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Osceola County Sheriff's Office
Policy and Procedure
Number: 415.0
Subject: Response to Persons with Mental Illness and/or Substance Abuse Impairment
Effective Date: 08/14/09
P.R.C. Review: 04/17/09
Rescinds: 07/07/05
Amends:
This order consists of the following:
1. Purpose
2. Policy
3. Definitions
4. Procedures
1. Purpose
Intoxication and mental illness are not crimes. The Baker Act is a statute that allows a law
enforcement officer to take immediate steps to protect an individual believed to be mentally ill and
safeguard those persons who may be harmed by the individual’s behavior, or from harming
themselves. The Marchman Act serves the same purpose for individuals who are substance
abusers.
The purpose of this policy is to establish guidelines for the lawful execution of the Baker Act and
the Marchman Act.
2. Policy
Sheriff’s Office members encountering individuals who meet the criteria of the Baker Act or the
Marchman Act will follow state law when exercising their authority. When available, Crisis
Intervention Team (CIT) members or deputies with CIT training will respond to calls involving the
mentally ill in crisis, and explore alternatives to arrest, if possible.
3. Definitions
A. B-52 Form - A DCFS form authorized by law to initiate the involuntary exam process under
the Baker Act.
B. Baker Act - A section of Chapter 394 Florida Statutes, which allows a law enforcement
officer to take a person, who is believed to suffer from a mental illness and is an immediate
threat to him/her-self or others, to a receiving facility for an involuntarily examination for
mental illness. Also known as the Florida Mental Health Act.
C. Crisis Intervention Team (CIT) - specially trained deputies who have received a minimum
of forty (40) hours of advanced training in the recognition of persons in a mental health
crisis and the appropriate intervention techniques.
D. Designated Receiving Facility - A hospital, community facility, public or private facility, or
receiving or treatment facility providing for the evaluation, diagnosis, care, treatment,
training, or hospitalization of persons who appear to have a mental illness and meet certain
criteria for voluntary admission or involuntary examination. The location and telephone
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number of the nearest appropriate facility may be obtained from communications.
E. Developmentally Disabled – retardation, autism, cerebral palsy, spina bifida, Prader-Willi
syndrome, or other disability that constitutes a substantial handicap that can reasonably be
expected to continue indefinitely and can never be cured. Developmental disabilities are
distinctly different from mental illness.
F. Excited Delirium Syndrome (EDS) - Excited Delirium Syndrome is a state of extreme
mental and physiological excitement primarily related to illicit stimulant drug abuse and less
often related to mental illness. EDS is manifested by acute behavioral and physiological
changes (i.e., great strength, extreme body temperature, incoherent speech) that may
result in sudden and unexplained death.
G. Ex Parte Order - A circuit court judge’s order requiring that the person named in the order
be taken into custody and delivered to a designated receiving facility for an involuntary
examination.
H. Incompetent to Consent to Treatment – A person’s judgment is so affected by their mental
illness that the person lacks the capacity to make a well-reasoned, willful, and knowing
decision concerning their mental health treatment.
I. Marchman Act - A section of Florida State Statute chapter 397 which allows a law
enforcement officer to take a person into protective custody who is substance abuse
impaired, has lost the power of self control and poses an immediate threat to him/her-self
or others. Also known as the Hal S. Marchman Alcohol and Other Drug Services Act of
1993.
J. Mental Health Crisis – A situation in which an individual who is believed to have a mental
illness displays one or more of the following:
1. Having delusions;
2. Exhibiting erratic behavior;
3. Creating a disturbance;
4. Real and credible threat of substantial harm due to self-neglect;
5. Threatening harm to oneself or others, or;
6. Displaying other activity or behavior that causes alarm.
K. Mental Illness – An impairment of the mental or emotional processes that exercises
conscious control of one’s actions or of the ability to perceive or understand reality, which
impairment substantially interferes with a person’s ability to meet the ordinary demands of
living. For the purpose of this policy, the term specifically excludes mental retardation or
developmental disabilities as defined in chapter 393, simple intoxication, drug addiction,
and conditions manifested only by antisocial behavior or substance abuse impairment.
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4. Procedures
A. Recognizing Subjects Suffering from Mental Illness
1. The terms “mental illness,” “emotional illness,” and “psychological illness,” describes
varying levels of a group of disabilities causing disturbances in thinking, feeling, and
relating. These terms should not be confused with developmentally disabled.
2. When identifying symptoms of behavior that may suggest mental illness, deputies
should not rule out other potential causes such as reactions to narcotics, Excited
Delirium Syndrome or temporary emotional disturbances that are situationally
motivated.
B. Law Enforcement Initiated Admissions
1. The Baker Act is a civil procedure which empowers law enforcement officers to take
a person to a designated receiving facility for involuntary examination if there is
reason to believe that the individual is mentally ill, and because of such illness: {CFA
2.04}
a. Has refused voluntary examination after a conscientious explanation and
disclosure of the purpose of the exam; or,
b. Is unable to determine for himself whether the examination is necessary; and
c. Without care or treatment, the person is likely to suffer from neglect or refuse
to care for himself; such neglect or refusal poses a real and present threat of
substantial harm to his well-being; and it is not apparent that such harm may
be avoided through the help of willing family members or friends or the
provision of other services; or,
d. There is a substantial likelihood that without care or treatment, he will cause
serious bodily harm to himself or others in the near future, as evidenced by
recent behavior.
2. The refusal to accept medical attention in life threatening situations may be
considered as one of the facts in determining the need for involuntary examination.
However, any person(s) who appears to be mentally competent and refuses
medical attention in apparent non-life-threatening situations may not meet the
criteria for an involuntary examination.
3. Under the Baker Act, deputies do not need to witness all of the behaviors of the
subject personally. Deputies can consider credible eyewitness accounts in
determining the need for further assessment. If relying on a credible witness,
deputies will have the witness complete a sworn statement and attach it to the
incident report.
C. Baker Act Procedures
1. General
a. If available, a deputy with Crisis Intervention Team (CIT) training shall
respond to incidents involving a mentally ill subject who is unstable or in a
state of crisis.
b. Upon contact with a person who meets the involuntary examination criteria,
deputies shall initiate a Baker Act and complete the required documentation.
c. Once a decision to Baker Act has been made, deputies shall determine if the
subject is injured and requires emergency medical attention. If the person is
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injured, he/she will be transported to the nearest hospital emergency room.
If there is a question concerning a subject’s medical condition, EMS should
evaluate the subject prior to transport. Transportation by EMS or OCSO
vehicle will be determined by the severity and nature of the medical
emergency.
2. Documentation
All records regarding any Baker Act subject except the Incident Report are
confidential and exempt from disclosure under Florida’s public records law. A Baker
Act requires:
a. An Incident Report.
b. B-52 form or original Ex-parte Order (with a raised seal).
c. Charging Affidavit (if applicable).
d. Medical clearance documents (if applicable).
e. Return of service (when an ex parte order is served).
f. Witness statements (if applicable).
3. Criminal Charges {CFA 2.04}
Subjects who are to be criminally charged with a misdemeanor but do not require
emergency medical attention may be transported to a designated receiving facility
for evaluation and/or treatment if the nature of the charge(s) is such that the person
does not present a threat of escape or violence toward others. The member must
notify his/her supervisor and complete an A.P.S. to be forwarded to the State
Attorney’s Office for follow-up. If a subject who meets the involuntary examination
criteria commits a felony and does not require medical treatment, he/she shall be
arrested and transported to jail. The arresting member will immediately notify
Corrections personnel who shall be responsible for the subject’s care and treatment.
4. Mentally Ill Under the Influence of Drugs or Alcohol
Subjects who meet Baker Act criteria and appear to be substance impaired but do
not require medical attention will be transported to the designated receiving facility.
If the receiving facility will not accept the subject due to substance impairment, the
subject will be transported to jail under the provisions of the Marchman Act.
5. Violent Subjects
Violent subjects who are not under arrest will be transported to the designated
receiving facility, unless the subject is so violent as to require the continued
presence of a law enforcement officer. Under no circumstances should a violent
subject be left unattended until personnel at the designated mental health receiving
facility or hospital indicate that there is no longer a need for a law enforcement
presence. In such cases, a supervisor will be contacted.
D. Voluntary Admissions
1. If an individual who is believed to be suffering from a mental illness is willing to be
evaluated by a mental health professional, the person does not meet the
requirements for involuntary examination. However, a voluntary admission is not
appropriate for a person(s) who is so affected by their illness that the deputy
believes they are incompetent to consent to mental health treatment.
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2. Deputies will transport a subject to the nearest receiving facility unless a less
restrictive means of transportation is discovered, such as willing family members or
a friend. However if there is a potential for violence or other mitigating
circumstance, deputies shall transport the person to the nearest receiving facility.
3. Even if an individual initially agrees to a voluntarily evaluation by a mental health
professional, deputies shall continue to observe the subject to determine if criteria
for an initiated involuntary examination are met. If the criteria are met, complete an
involuntary examination.
E. Court-Ordered Admissions
1. A judge may issue an ex parte order after a family member or other concerned
person goes to the Clerk of Court probate office and fills out the required paperwork
under oath.
2. Court orders are sent to the Osceola County Sheriff’s Office Judicial Services
Section for service, but may be served by any sworn member. An ex parte order
can be executed any hour of the day or night, any day of the week, and use
reasonable physical force as is necessary to gain entry to any structures on the
premises to take custody of the person who is the subject of the ex parte order.
3. At times family members or persons involved with the subject to be served will
contact the agency to advise the subject’s location. If this occurs and a Judicial
Services Unit is unavailable, the Communications Section will dispatch a patrol unit
to locate and transport the subject to a receiving facility. The on-call Judicial
Services Unit must be notified to meet the transporting deputy at the receiving
facility to serve the order.
4. If the subject of a Court Ordered Ex-Parte appears to have an emergency medical
condition, the subject should be taken to the nearest emergency room, regardless
of whether it is designated as a psychiatric receiving facility. Once medical
clearance is obtained, the Sheriff’s Office will be responsible for transportation of
the person to a designated receiving facility.
5. Before serving an ex-parte order, members shall ensure that it has not expired.
F. Health Care Professional Initiated Admissions
1. A Baker Act may also be initiated by a physician, licensed clinical psychologist,
psychiatric nurse, licensed clinical social worker, licensed mental health counselor,
or a licensed marriage and family therapist.
2. The health care professional will execute a certificate (BA-52) stating that he has
examined a person within the preceding 48 hours and finds that the individual
appears to meet the criteria for involuntary examination.
3. The Sheriff’s Office will transport for these types of admissions.
G. Transport
All persons will be transported with dignity, including those who face criminal charges. The
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individual will be searched for weapons prior to transport and handcuffed according to
Policy 403.0, Handcuffs and Other Restraints. Prior to transport, the member will notify the
designated receiving facility. Under this policy, deputies will transport persons when:
1. The member is acting upon an order from the court; or
2. The member initiates a Baker Act.
3. Extraordinary circumstances cause another law enforcement agency to request
assistance with a transport, and the transport is approved by a lieutenant or higher
authority.
4. A health care professional who has Baker Acted a subject requests transport to a
designated receiving facility, and the transport is approved by a supervisor.
H. Liability/Immunity
Any person who violates or abuses any rights or privileges of patients provided by the
Baker Act may be liable for damages. Any person who acts in good faith in compliance
with the provision of this part of the Act is immune from the civil or criminal liability for his
actions in connection with the admission, diagnosis, treatment, or discharge of a patient to
or from a facility. However, this provision does not relieve any person from liability for a
negligent act (failure to act) (F.S.S. 394.459 (10)).
I. Agency Mental Health Training
1. All sworn agency members, Community Service Officers, and Communications
Section members shall receive two (2) hours of entry level mental health training
and refresher training as needed, which shall be documented and entered into the
member's training record.
2. In order to determine the necessity and scope of future agency-wide mental health
training, a copy of every offense report documenting the initiation of a Baker Act
shall be forwarded to the CIT Coordinator.
3. CIT members shall receive a minimum of forty (40) hours advanced training based
on the “Memphis Model” of crisis intervention training. CIT members shall receive
annual refresher training via on-line studies as provided by the Training Unit.
J. Structure and Deployment of CIT-Trained Members:
1. The Crisis Intervention Team (CIT) Coordinator is a sworn supervisor designated by
the Enforcement Bureau Major or designee. The CIT Coordinator shall be
responsible for:
a. Compiling monthly and yearly activity reports to assist in determining the
effectiveness of the CIT Unit.
b. Coordinating mental health training.
c. Coordinating the operation of the CIT Unit.
d. Reviewing CIT tracking sheets.
e. Serving as the agency liaison with other mental health service providers and
community mental health support groups.
2. CIT Member Selection Criteria:
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a. Minimum of two (2) years experience as a law enforcement officer.
b. Recommendation by the chain of command.
c. Above average verbal communications skills.
d. Successful completion of an approved forty (40)-hour CIT training class.
3. CIT members are specially trained deputies who are designated to handle situations
involving the mentally ill in crisis; however, the Hostage Negotiation Team will be the
primary unit to handle those incidents that involve weapons, hostages, and/or
barricaded subjects.
4. CIT members shall be assigned a unique radio dispatch identifier “Charlie” in
conjunction with their radio call sign to allow Communications Section members to
readily identify them. When CIT members come on duty, they must notify
Communications of their CIT status.
5. Whenever possible, a CIT member shall be dispatched to calls involving a
confirmed or suspected mentally ill person in crisis. A crisis could consist of, but is
not limited to: a person having delusions, refusing to take prescribed psychotropic
medications, erratic behavior, suicidal thoughts or ideation, causing a disturbance,
talking to themselves, or other activity that causes alarm or concern to the average
person.
6. The CIT member shall complete a Crisis Intervention Tracking Form in every
circumstance within the scope of crisis intervention. The form shall be forwarded to
the CIT Coordinator within for inclusion in the monthly CIT status report.
7. CIT members are approved to display the recognized CIT service pin above the
right side pocket flap of the class A or B uniform.
K. Marchman Act (Hal S. Marchman Alcohol and Other Drug Services Act of 1993, F.S.S.
397.677)
1. A member may implement protective custody measures when a person (minor or
adult) who appears to meet the following involuntary admission criteria is brought to
the attention of law enforcement, or is in a public place. Protective custody can be
initiated if either element is present. Any law enforcement officer acting in good
faith may not be held criminally or civilly liable for false imprisonment when initiating
protective custody measures. {CFA 2.04}
2. Upon meeting with such a person, the member must have a good faith reason to
believe the person is substance abuse impaired and, because of such impairment
has lost the power of self-control with respect to substance abuse, and either; {CFA
2.04}
a. Has inflicted, or threatened or attempted to inflict, or unless admitted is likely
to inflict, physical harm on himself or another; or
b. Is in need of substance abuse services and, by reason of substance abuse
impairment, his judgment has been so impaired that the person is incapable
of appreciating his/her need for such services and of making a rational
decision in regard thereto. Mere refusal to receive such services does not
constitute lack of judgment with respect to his or her need for such services.
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3. Protective Custody With Consent (F.S.S. 397.6771)
With the consent of the person meeting the above criteria, a member may assist the
person to his home, to a hospital, or to a licensed detoxification or addictions
receiving facility. The member will determine which is the most appropriate action
to take. For officer safety reasons, handcuffing will be per Policy 403.0.
4. Protective Custody Without Consent (F.S.S. 397.6772)
a. A member may initiate protective custody without the consent of the impaired
person when:
(1). The person fails or refuses to consent to assistance, and
(2). The member has determined that a hospital or a licensed
detoxification or addictions receiving facility is the most appropriate
place for the person.
b. The member will, after giving due consideration to the expressed wishes of
the person, take the person to a hospital or detoxification facility.
c. If circumstances prevent admission into a hospital or detoxification facility
(e.g., lack of bed space), the member will:
(1). Detain an adult in the county jail and notify the nearest relative, unless
the adult requests that there be no notification.
(2). Notify the nearest relative of a juvenile for involuntary assessment
and emergency admission.
d. The member must not use unreasonable force to take the person into
custody, but, for officer and individual safety reasons, will handcuff the
person during transport.
e. A person taken into protective custody under the Marchman Act will be
confined in a detoxification holding cell until evaluated by medical personnel
to be sober. In no case can protective custody extend beyond 72 hours.
5. Reports/Records
Any person taken into protective custody under the Marchman Act will not be
considered an arrestee for any purpose, and no entry or other record will be made
to indicate that the individual has been arrested or charged with a crime. The
member will document the incident on an incident report and complete a booking
report titled, “Marchman Act”, to show that the person was in the care of the jail.
The report narrative will indicate that no crime was committed.
Approved by: Sheriff Robert E. Hansell