introduction to the marchman act · 6/29/2020 3 marchman act history 1970: chapters 396 & 397,...

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Introduction to the Marchman Act

June 29, 2020

Carali McLean, LCSW-SChief Human Resources OfficerHeart of Florida Health Center

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Florida Certification Board

6/29/2020

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THIS WEBINAR IS SUPPORTED BY THE FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES, OFFICE

OF SUBSTANCE ABUSE AND MENTAL HEALTH

Topics

◈ History

◈ Criteria for Involuntary

Services

◈ Clinical and Ethical

Considerations

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Marchman Act History

◈ 1970: Chapters 396 & 397, Florida Statute (F.S.)

◈ 1993: Hal S. Marchman Alcohol and Other Drug

Services Act of 1993 (397 F.S.)

⬩ Combined two laws that had separately

addressed alcohol use and other drug use

◈ Updated in 2016 with Senate Bill 12

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Involuntary Criteria6 ◈ Either impaired by substance use or a

co-occurring mental health condition, and

◈ Has lost the power of self-control over

substance use, and either

⬩ Cannot make a rational

decision about treatment due

to impaired judgment, or

⬩ Significant harm is probable if

treatment is not initiated


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2016 Senate Bill 12

◈ Changes made to the process

for professional certificates and

ex parte orders

◈ Access to guardian advocates

◈ Required transportation plan

◈ “No-wrong-door model”

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Designated Behavioral Health Receiving Systems

Central Receiving

System

◈ Single point of

entry for providers

offering evaluation

or treatment

8Coordinated and

Tiered Receiving

Systems

◈ Multiple points of

entry in a cooperative

system that primarily

provides care

coordination and case

management


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Marchman Act and Baker Act Criteria

◈ The individual is unable to determine the need

for, or is unwilling to engage in, an

examination, and either

⬩ Without care is likely to suffer from neglect

that will pose significant threat to the

individual’s well-being, or

⬩ Without care is likely to cause serious bodily

harm to self or others

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10 Voluntary and Involuntary Admission Procedures

Voluntary Admission

Involuntary Admission

Noncourt Involved Admissions

Protective Custody

Professional Certificate for Emergency Admission

Alternative Involuntary

Assessment for Minors

Court Involved Admissions

Involuntary Assessment

and Stabilization

Civil Involuntary

Proceedings

Involuntary Treatment


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“Methods which are used to

avoid imposing involuntary

examination and services on

an individual unless there is

no less restrictive option that

is appropriate to the

individual’s treatment needs.

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Diversion

Direct application

for admission

from the

individual seeking

services to a

provider

Voluntary Admission Procedures

Sufficient evidence of impairment from substance use,

Medical and behavioral conditions can be safely managed by provider, and

The provider has capacity and financial capability to offer appropriate treatment

Admission may occur

if:

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Autonomy vs. Safety Decision Points

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Autonomy vs. Safety Decision Points


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Non-Court Involved

Admission:

Protective Custody

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Protective Custody Circumstances

◈ Law enforcement identifies that individual

appears to meet involuntary criteria

⬩ Individual is in a public place, or

⬩ Individual is brought to the attention of law

enforcement

◈ May be initiated with or without consent

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Protective Custody

If transported to a municipal or county jail or

detention center:

◈ Notification within 8 hours and arrange transport

◈ Assessed within 72-hour without unnecessary

delay

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Non-Court Involved

Admissions:

Professional Certificate for

Emergency Admission

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Emergency Assessment & Stabilization

◈ LCSW

◈ LMFT

◈ LMHC

◈ Master’s CAP

◈ Physician

◈ Physician Assistant

◈ Clinical Psychologist

◈ APRN

19 Initiated by a qualified professional

Professional Certificate Elements

◈ Name of individual

◈ Professional’s

relationships with:

⬩ Individual

⬩ Applicant

⬩ Licensed service

provider

◈ Statement of

examination

◈ Factual evidence

◈ Recommendations

for least restrictive

environment

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Evaluation and Disposition21

◈ Transportation to a

service provider with

signed certificate and

application

◈ Assessment of needed

services

◈ Disposition

Non-Court Involved

Admissions:

Alternative Involuntary Assessment

for Minors

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Minors

Application must include all of the following:

◈ The applicant’s name and signature

◈ The name of the minor for admission

◈ The relationship between the minor and the

applicant

◈ Factual evidence which establishes the need

for immediate service

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Court Involved

Admissions:

Involuntary Assessment and

Stabilization

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Involuntary Assessment & Stabilization

Petition minimum requirements:

◈ Name of the individual who is the subject of the

petition (respondent)

◈ Name of the persons filing the petition

(petitioner/s)

◈ The relationship between the petitioner/s and

respondent

◈ Facts that support the petitioner’s belief that the

respondent meets criteria

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Court Involved

Admissions:

Civil Involuntary Proceedings

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Petition Requirements

◈ Name of the respondent

◈ Name of the applicant

◈ Relationship between respondent and

applicant

◈ Name of respondent’s attorney

◈ Facts which support the criteria

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Court Involved

Admissions:


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The following persons who have personal

knowledge of the individual’s substance use may

initiate involuntary treatment proceedings:

◈ For an adult, any adult including a spouse,

guardian, relative, or qualified professional

◈ For a minor, a parent, legal guardian, legal

custodian, or service provider

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Court Hearing

The court hears

testimony to determine

if individual meets

criteria


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Court Involved

Admissions

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Provider Responsibilities

◈ Court order must be sent to the Managing Entity

by the admitting provider within one (1)

working day

◈ If individual continues to meet criteria, a new

petition must be filed 10 days prior to the

expiration

◈ If the individual needs a second renewal, a new

assessment and petition must be filed

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General Procedures for Involuntary

Assessment and Stabilization

◈ Individual must receive an assessment within

72 hours

◈ Individual is expected to be released from

involuntary status within five (5) days of

admission

◈ The service provider may be granted

additional time by the court to complete the

initial assessment

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Discharge Criteria

◈ Individual agrees to continue services voluntarily

◈ Individual no longer meets criteria

◈ Further services are not believed to be beneficial

◈ Individual successfully completes services

◈ Individual is beyond safe management

capabilities of provider

◈ Service provider must notify court and all parties

identified in the court order

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Assessment and Disposition

◈ Inpatient⬩ Qualified Professional must conduct or review

the assessment and make a determination

◈ Outpatient⬩ Qualified professional may

conduct assessment and

determine disposition

◈ Disposition

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Rights of Persons Served Under the Marchman Act

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The Right to Individual

Dignity

The Right to

Nondiscriminatory

Services

The Right to Quality

Services

The Right to

Communication

The Right to Care and

Custody of Personal

Effects

The Right to

Confidentiality of

Individual Records

The Right to Education

of MinorsThe Right to Counsel

The Right to Habeas

Corpus


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“

Right to receive

nondiscriminatory services

“administered skillfully,

safely, and humanely.”

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Quality of Services

◈ Least restrictive environment

◈ Individualized to specific

treatment and safety needs

◈ Individual participation in

treatment planning

◈ De-escalation techniques applied

by trained staff

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Additional Rights

◈ Confidentiality

◈ Communication

◈ Personal Effects

◈ Education of Minors

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Advance Directives

Identifying treatment wishes in advance of a

potential crisis

◈ Collateral contacts and supports

◈ Provider preferences

◈ Medication and therapy preferences or history

◈ De-escalation and soothing techniques

◈ Triggers

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Guardian Advocates

◈ Guardian advocate may be appointed for an

individual unable to provide express and

informed consent

◈ Individual has a right to be represented by

legal counsel at the court hearing

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Individual Rights at Court Hearings

◈ Counsel

◈ Present evidence

◈ Question witnesses

◈ Case reviewed by the court

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Marchman Act Overview

◈ Opportunity for voluntary and involuntary

assessment and treatment

◈ Initiated by concerned family, friends,

professionals, and law enforcement

◈ Coordinated system of care with “No-wrong-

door” approach

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Overcoming Barriers

▪ Make treatment accessible

▪ Reduce stigma

▪ Offer a range of treatment options

▪ Skilled workforce with team approach

▪ Utilize and enhance support system

▪ Expect ambivalence

▪ Sufficient duration of services


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Questions45

Resources

◈ Florida Department of Children and Families Marchman Act forms

⬩ https://www.myflfamilies.com/service-programs/samh/crisis-

services/marchman-act.shtml (WEB)

◈ Chapter 397, Florida Statutes

⬩ http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&S

earch_String=&URL=0300-0399/0397/0397ContentsIndex.html (WEB)

◈ Chapter 394, Florida Statutes⬩ http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&U

RL=0300-0399/0397/0397.html (WEB)

◈ Chapter 65D-30, Florida Administrative Code

⬩ https://www.flrules.org/gateway/ChapterHome.asp?Chapter=65D-30 (WEB)


http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0397/0397ContentsIndex.html

http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0300-0399/0397/0397.html

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