September 5, 2000
SUMMARY OF FLORIDA'S LAW ON SUBSTANCE ABUSE TREATMENT
By: Sandra Norman-Eady, Senior Attorney
You wanted a summary of Florida's “Marchman” law on the involuntary commitment of substance abusers.
Florida enacted its involuntary civil commitment law in 1993. PA 93-39 is called the Hal S. Marchman Alcohol and Other Drug Services Act and can be found at FSA § 397.301 to 397.998. It has nine different parts; part five is devoted to involuntary admissions procedures. The other parts include sections on client rights, voluntary admission procedures, and inmate substance abuse programs. We have attached a copy of the entire act.
Florida permits a person to be admitted for treatment against his will in three different circumstances: (1) a law enforcement officer may have him placed in protective custody if he exhibits a need for treatment in a public place or in a way that attracts the officer's attention; (2) any responsible person with knowledge of a person's substance abuse may have him admitted in an emergency if he is likely to harm himself or others or he is so impaired that he cannot recognize his need for treatment; and (3) a spouse, relative, guardian, or three adults with knowledge of the person's substance abuse may petition the court for involuntary treatment.
The remainder of this report describes separately the circumstances that may give rise to involuntary admission in Florida, the admission process, the duration of admission, and the duties of service providers.
We have attached a summary of Connecticut's law on involuntary commitment for your information. As you will see, the laws in these two states are somewhat similar. For example, both allow for commitment when someone is a substance abuser and either poses a danger to himself or others or fails to realize the need for treatment, establish a forum where all evidence is heard, and have expedited procedures for emergency commitment. Florida, however, requires a good faith belief that the person to be committed is a substance abuser and either harmful to himself or others or incapable of making a rational decision regarding substance abuse services. In Connecticut, a court needs to find by clear and convincing evidence that the person to be committed has psychiatric disabilities and is dangerous to himself or others, or gravely disabled.
GENERAL INVOLUNTARY ADMISSION PROCEDURES
Who May Commit
A law enforcement officer, physician, parent, legal guardian, or the court and a petitioner may admit a person involuntarily. A parent or legal guardian who seeks to admit a minor must participate in all aspects of treatment.
Basis for Commitment
A person may be involuntary admitted if there is a good faith reason to believe that he is substance abuse impaired and (1) cannot control his substance use; (2) has inflicted, threatened or attempted to inflict, or is likely to inflict physical harm on himself or others; or (3) is in need of substance abuse services but is incapable of realizing it or making a rational decision regarding it. Mere refusal to receive services does not constitute lack of judgment.
Service Provider Responsibilities
When someone is involuntarily admitted, the service provider must:
1. make sure that he meets the admission criteria,
2. determine whether the person's medical and behavioral conditions are beyond the provider's safe management capabilities,
3. admit the person to the least restrictive available setting that meets his treatment needs,
4. verify that the admission will not exceed the facility's service capacity,
5. determine whether the person or those financially responsible for him can afford the services,
6. provide a safe environment, and
7. discharge and refer to a more appropriate setting any client whose medical condition or behavioral problem becomes more than the facility can safely manage.
If the person should not be admitted for any of the above-stated reasons, the service provider must attempt to contact the referral source and assist in arranging alternative interventions. If the referring party cannot be reached, the provider must refuse admission and attempt to assist the person in gaining access to other appropriate services, if indicated. Within one weekday, the service provider must give the referring party a written report of the reasons for the refusal to admit.
If the service provider determines that an involuntary client's behavioral problems become unmanageable, it must discharge the client and attempt to assist him in securing more appropriate services in a setting more responsive to his needs. Within 72 hours after taking this action, the service provider must complete a report stating the reasons for the discharge and documenting its efforts to assist the client in finding other services.
Release from Involuntary Commitment
Only a qualified professional in a hospital, a detoxification facility, an addiction receiving facility, or any less restrictive treatment component may release a client who has been involuntarily admitted. The service provider must give notice of the release to different parties depending on the nature of the commitment. For example, applicants must be notified when someone admitted in an emergency is released.
NONCOURT INVOLVED ADMISSIONS: PROTECTIVE CUSTODY
Who May Commit and When
A law enforcement officer can seek to place in protective custody someone who meets the involuntary admission criteria stated above and who is brought to his attention or observed in a public place.
A law enforcement officer acting in good faith cannot be held criminally or civilly liable for false imprisonment.
Procedure for Involuntary Placement
After giving consideration to a person's refusal to consent to assistance, a law enforcement officer may (1) take him to a hospital or a licensed detoxification or addictions receiving facility, or (2) detain him in any municipal or county jail or other appropriate detention facility.
The officer in charge of the detention facility must notify the nearest appropriate licensed service provider of the detention within the first eight hours. The facility must arrange transportation to an appropriate licensed service provider with an available bed.
An attending physician must assess people in protected custody within the first 72 hours to determine the need for further services. The law enforcement officer must notify the nearest relative of the person placed in protective custody unless the person is an adult who requests no notification.
Release from Protective Custody
A qualified professional must release a client from protective custody when he no longer meets the involuntary admission criteria, the 72-hours have elapsed, or the client agrees to voluntary admission.
NONCOURT INVOLVED ADMISSIONS: EMERGENCY
Who May Commit and When
A physician, spouse, guardian, relative, or any other responsible adult with personal knowledge of a person's substance abuse may request an emergency admission. A minor's parent, legal guardian, or legal custodian may seek his admission in an emergency.
A treatment facility may admit a person for emergency assessment and stabilization upon a physician's certificate and the completion of an application for emergency admission.
The physician's certificate must (1) specify the relationship between the physician and person to be admitted, the applicant, and the treatment facility; (2) state that the physician examined and assessed the person to be admitted within five days of the application date; and (3) include factual allegations that support the need for emergency admission.
The certificate must recommend the least restrictive service appropriate for the person to be admitted. A signed copy of the certificate must accompany the admittee and become a part of his clinical record.
Release after Emergency Admission
A physician must assess clients to determine their need for further service within 72 after their emergency admission to a residential treatment facility. A qualified professional must assess clients in nonresidential facilities within five days. Based upon this assessment, the facility must release the client and refer him to any other needed services or continue the admission (1) with the client's consent or (2) without it if a petition for involuntary assessment or treatment has been initiated.
COURT INVOLVED ADMISSIONS: INVOLUNTARY TREATMENT
Who May Apply
A spouse, guardian, relative, service provider, or any three adults with personal knowledge of a person's substance abuse and treatment and assessment history may petition for involuntary treatment. If the substance abuser is a minor, his parent, legal guardian, or service provider may complete the petition.
Who May Be Committed and When
A person may be the subject of a petition for court-ordered involuntary treatment if he meets the criteria for involuntary admission and he has been (1) placed under protective custody or subjected to emergency admission during the previous 10 days,
(2) assessed by a qualified professional within the past five days, or (3) subjected to involuntary assessment and stabilization or alternative involuntary admission within the previous 12 days.
The petition must name the person to be committed (respondent), his attorney, and the petitioner; and state the respondent's relationship to the petitioner, the findings and recommendations of the professional assessment, and the factual allegations establishing the need for involuntary treatment.
Hearing on Petition. Once the petition is filed, the court must immediately determine if the respondent is represented by an attorney or if he needs appointed counsel. The court must schedule a hearing on the petition within 10 days. The court must send the respondent, the petitioner, any legal representatives, and any other people it may direct a copy of the petition and notice of the hearing. The court must also send the respondent a summons.
The petitioner has the burden of proving by clear and convincing evidence that the respondent is substance abuse impaired, that his condition has caused him to lose the power of self-control with respect to substance abuse, and that (1) he has inflicted or is likely to inflict physical harm himself or others unless admitted or (2) his refusal to receive care voluntarily is based on judgment impaired by substance abuse. The court must hear and review all relevant evidence and render a decision at the conclusion of the hearing.
Court Order. If the petitioner meets his burden, the court may order treatment for up to 60 days. If necessary, the court may order the sheriff to take the respondent into custody and deliver him to a licensed service provider. The facility must release the respondent when the conditions justifying treatment no longer exist. When these conditions are expected to last longer than 60 days, applicants may request a renewal before the 60 days expire. The original court retains jurisdiction of the case for the entry of such further orders as circumstances may require.
At any time before the 60 days expire, the respondent may be discharged if he:
1. no longer meets the criteria for involuntary admission and has given his informed consent to be transferred to voluntary treatment;
2. was admitted because of his likelihood to inflict physical harm on himself or others and that likelihood no longer exists; or
3. is no longer incapable of making sound decision regarding his treatment needs or shows signs that further treatment will not bring about further significant improvements in his condition;
4. no longer needs services; or
5. is beyond the service provider's safe management capabilities.
Extension of Involuntary Treatment
A service provider may file a petition to renew a treatment order at least 10 days before the initial order expires if the respondent continues to meet the criteria for involuntary treatment. The court must immediately schedule a hearing within 15 days after the petition is filed. The notification required and the hearing process is the same as that for the initial hearing.
The court may grant the extension for up to 90 days. As with the initial order, the respondent must be released when the conditions justifying treatment no longer exist. Any petition for an extension must be filed before the order in effect expires.
At the conclusion of 60 days, the respondent is automatically discharged unless the service provider makes a motion for an extension as indicated above.