(1) Court Order. Sworn testimony shall be documented by using Form CF-MH 3002, (July 2023), “”Petition and Affidavit Seeking Ex Parte Order Requiring Involuntary Examination,”” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-15765, or other form used by the court. Documentation of the findings of the court on Form CF-MH 3001, (July 2023), “”Ex Parte Order for Involuntary Examination,”” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-15766, or other order used by the court, shall be used when there is reason to believe the criteria for involuntary examination are met. The ex parte order for involuntary examination shall accompany the individual to the receiving facility.

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Terms Used In Florida Regulations 65E-5.280

  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Examination: the integration of the physical examination required under Florida Statutes § 394. See Florida Regulations 65E-5.100
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
    (2) Law Enforcement.
    (a) If a law enforcement officer in the course of his or her official duties initiates an involuntary examination, the officer shall complete Form CF-MH 3052a, “”Report of Law Enforcement Officer Initiating Involuntary Examination,”” (July 2023), which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-15767.
    (b) Form CF-MH 3052a, “”Report of Law Enforcement Officer Initiating Involuntary Examination”” shall accompany the individual to the receiving facility.
    (3) Professional Certificate.
    (a) A professional authorized by Section 394.463(2)(a)3., F.S., who determines, after personally examining an individual believed to meet the involuntary examination criteria within the preceding 48 hours, that the criteria are met, is authorized to execute Form CF-MH 3052b, “”Certificate of Professional Initiating Involuntary Examination,”” (July 2023), which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-15768.
    (b) Form CF-MH 3052b, “”Certificate of Professional Initiating Involuntary Examination,”” shall be executed immediately after it is completed by arranging for transportation to a designated receiving facility. The Certificate is valid throughout the state. The completed certificate shall accompany the individual to a receiving facility.
    (4) Emergency Medical Conditions.
    (a) Form CF-MH 3101, (July 2023), “”Hospital Determination that Individual Does Not Meet Involuntary Placement Criteria,”” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-15769 may be used to document the results of the examination prescribed in Section 394.463(2)(h), F.S.
    (b) Receiving facilities shall develop policies and procedures that expedite the transfer of individuals referred from non-designated hospitals after examination or treatment of an emergency medical condition, within the 12 hours required by Section 394.463(2)(i), F.S.
    (c) The 72-hour involuntary examination period set out in Section 394.463(2)(g), F.S., shall not be exceeded. In order to document the 72-hour period has not been exceeded, Form CF-MH 3102, (July 2023), “”Request for Involuntary Examination After Stabilization of Emergency Medical Condition,”” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-15770 may be used for this purpose. The form may be sent to a designated receiving facility at which appropriate medical treatment is available.
    (5) The Department requires specific data to identify trends and patterns experienced by individuals served under Part I of Florida Statutes Chapter 394, to be included in required reports, to support justifications for program funding and to implement the provisions of Section 394.463(2)(e), F.S. Web-based Baker Act Data Collection Form CF-MH 3118, (July 2023), titled “”Baker Act Data Collection Form,”” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-15771, shall be completed in its entirety by the assessor conducting the initial screening and only submitted one time from the admitting facility for the episode of care. Effective July 1, 2023, designated receiving facilities shall submit the required data within five (5) business days through the Department’s statewide Baker Act data collection portal, which can be accessed at https://dcfapps.myflfamilies.com/BakerAct. Instructions on training requirements and how to submit the Baker Act data, petitions, and forms may be found at https://www.myflfamilies.com/service-programs/samh/crisis-services/training/badc.shtml. The Baker Act Data Collection Form must be accompanied by the following:
    (a) Form CF-MH 3001, “”Ex Parte Order for Involuntary Examination,”” or other order provided by the court;
    (b) Form Mandatory form CF-MH 3052a, “”Report of Law Enforcement Officer Initiating Involuntary Examination;”” or
    (c) Form Mandatory form CF-MH 3052b, “”Certificate of Professional Initiating Involuntary Examination; and””
    (d) Form CF-MH 3100, “”Transportation to Receiving Facility,”” if the individual is transported by a law enforcement officer, medical transport, mental health overlay program, mobile response team or private transport.
    (6) If a person is delivered to a receiving facility for an involuntary examination from any program or residential services provider licensed under the provisions of Chapter 400 or 429, F.S., without an ex parte order, Form CF-MH 3052a, “”Report of Law Enforcement Officer Initiating Involuntary Examination,”” or Form CF-MH 3052b, “”Certificate of Professional Initiating Involuntary Examination,”” the receiving facility shall notify the Department by the method and timeframe required by Section 394.463(2)(b), F.S. The receiving facility may use Form CF-MH 3119, “”Notification of a Facility’s Non-Compliance,”” which is incorporated by reference in Fl. Admin. Code R. 65E-5.270, for this purpose.
    (7) Form CF-MH 3045, (July 2023), “”Notice of Individual’s Admission for Involuntary Examination,”” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-15772, may be used when notifying authorized individuals of an individual’s involuntary admission to a receiving facility.
Rulemaking Authority Florida Statutes § 394.457(5). Law Implemented Florida Statutes § 394.463. History-New 11-29-98, Amended 4-4-05, 1-8-07, 7-5-16, 5-4-20, 8-14-23.