394.495 Child and adolescent mental health system of care; programs and services.—
(1) The department shall establish, within available resources, an array of services to meet the individualized service and treatment needs of children and adolescents who are members of the target populations specified in s. 394.493, and of their families. It is the intent of the Legislature that a child or adolescent may not be admitted to a state mental health facility and such a facility may not be included within the array of services.
(2) The array of services must include assessment services that provide a professional interpretation of the nature of the problems of the child or adolescent and his or her family; family issues that may impact the problems; additional factors that contribute to the problems; and the assets, strengths, and resources of the child or adolescent and his or her family. The assessment services to be provided shall be determined by the clinical needs of each child or adolescent. Assessment services include, but are not limited to, evaluation and screening in the following areas:
(a) Physical and mental health for purposes of identifying medical and psychiatric problems.
(b) Psychological functioning, as determined through a battery of psychological tests.
(c) Intelligence and academic achievement.
(d) Social and behavioral functioning.
(e) Family functioning.
The assessment for academic achievement is the financial responsibility of the school district. The department shall cooperate with other state agencies and the school district to avoid duplicating assessment services.
(3) Assessments must be performed by:
(a) A professional as defined in s. 394.455(5), (7), (33), (36), or (37);
(b) A professional licensed under chapter 491; or
(c) A person who is under the direct supervision of a qualified professional as defined in s. 394.455(5), (7), (33), (36), or (37) or a professional licensed under chapter 491.
(4) The array of services may include, but is not limited to:
(a) Prevention services.
(b) Home-based services.
(c) School-based services.
(d) Family therapy.
(e) Family support.
(f) Respite services.
(g) Outpatient treatment.
(h) Day treatment.
(i) Crisis stabilization.
(j) Therapeutic foster care.
(k) Residential treatment.
(l) Inpatient hospitalization.
(m) Case management.
(n) Services for victims of sex offenses.
(o) Transitional services.
(p) Trauma-informed services for children who have suffered sexual exploitation as defined in s. 39.01(77)(g).
(q) Crisis response services provided through mobile response teams.
(5) In order to enhance collaboration between agencies and to facilitate the provision of services by the child and adolescent mental health treatment and support system and the school district, the local child and adolescent mental health system of care shall include the local educational multiagency network for severely emotionally disturbed students specified in s. 1006.04.
(6) The department shall contract for community action treatment teams throughout the state with the managing entities. A community action treatment team shall:
(a) Provide community-based behavioral health and support services to children from 11 to 13 years of age, adolescents, and young adults from 18 to 21 years of age with serious behavioral health conditions who are at risk of out-of-home placement as demonstrated by:
1. Repeated failures at less intensive levels of care;
2. Two or more behavioral health hospitalizations;
3. Involvement with the Department of Juvenile Justice;
4. A history of multiple episodes involving law enforcement; or
5. A record of poor academic performance or suspensions.
Children younger than 11 years of age who otherwise meet the criteria in this paragraph may be candidates for such services if they demonstrate two or more of the characteristics listed in subparagraphs 1.-5.
(b) Use an integrated service delivery approach to comprehensively address the needs of the child, adolescent, or young adult and strengthen his or her family and support systems to assist the child, adolescent, or young adult to live successfully in the community. A community action treatment team shall address the therapeutic needs of the child, adolescent, or young adult receiving services and assist parents and caregivers in obtaining services and support. The community action treatment team shall make referrals to specialized treatment providers if necessary, with follow up by the community action treatment team to ensure services are received.
(c) Focus on engaging the child, adolescent, or young adult and his or her family as active participants in every phase of the treatment process. Community action treatment teams shall be available to the child, adolescent, or young adult and his or her family at all times.
(d) Coordinate with other key entities providing services and supports to the child, adolescent, or young adult and his or her family, including, but not limited to, the child’s, adolescent’s, or young adult’s school, the local educational multiagency network for severely emotionally disturbed students under s. 1006.04, the child welfare system, and the juvenile justice system. Community action treatment teams shall also coordinate with the managing entity in their service location.
(e)1. Subject to appropriations and at a minimum, individually serve each of the following counties or regions:
a. Alachua.
b. Alachua, Columbia, Dixie, Hamilton, Lafayette, and Suwannee.
c. Bay.
d. Brevard.
e. Collier.
f. DeSoto and Sarasota.
g. Duval.
h. Escambia.
i. Hardee, Highlands, and Polk.
j. Hillsborough.
k. Indian River, Martin, Okeechobee, and St. Lucie.
l. Lake and Sumter.
m. Lee.
n. Manatee.
o. Marion.
p. Miami-Dade.
q. Okaloosa.
r. Orange.
s. Palm Beach.
t. Pasco.
u. Pinellas.
v. Walton.
2. Subject to appropriations, the department shall contract for additional teams through the managing entities to ensure the availability of community action treatment team services in the remaining areas of the state.
(7)(a) The department shall contract with managing entities for mobile response teams throughout the state to provide immediate, onsite behavioral health crisis services to children, adolescents, and young adults ages 18 to 25, inclusive, who:
1. Have an emotional disturbance;
2. Are experiencing an acute mental or emotional crisis;
3. Are experiencing escalating emotional or behavioral reactions and symptoms that impact their ability to function typically within the family, living situation, or community environment; or
4. Are served by the child welfare system and are experiencing or are at high risk of placement instability.
(b) A mobile response team shall, at a minimum:
1. Triage new requests to determine the level of severity and prioritize new requests that meet the clinical threshold for an in-person response. To the extent permitted by available resources, mobile response teams must provide in-person responses to such calls meeting such clinical level of response within 60 minutes after prioritization.
2. Respond to a crisis in the location where the crisis is occurring.
3. Provide behavioral health crisis-oriented services that are responsive to the needs of the child, adolescent, or young adult and his or her family.
4. Provide evidence-based practices to children, adolescents, young adults, and families to enable them to deescalate and respond to behavioral challenges that they are facing and to reduce the potential for future crises.
5. Provide screening, standardized assessments, early identification, and referrals to community services.
6. Provide care coordination by facilitating the transition to ongoing services.
7. Ensure there is a process in place for informed consent and confidentiality compliance measures.
8. Promote information sharing and the use of innovative technology.
9. Coordinate with the applicable managing entity to establish informal partnerships with key entities providing behavioral health services and supports to children, adolescents, or young adults and their families to facilitate continuity of care.
(c) When procuring mobile response teams, the managing entity must, at a minimum:
1. Collaborate with local sheriff’s offices and public schools in the planning, development, evaluation, and selection processes.
2. Require that services be made available 24 hours per day, 7 days per week.
3. Require the provider to establish response protocols with local law enforcement agencies, local community-based care lead agencies as defined in s. 409.986(3), the child welfare system, and the Department of Juvenile Justice.
4. Require access to a board-certified or board-eligible psychiatrist or psychiatric nurse practitioner.
5. Require mobile response teams to refer children, adolescents, or young adults and their families to an array of crisis response services that address individual and family needs, including screening, standardized assessments, early identification, and community services as necessary to address the immediate crisis event.
History.—s. 6, ch. 98-5; s. 981, ch. 2002-387; s. 7, ch. 2014-161; s. 38, ch. 2015-2; s. 5, ch. 2015-4; s. 13, ch. 2016-24; s. 66, ch. 2016-241; s. 39, ch. 2017-151; s. 9, ch. 2018-3; s. 15, ch. 2018-103; s. 16, ch. 2020-39; s. 2, ch. 2020-107.
