filed prior to the expiration of the involuntary inpatient placement order in the county where the person will be living after discharge from the treatment facility.

2. A copy of form CF-MH 7001, Jan. 98, “State Mental Health Facility Discharge Form,” as referenced in subsection 65E-5.1305(1), F.A.C., shall be attached to the petition.

3. The service provider designated by the department that will have primary responsibility for service provision shall provide a certification to the court, attached to the petition, that the services recommended in the discharge plan are available in the local community and that the provider agrees to provide those services.

4. The petition shall have attached an individualized treatment or service plan that addresses the needs identified in the discharge plan developed by the treatment facility as represented by form CF-MH 3145, “Proposed Individualized Treatment Plan for Involuntary Outpatient Placement and Continued Involuntary Outpatient Placement,” as referenced in subparagraph 65E-5.285(1)(b)5., F.A.C. The plan must have been deemed to be clinically appropriate by a physician, clinical psychologist, psychiatric nurse, mental health counselor, marriage and family therapist, or clinical social worker, as defined in Section 394.455, F.S.

5. A copy of the petition for involuntary outpatient placement and the proposed treatment plan shall be provided within 1 working day after filing by the clerk of the court to the respondent, department, guardian or representative, state attorney, and counsel for the respondent. A notice of filing of the petition shall be provided by the clerk of court using recommended form CF-MH 3021, Feb. 05, “Notice of Petition for Involuntary Placement,” as referenced in subparagraph 65E-5.285(1)(b)7., F.A.C., or other equivalent form adopted by the court.

(2) Hearing on Petition for Involuntary Outpatient Placement.

(a) The clerk of court shall provide notice of the hearing, using recommended form CF-MH 3021, Feb. 05, “Notice of Petition for Involuntary Placement”, as referenced in subparagraph 65E-5.285(1)(b)7., F.A.C., or other form used by the court.

(b) A hearing on the petition for involuntary outpatient placement shall be conducted within 5 working days after the filing of the petition in the county in which the petition is filed. The person is entitled, with the concurrence of counsel, to at least 1 continuance of the hearing, for a period of up to 4 weeks. Recommended form CF-MH 3113, Feb. 05, “Notice to Court – Request for Continuance of Involuntary Placement Hearing,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter may be used for this purpose.

(c) The person and his representative or guardian shall be informed by the court of the right to an independent expert examination and that if the person cannot afford such an examination, the court shall provide for one. Recommended form CF-MH 3022, Feb. 05, “Application for Appointment of Independent Expert Examiner,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter may be used for this purpose.

(d) Recommended form CF-MH 3033, Feb. 05, “Notification to Court of Withdrawal of Petition on Involuntary Inpatient or Involuntary Outpatient Placement,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter may be used if the facility administrator seeks to withdraw the petition for involuntary outpatient placement prior to the hearing. The facility will retain a copy in the person’s clinical record. When a facility withdraws a petition for involuntary placement, it shall notify the court, state attorney, public defender or other attorney for the person, and guardian or representative by telephone within 1 business day of its decision to withdraw the petition, unless such decision is made within 24 hours prior to the hearing. In such cases, the notification must be made immediately.

(e) If the court determines the person does not meet the criteria for involuntary outpatient placement, but instead meets the criteria for involuntary inpatient placement use of recommended form CF-MH 3001, Feb. 05, “Ex Parte Order for Involuntary Inpatient Examination,” as referenced in subsection 65E-5.260(1), F.A.C., or other order used by the court, may be used.

(f) If the court determines the person meets the criteria for involuntary assessment, protective custody, or involuntary admission pursuant to Section 397.675, F.S., and issues an order for one of the same, recommended form CF-MH 3114, Feb. 05, “Order Requiring Involuntary Assessment and Stabilization for Substance Abuse and for Baker Act Discharge of Person,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter, or other order entered by the court, may be used.

(3) Court Order.

(a) If the court concludes that the person meets the criteria for involuntary outpatient placement pursuant to Section 394.4655, F.S., it shall prepare an order. Recommended form CF-MH 3155, Feb. 05, “Order for Involuntary Outpatient Placement or Continued Involuntary Outpatient Placement,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter, or other order entered by the court, may be used for this purpose. This signed order shall be given to the person, guardian, guardian advocate or representative, counsel for the person, state attorney, and administrator of the receiving or treatment facility, with a copy of the order retained in the person’s clinical record.

(b) Upon receipt of the court order for involuntary outpatient placement, the administrator of a treatment facility will provide a copy of the court order and adequate documentation of a person’s mental illness to the service provider, including any advance directives, a psychiatric evaluation of the person, and any evaluations of the person performed by a clinical psychologist, mental health counselor, marriage and family therapist, or clinical social worker.

(c) In order for the department to implement the provisions of Section 394.463(2)(e), F.S., and to ensure that the Agency for Health Care Administration will be able to analyze the data it receives pursuant to that section, service providers shall forward copies of each recommended form CF-MH 3155, “Order for Involuntary Outpatient Placement or Continued Involuntary Outpatient Placement,” as referenced in paragraph 65E-5.285(3)(a), F.A.C., or other order provided by the court, accompanied by mandatory form CF-MH 3118, “Cover Sheet to Agency for Health Care Administration,” as referenced in subsection 65E-5.280(5), F.A.C., to: BA Reporting Center, FMHI-MHC 2637, 13301 Bruce B. Downs Boulevard, Tampa, Florida 33612-3807.

(d) At any time material modifications are proposed to the court ordered treatment plan for which the person and his or her substitute decision-maker if any, agree, the service provider shall submit recommended form CF-MH 3160, Feb. 05, “Notice to Court of Modification to Treatment Plan for Involuntary Outpatient Placement and/or Petition Requesting Approval of Material Modifications to Plan,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter or other form adopted by the court. Each person undergoing involuntary outpatient placement and his or her substitute decision-maker if any, must be given a copy of this form by the service provider, and if requested, the service provider shall assist the person or substitute decision-maker in its completion. If the person or his substitute decision-maker object to the modifications proposed by the service provider or wish to propose modifications not proposed by the service provider, recommended form CF-MH 3160, Feb. 05, “Notice to Court of Modification to Treatment Plan for Involuntary Outpatient Placement and/or Petition Requesting Approval of Material Modifications to Plan,” as referenced in this subsection, or other form adopted by the court may be used.

(e) If a physician has determined the person who is subject to a court order for involuntary outpatient placement has failed or has refused to comply with the treatment ordered by the court, and in his or her clinical judgment, efforts were made to solicit compliance and the person meets the criteria for involuntary examination, the person may be brought to a receiving facility pursuant to Section 394.463, F.S. Mandatory form CF-MH 3052b, “Certificate of a Professional Initiating Involuntary Examination,” as referenced in subsection 65E-5.260(1), F.A.C., shall be used.

(4) Continued Involuntary Outpatient Placement.

(a) A request for continued involuntary outpatient placement by the service provider administrator shall be filed prior to the expiration of the period for which the treatment was ordered. Recommended form CF-MH 3180, Feb. 05, “Petition Requesting Authorization for Continued Involuntary Outpatient Placement,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter, may be used as documentation of that request. The petition shall be filed with the clerk of the circuit court in the county where the person who is the subject of the petition resides.

(b) The petition requesting authorization for continued involuntary outpatient placement shall contain the signed statement of the person’s physician or clinical psychologist justifying the request and shall be accompanied by the following additional documentation:

1. Evidence justifying the request by the physician or clinical psychologist for continued involuntary outpatient placement, including how the person meets each of the statutorily required criteria;

2. A brief summary of the person’s treatment during the time he or she was subject to involuntary outpatient placement; and

3. An individualized plan of continued treatment.

(c) If the service provider developing a treatment plan pursuant to involuntary outpatient placement determines the person is in need of services that cannot be proposed due to non-availability of services, funding, a willing provider, or other reason, it shall submit completed recommended form CF-MH 3150, Feb. 05, “Notice to Department of Children and Families of Non-Filing of Petition for Involuntary Outpatient Placement or Diminished Treatment Plan Due to Non-Availability of Services or Funding,” as referenced in subparagraph 65E-5.285(1)(b)6., F.A.C. This completed form shall be submitted to the BA Reporting Center, FMHI-MHC 2637, 13301 Bruce B. Downs Boulevard, Tampa, Florida 33612-3807.

(d) Each criterion alleged must be substantiated by evidence.

(e) The clerk of court shall provide notice of the hearing, using recommended form CF-MH 3021, Feb. 05, “Notice of Petition for Involuntary Placement,” as referenced in subparagraph 65E-5.285(1)(b)7., F.A.C., or other form approved by the court.

(f) The person and his or her attorney may agree to a period of continued outpatient placement without a court hearing. Should such a hearing be waived, recommended form CF-MH 3185, Feb. 05, “Notice to Court of Waiver of Continued Involuntary Outpatient Placement Hearing and Request for Order,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter may be used for this purpose.

(g) Use of recommended form CF-MH 3033, Feb. 05, “Notification to Court of Withdrawal of Petition on Involuntary Inpatient or Involuntary Outpatient Placement,” as referenced in paragraph 65E-5.285(2)(d), F.A.C., if the facility administrator seeks to withdraw the petition for continued involuntary outpatient placement prior to the hearing. The facility will retain a copy in the person’s clinical record. When a facility withdraws a petition for continued involuntary outpatient placement, it shall notify the court, state attorney, public defender or other attorney for the person, and guardian or representative by telephone within 1 business day of its decision to withdraw the petition, unless such decision is made within 24 hours prior to the hearing. In such cases, the notification must be made immediately.

(h) Based on the findings at the hearing, the court may extend the period of involuntary outpatient placement, release the person from involuntary outpatient placement, or find the person eligible for voluntary status. Recommended form CF-MH 3155, Feb. 05, “Order for Involuntary Outpatient Placement or Continued Involuntary Outpatient Placement,” as referenced in paragraph 65E-5.285(3)(a), F.A.C., or other equivalent form adopted by the court may be used. A copy of the completed order shall be filed in the person’s clinical record and a copy shall be provided to the person, attorney, facility administrator, and guardian, guardian advocate or representative.

(i) In order for the department to implement the provisions of Section 394.463(2)(e), F.S., and to ensure that the Agency for Health Care Administration will be able to analyze the data it receives pursuant to that section, service providers shall forward copies of each recommended form CF-MH 3155, “Order for Involuntary Outpatient Placement or Continued Involuntary Outpatient Placement,” as referenced in paragraph 65E-5.285(3)(a), F.A.C., or other order provided by the court, accompanied by mandatory form CF-MH 3118, “Cover Sheet to Agency for Health Care Administration,” as referenced in subsection 65E-5.280(5), F.A.C., to: BA Reporting Center, FMHI-MHC 2637, 13301 Bruce B. Downs Boulevard, Tampa, Florida 33612-3807.

(j) If at any time material modifications are proposed to the court ordered treatment plan to which the person and his or her substitute decision-maker, if any, agree, the service provider shall submit recommended form CF-MH 3160, Feb. 05, “Notice to Court of Modification to Treatment Plan for Involuntary Outpatient Placement and/or Petition Requesting Approval of Material Modifications to Plan,” as referenced in paragraph 65E-5.285(3)(d), F.A.C., or other form adopted by the court. If the person or his substitute decision-maker object to the modifications proposed by the service provider or wish to propose modifications not proposed by the service provider, recommended form CF-MH 3160, Feb. 05, “Notice to Court of Modification to Treatment Plan for Involuntary Outpatient Placement and/or Petition Requesting Approval of Material Modifications to Plan,” as referenced in paragraph 65E-5.285(3)(d), F.A.C., or other form adopted by the court may be used.

(k) If a physician has determined the person who is subject to a court order for involuntary outpatient placement has failed or has refused to comply with the treatment ordered by the court, and in his or her clinical judgment, efforts were made to solicit compliance and the person meets the criteria for involuntary examination, the person may be brought to a receiving facility pursuant to Section 394.463, F.S. Mandatory form CF-MH 3052b, “Certificate of a Professional Initiating Involuntary Examination,” as referenced in subsection 65E-5.260(1), F.A.C., shall be used.

(5) Discharge from Involuntary Outpatient Placement.

(a) At any time a person no longer meets each of the criteria for involuntary outpatient placement, the administrator of the service provider shall discharge the person from treatment or transfer the person, if the person is able and willing to provide express and informed consent, to voluntary status.

(b) The administrator of the service provider will provide notification to the person, guardian, guardian advocate, representative, attorney for the person, and the court that ordered such treatment, with a copy placed in the person’s clinical record. Recommended form CF-MH 3038, Feb. 05, “Notice of Release or Discharge,” as referenced in paragraph 65E-5.2801(8)(e), F.A.C., may be used for this purpose.

(c) At any time a person who is subject to an order for involuntary outpatient placement or continued involuntary outpatient placement, or the guardian, guardian advocate, health care surrogate or proxy, or attorney representing the person, believes any one of the criteria for involuntary outpatient placement are no longer met, a petition for termination of an involuntary outpatient placement order may be filed with the circuit court having jurisdiction. Recommended form CF-MH 3170, Feb. 05, “Petition for Termination of Involuntary Outpatient Placement Order,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter, or other form adopted by the court may be used for this purpose. If the court determines to conduct a hearing on the petition, notice of the hearing shall be provided by the clerk of court, pursuant to Section 394.4599, F.S.

Specific Authority 394.46715 FS. Law Implemented 394.455, 394.455(18), 394.4599, 394.463, 394.4655, 394.4655(2)(a), 397.675 FS. History– New 4-4-05, Amended 1-8-07.