HomeMy WebLinkAbout2022-252A2022 Indian River County Transportation Plan
Language additions in FY 22-23 to comply with July 1St legislation passed:
Senate Bill 1262
✓ Requires law enforcement officers to report any known contact information for
relatives of persons detained under the Baker Act.
✓ Requires law enforcement officers to search certain electronic databases for
emergency contact information of Baker and Marchman Act patients being
transported to a receiving facility.
Senate Bill 1844
✓ Directs law enforcement officers transporting individuals under the Baker Act or
Marchman Act to restrain individuals using the least restrictive means available
and appropriate under the circumstances.
General Provisions
Indian River County in partnership with Southeast Florida Behavioral Health Network, in
accordance with Florida Statute Chapter 394, Part 1, Florida Mental Health Act or the
"Baker Act" Florida Statute Chapter 397, Hal S. Marchman Alcohol and Other Drug
Services A t of 1993, and pursuant to Chapter 394.462, Florida Statutes (F.S), has
developed a plan to organize a centralized system for acute care services. This plan has
been reviewed by community stakeholders and the Indian River County Public Safety
Coordinating Council for Criminal Justice, Mental Health, and Substance Abuse. This
Transportation Plan requires approval by the Indian River County Board of County
Commissioners, Southeast Florida Behavioral Health Network and the Department of
Children and Families. Upon approval, this document will serve as the Transportation
Plan for Indian River County.
The 2022 Indian River County Transportation Plan (referenced below as "Transportation
Plan") is intended to serve the continue best interest of persons in need of public
behavioral healthcare in Indian River County. The Transportation Plan will ensure that
individuals on an involuntary Baker Act/Marchman Act will obtain immediate access to
acute care services and will reduce the need for inter -hospital transfers for psychiatric and
addiction services. Coordination of services among providers in Indian River County will
continue to meet individual needs.
A. The intent of this Transportation Plan is to:
a. Arrange the centralization and improvement in the provision of services
within Indian River County, which may include an exception to the
requirement for transportation to the nearest receiving facility;
b. Establish a procedure by which a facility may provide, in addition to required
psychiatric and addiction services; an environment and services which are
uniquely tailored to the needs of an identified group of persons with special
needs, such as persons with hearing impairments or visual impairments, or
persons with physical frailties; or
c. Create a specialized transportation system that provides an efficient and
humane method of transporting patients to receiving facilities, among
receiving facilities, and to treatment facilities.
B. Section 394.462, F.S. requires that "Each county shall designate a single law
enforcement agency within the county, or portions thereof, to take a person into
custody upon entry of an ex parte order or the execution of a certificate for
involuntary examination by an authorized professional and to transport that person
to the appropriate facility within the designated receiving system...." This section
also permits a county to contract with an emergency medical transport service or
private transport company for transportation of persons to receiving facilities.
Under this Transportation Plan each law enforcement agency is responsible for its
jurisdiction and is designated to effectuate the Transportation Plan for Indian River
County.
The Transportation Plan calls for the designated law enforcement agencies to
transport as follows:
Palm Beach County
a. Adults on an involuntary Baker Act to:
a. Fair Oaks Pavilion at Delray Medical Center
b. HCA Florida JFK Medical Center North
c. South County Mental Health Center
d. Neuro Behavioral Hospital
b.Adults on an involuntary Marchman Act to:
a. Drug Abuse Foundation
c. Youth under the age 18 years on an involuntary Baker Act to:
a. HCA Florida JFK Medical Center North
d.Youth under the age of 18 years on an involuntary Marchman Act to:
a. Drug Abuse Foundation
Martin County
a. Adults on an involuntary Baker Act to:
a. New Horizons of the Treasure Coast
b. Coral Shores Behavioral Health
b.Adults on an involuntary Marchman Act to:
a. New Horizons of the Treasure Coast
c. Youth under the age of 18 on an involuntary Baker Act to:
a. New Horizons of the Treasure Coast
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b. Coral Shores Behavioral Health
d.Youth under the a-ge of 18 years on an involuntary Marchman Act to:
a. New Horizons of the Treasure Coast
St. Lucie County
a. Adults on an involuntary Baker Act to:
a. New Horizons of the Treasure Coast
b. Lawnwood Medical Center
c. Port St. Lucie Hospital
b.Adults on an involuntary Marchman Act to:
a. New Horizons of the Treasure Coast
c. Youth under the age of 18 on an involuntary Baker Act to:
a. New Horizons of the Treasure Coast
b. Lawnwood Medical Center
d.Youth under the age of 18 years on an involuntary Marchman Act to:
a. New Horizons of the Treasure Coast
Indian River County
a. Adults on an involuntary Baker Act to:
a. New Horizons of the Treasure Coast
b. Cleveland Clinic Indian River Medical Center
b.Adults on an involuntary Marchman Act to:
a. New Horizons of the Treasure Coast
c. Youth under the age of 18 on an involuntary Baker Act to:
a. Nearest Receiving Facility Cleveland Clinic Indian River Medical
Center
d.Youth under the age of 18 years on an involuntary Marchman Act to:
a. Nearest Receiving Facility
b. New Horizons of the Treasure Coast
Okeechobee County
a. Adults on an involuntary Baker Act to:
a. New Horizons of the Treasure Coast
b.Adults on an involuntary Marchman Act to:
a. New Horizons of the Treasure Coast
c. Youth under the age of 18 on an involuntary Baker Act to:
a. New Horizons of the Treasure Coast
d.Youth under the age of 18 years on an involuntary Marchman Act to:
a. New Horizons of the Treasure Coast
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Current System Capacity
Palm Beach County
Baker Act Receiving Facilities
• Fair Oaks Pavilion at Delray Medical Center: 50 beds
• HCA Florida JFK Medical Center North: 123 beds
• South County Mental Health Center: 45 beds
• Neuro Behavioral Hospital: 42 beds
Substance Abuse Detoxification
• HCA Florida JFK Medical Center North: Stabilization Center for Opioid overdoses
• Drug Abuse Foundation: 44 Detox Beds
Martin County
Baker Act Receiving Facilities
• Coral Shores Behavioral Health: 56 beds
• New Horizons of the Treasure Coast: 68 beds
Substance Abuse Detoxification
• New Horizons of the Treasure Coast: 20 beds
St. Lucie County
Baker Act Receiving Facilities
• New Horizons of the Treasure Coast and Okeechobee: 68 beds
• Lawnwood Medical Center
• Port St. Lucie Hospital
Substance Abuse Detoxification
• New Horizons of the Treasure Coast: 20 beds
Indian River County
Baker Act Receiving Facilities
• New Horizons of the Treasure Coast and Okeechobee: 68 beds
• Cleveland Clinic Indian River Medical Center
Substance Abuse Detoxification
• New Horizons of the Treasure Coast: 20 beds
Okeechobee
Baker Act Receiving Facilities
• New Horizons of the Treasure Coast and Okeechobee: 68 beds
• Cleveland Clinic Indian River Medical Center
Substance Abuse Detoxification
Z
New Horizons of the Treasure Coast: 20 beds
The receiving facilities listed in this paragraph will notify the Baker Act Task Force
Committee of any changes in system capacity.
Marchman Act and Baker Act Statistics of 2021
Martin, Indian River, St. Lucie, and Okeechobee
Total Mobile Response Team calls in Circuit 19 for FY 21-22 was 1172; with a breakdown
of 1,1019 face-to-face community, 119 involuntary/Baker Acts; and 307 youth (under 18
years of age).
Marchman and Baker Act filings for the 19th Judicial Circuit show a total of 2,972 filings
for 2021; with a breakdown of 1034 Baker Acts and 169 Marchman Acts.
Baker Act
Florida Statutes, Chapter 394, Part 1, Florida Mental Health Act commonly called the
"Baker Act" is a means for providing persons suffering from a mental illness with
emergency services and evaluation for mental health treatment, when required, either on
a voluntary or involuntary basis.
Florida law provides a methodology by which a person believed to suffer from a mental
illness may be examined to determine if he or she qualifies for involuntary services. Under
Florida law, there are three methods by which a person who appears to suffer from a
mental illness can be involuntarily examined. Those methods are as follows, to -wit:
1. Involuntary Court Proceeding: Through the issuance of an ex parte order by the
Court under Section 394.463, F.S. if less restrictive means are not available,
requiring the law enforcement officer or other designated agent of the court, to take
the person to the appropriate, or nearest facility, within the designated receiving
system; or alternatively;
2. Involuntary Health Care Admission: Through the execution of a certificate
issued by a physician, clinical psychologist, psychiatric nurse, mental health
counselor, Licensed Clinical Social Worker, marriage and family therapist requiring
the law enforcement officer to take the person to the appropriate, or nearest, facility
with in the designated receiving system; or alternatively;
3. Law Enforcement Baker Act (LESA): Through the action of a law enforcement
officer who finds a person meets the criteria for a Baker Act involuntary
examination and who executes a written report detailing the circumstances under
which the person was taken into custody and then deliver that person to the
appropriate, or nearest, facility within the designated receiving system.
Under each circumstance the person must be transported by law enforcement (or under
the exceptions provision of Florida Law or another entity) in accordance with the
Transportation Plan set forth herein.
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Choice
Law Enforcement may take into consideration individual choice when making a
determination of which Baker Act receiving facility to transport the individual. However, if
an Ex Parte order for involuntary Examination has been entered by the Court, requiring
the law enforcement officer to take the person to a specifically named facility, or the
appropriate, or nearest, facility within the designated receiving system.
Least Restrictive Means to Transport
Pursuant to Senate Bill 1844, passed by the Florida Legislature and made effective on
July 1St, 2022, Law Enforcement Officers transporting individuals under the Baker Act
should use the least restrictive means available and appropriate under the circumstances
to transport individuals. This may include the utilization of de-escalation techniques,
forgoing handcuffs, and other restraints, and/or the inclusion of Community Intervention
Team (CIT) officers.
Emergency Contact Information
Pursuant to Senate Bill 1262, passed by the Florida Legislature and made effective on
July 1St, 2022, Law Enforcement Officers are required to: (a) search certain electronic
databases for emergency contact information of Baker Act patients being transported to
a receiving facility, and; (b) report any known contact information for relatives of persons
detained under the Baker Act.
Medical Treatment
Pursuant to Section 394.462(1)(i), F.S., "[i]f the appropriate law enforcement officer
believes that a person has an emergency medical condition as defined in Section
395.002, Florida Statutes, the person may be first transported to a hospital for emergency
medical treatment, regardless of whether the hospital is a designated receiving facility."
Transportation Upon Being Medically Stabilized: Upon completion of treatment for
individuals who are designated "on hold" or "still in custody", law enforcement is
responsible for arranging transport to the jail to be booked and/or to the appropriate Baker
Act receiving facility. For persons not in custody for a criminal offense and the individual
has been stabilized, the hospital or emergency care center shall be responsible for
arranging transportation to the appropriate Baker Act receiving facility under this
Transportation Plan.
Persons Arrested or in Custody
Felony Arrests: Pursuant to Chapter 394.462, (1){f), Florida Statutes, 'When any
law enforcement officer has arrested a person for a felony and it appears that the
person meets the statutory guidelines for involuntary examination or placement
under this part, such person must first be processed in the same manner as any
other criminal suspect. The law enforcement agency shall thereafter immediately
notify the appropriate facility within the designated receiving system pursuant to a
transportation plan or an exception under Subsection (4), or to the nearest
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receiving facility if neither apply. The receiving facility shall be responsible for
promptly arranging for the examination and treatment of the person. The receiving
facility is not required to admit a person charged with a crime for whom the facility
determines and documents that it is unable to provide adequate security but shall
provide examination and treatment to the person where he or she is held."
2.
3. Minor Criminal Offenses (Includes some misdemeanors and non -criminal
offenses) Pursuant to chapter 394.462(1)(g) F.S., when a designated law
enforcement agency "has custody of a person based on either noncriminal or minor
criminal behavior that meets the statutory guidelines for involuntary examination
pursuant to s. 394.463, the law enforcement officer shall transport the person to
the appropriate facility within the designated receiving system pursuant to a
transportation plan"
4. Transportation Upon Stabilization and Assessment under the Baker Act:
Upon completion of assessment and stabilization on persons who are designated
on hold or "still in custody", law enforcement is responsible for arranging transport
to the jail to be booked and/or to the appropriate Baker Act receiving facility. For
persons not in custody for a criminal offense and the individual has been stabilized,
the hospital or emergency care center shall be responsible for arranging
transportation to the appropriate Baker Act receiving facility under this
Transportation Plan.
Transfer Between Receiving Facilities
Once an individual is in a Baker Act receiving facility, there are occasions when that
individual needs to be discharged from one Baker Act receiving facility and transferred to
another Baker Act receiving facility. Transportation between facilities is coordinated by
the transferring Baker Act facility. Law enforcement is not responsible to transport
individuals from one Baker Act receiving facility to another unless the individual has
criminal changes. In that case, the Indian River County Sheriffs Office shall be noticed
prior to transfer and will, provide the transportation.
Transfer of Custody: Under section 394.462(3), Custody of a person who is transported
pursuant to the Florida Mental Health Act, Part I, of Chapter 394, Florida Statutes, along
with related documentation, shall be relinquished to a responsible individual at the
appropriate receiving or treatment facility. Law enforcement shall not leave the individual
until this has been accomplished.
Marchman Act
Florida Statutes Chapter 397, commonly called the "Marchman Act" is a means for
providing persons suffering from a substance use disorder with emergency services and
temporary evaluation for substance abuse treatment, when required, on an involuntary
basis.
Florida law provides a methodology by which a person believed to suffer from a substance
use disorder may be assessed and stabilized to determine if he or she qualifies for I
involuntary assessment and stabilization. Under Florida law there are several methods
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by which a person who appears to suffer from a substance use disorder can be
involuntarily assessed and stabilized. Those methods are as follows, to -wit:
1. Involuntary Court Admission: Through the issuance by the Court of an order either
(a.) after an evidentiary hearing or (b.) alternatively without hearing on an ex parte
basis by the Court. Under either circumstance the Court shall issue an order
expressly designating the facility the person is to be delivered to for assessment
and stabilization. Under this method the court will dictate the specific facility law
enforcement must deliver the person to; or alternately;
2. Emergency Admissions: Through the execution of a certificate issued by a
physician, an advanced registered nurse practitioner, a psychiatric nurse, a clinical
psychologist, a clinical social worker, marriage and family therapist, a mental
health counselor, a physician assistant working under the scope of practice of the
supervising physician, or a master's level certified addictions professional for
substance abuse services, and the completion of an application for emergency
admission requiring the law enforcement officer to take the person to the
appropriate, or nearest, facility within the designated receiving system; or
alternately;
3. Protective Custody: Through the action of a law enforcement officer who may
implement protective custody measures either with or without consent of the
person requiring the law enforcement officer to take the person to the appropriate,
or nearest, facility within the designated receiving system; or alternatively
4. Involuntary Assessment Procedure for Minors: By the execution of an application
for admissions compiled with an addiction receiving facility by the minor's parent,
guardian or legal custodian, requiring the law enforcement officer to take the
person to the appropriate, or nearest, facility within the designated receiving
system.
Under each circumstance the person must be transported by law enforcement (or under
the exceptions provisions of Florida law another entity) in accordance with the
Transportation Plan set forth herein.
Involuntary Assessments
1. Court -Ordered: Under Chapter 397.6818, F.S.: If the court enters an order
authorizing involuntary assessment and stabilization, the order shall include the
court's findings with respect to the availability and appropriateness of the least
restrictive alternatives and the need for the appointment of an attorney to represent
the respondent and may designate the specific licensed service provider to
perform the involuntary assessment and stabilization of the respondent. The
respondent may choose the licensed service provider to deliver the involuntary
assessment where possible and appropriate.
2. If the court finds it necessary, it may order the Indian River County Sheriffs Office
to take the respondent into custody and deliver him or her to the licensed service
provider specified in the court order or, if none is specified, to the nearest
appropriate licensed service provider for involuntary assessment.
3. Pursuant to Chapter 397.6818, Florida Statutes, the court may enter an order
requiring involuntary assessment and stabilization. In that order, the court may
require the Indian River County Sheriffs office to deliver the individual for
assessment and stabilization and the court shall designate the appropriate
licensed Marchman Act receiving facility for the individual.
4. Non -Court-ordered Involuntary Assessments: The designated law enforcement
agency shall be responsible for: transporting.
5. Unless otherwise ordered by the court, all persons on an involuntary Marchman
Act are to be transported to the Drug Abuse Foundation or the Detox facility in
Belle Glade based on their capacity and capability to serve the individual.
6. The order is valid only for the period specified in the order or, if a period is not
specified, for seven (7) days after the order is signed.
Choice
Law Enforcement may take into consideration individual choice when making a
determination of which Marchman Act receiving facility to transport the individual.
However, if an Ex -Parte Orderfor Involuntary Examination has been entered by the Court,
requiring the law enforcement officer to take the person to a specifically named facility, or
the appropriate, or nearest, facility within the designated receiving system.
Least Restrictive Means to Transport
Pursuant to Senate Bill 1844, passed by the Florida Legislature and made effective on
July 1st, 2022, Law Enforcement Officers transporting individuals under the Marchman
Act should use the least restrictive means available and appropriate under the
circumstances. This may include the utilization of de-escalation techniques, forgoing
handcuffs and other restraints, and/or the inclusion of Community Intervention Team
(CIT) officers.
Emergency Contact Information
Pursuant to Senate Bill 1262, passed by the Florida Legislature and made effective on
July 1st, 2022, Law Enforcement Officers are required to search certain electronic
databases for emergency contact information of Marchman Act patients being transported
to a receiving facility, and; (b) report any known contact information for relatives of
persons detained under the Marchman Act.
Medical Treatment
Pursuant to 394.462(2)(a), F.S., if an individual has a medical issue that needs to be
addressed or an intoxication level that is medically compromising, law enforcement, or
Emergency Medical Services are required to transport the individual being detained under
a Marchman Act to the nearest hospital or emergency care center for medical
stabilization.
Transportation on Upon Being Medically Stabilized: Upon completion of treatment for
individuals who are designated "on hold" or "still in custody", law enforcement is
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responsible or arranging transport to the jail to be booked and/or to the appropriate
Marchman Act receiving facility. For persons not in custody for a criminal offense and the
individual has been stabilized, the hospital or emergency care center shall be responsible
for arranging transportation to the appropriate Marchman Act receiving facility under this
Transportation Plan. See Section 394.462(1)(g), F.S.
Persons Arrested or in Custody
1. Felony Offenses: Pursuant to 394.462(1)(h), Florida Statutes: 'When any law
enforcement officer has arrested a person for a felony and it appears that the
person meets the statutory guidelines for involuntary examination or placement
under this part, such person must first be processed in the same manner as any
other criminal suspect. The law enforcement agency shall thereafter immediately
notify the appropriate facility within the designated receiving system pursuant to a
transportation plan. The receiving facility shall be responsible for promptly
arranging for the examination and treatment of the person. The receiving facility is
not required to admit a person charged with a crime for whom the facility
determines and documents that it is unable to provide adequate security, but shall
provide examination and treatment to the person where he or she is held."
2. Minor Criminal Offenses: (Includes some misdemeanors and noncriminal
offenses). Pursuant to 394.462(1)(g), F.S.: "Persons who meet the statutory
guidelines for involuntary admission, pursuant to Section 397.675 may also be
transported by law enforcement officers to the extent resources are available and
as otherwise provided by law. Such persons shall be transported to an appropriate
facility within the designated receiving facility pursuant to a transportation plan."
3. Transportation Upon Stabilization and Assessment under the Marchman
Act: Upon completion of assessment and stabilization of persons who are
designated "on hold" or "still in custody", law enforcement is responsible for
arranging transport to the jail to be booked and/or to the appropriate Marchman
Act receiving facility. For persons not in custody for a criminal offense and the
individual has been stabilized, the hospital or emergency are center shall be
responsible for arranging transportation to the appropriate Marchman Act receiving
facility under this Transportation Plan. See Section 394.462(1)(g), F.S.
Transportation to a Treatment Facility
1. For those hospitalized patients unable to afford transportation between hospitals
and receiving facilities under 394.462(1), F.S. or Section 397.675, regardless of
whether the patient is under an involuntary order or is voluntarily requesting
transportation, the facility will be responsible for transporting the patient to the
receiving facility. See Section 394.462(2)(a), F.S.
2. However, under this Transportation Plan, "county or municipal law enforcement
and correctional personnel and equipment may not be used to transport patients
adjudicated incapacitated or found by the court to meet the criteria for involuntary
placement pursuant to, Section 394.467, except in small rural counties where there
are no cost-efficient alternatives. See Section 394.462, F.S.
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System Oversight
In an effort to resolve complaints, grievances, and disputes, which may arise during
implementation of the plan, The Baker Act Task Force Committee will implement
necessary actions in response to its ongoing review and any public or Southeast Florida
Behavioral Health Network (SEFBHN) or Department of Children and Families review.
The Southeast Region Department of Children and Families, Substance Abuse and
Mental Health Program Office and SEFBHN is responsible for providing oversight to the
Transportation Plan. The Department of Children and Families and SEFBHN have the
authority to resolve issues concerning the Transportation Plan, approve inter -agency
agreements, as well as coordinate other services needed for individuals beyond acute
care services. The Regional office also has a working relationship with the Agency for
Health Care Administration if issues arise beyond the department's authority.
Interorganizational Collaboration
Implementing an excellent Transportation Plan on behalf of persons in need of behavioral
health services requires a significant amount of cooperation, commitment, and
collaboration from all parties involved. Besides having the strong support of law
enforcement and the behavioral health providers, Indian River County hospitals have
engaged in public planning process that has strengthened the relationships between all
parties responsible for implementing the Transportation Plan in Indian River County.
Definitions
Baker Act: The Florida Mental Health Act.
Marchman Act: The Hal S. Marchman Alcohol and Other Drug Services Act.
Receiving Facility: Any public or private facility designated by the Department of
Children and Families to receive and hold involuntary patients under emergency
conditions or for psychiatric evaluation and to provide short-term treatment.
Private Receiving Facility: Any hospital or facility operated by a for-profit or not -for- profit
corporation or association that provides mental health services and is not a public facility.
Public Receiving Facility: Any facility that has contracted with the Department of
Children and Families to provide mental health services to all persons, regardless of their
ability to pay, and is receiving state funds for such purpose.
Adopted by the Indian River County Board of County Commissioners: December 6, 2022