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emergency medical condition is a lifethreatening one.EMTALA/COBRA, 42 USC 1395dd Afederal statute prohibiting hospitals to delayor deny emergency medical services,including psychiatric and substance abuseemergencies. The law requires that eachpatient must have a medical screeningconducted within the full capability andcapacity of the hospital and must bestabilized before a transfer or dischargetakes place.Access to Emergency Services and Care.395.1041, F.S. is a state statute, equivalentof the federal EMTALA/COBRA law,prohibiting the denial of emergency servicesand care by hospitals and physicians andenforcing the ability of persons to get allnecessary and appropriate emergency carewithin the capability and capacity of eachhospital.This statute also requireshospitals to adhere to rights and involuntaryexamination procedures provided by theBaker Act, regardless of whether thehospital is designated as a receiving ortreatment facility.Adult Abuse, Neglect, and Exploitations.415.1051, F.S. is a state statute that may beappropriate when a vulnerable adult (elderlyor disabled) is alleged to be a victim ofabuse, neglect, or exploitation and lacks thecapacity to consent. This means a mentalimpairment that causes a person to lacksufficient understanding or capacity to makeor communicate responsible decisionsconcerning his person or property, includingwhether or not to accept protective servicesfrom DCF.Advance Directive. Chapter 765, F.S.provides that if a person has previouslyexecuted an advance directive designatinga health care surrogate and a physician hasfound the person to be incompetent orincapacitated to consent to his/her owntreatment, the surrogate may instead beasked to provide such consent.In theabsence of an advance directive, a healthcare proxy may be notified, if a personmeeting the degree of relationship isavailable to serve.Guardianship. Chapter 744, F.S. governsguardianship procedures. Some persons,due to their incapacity, require either alimited or a plenary guardian appointed bythe court to make many life decisions. Anincapacitated person is one who has beenjudicially determined to lack the capacity tomanage at least some of his/her property orto meet at least some of the essential healthand safety requirements of such person.Legislative IntentThe 1993 Florida Legislature studied issuessurrounding the use and abuse of alcoholand other drugs. The legislators made thefollowing findings:1. Substance abuse is a major healthproblem and leads to such t, chronic addiction, criminalbehavior, vehicular casualties, spiralinghealth care costs, AIDS, and businesslosses, and profoundly affects the learningability of children within our schools andeducational systems. Substance abuseimpairment is a disease, which affects thewhole family and the whole society andrequiresspecializedprevention,intervention, and treatment services thatsupport and strengthen the family unit.2. Provide for a comprehensive continuumof accessible and quality substance abuseprevention, intervention, and treatmentservices in the least restrictive environmentof optimum care that protects and respectsthe rights of clients, especially forinvoluntary admissions, primarily rs working with local governmentalprograms involving a wide range ofagencies from both the public and privatesectors.Marchman Act Handbookpage 8

3, Ensure within available resources a fullcontinuum of substance abuse servicesbased on projected identified needs,delivered without discrimination and withadequate provision for specialized needs.4. Discouragesubstanceabusebypromoting healthy lifestyles and drug-freeschools, workplaces, and communities.5. Integrate program evaluation efforts,adequate administrative support services,and quality assurance strategies with directservice provision requirements and toensure funds for these purposes.6. Require the cooperation of departmentalprograms, services, and program offices inachieving the goals of this chapter andaddressing the needs of clients.7. Provide, for substance abuse impairedadult and juvenile offenders, an alternativeto criminal imprisonment by encouraging thereferral of such offenders to serviceproviders not generally available within thecorrectional system instead of or in additionto criminal penalties.8. Provide, within the limits of appropriationsand safe management of the correctionalsystem, substance abuse services tosubstance abuse impaired offenders whoare incarcerated within the Department ofCorrections, in order to better enable theseinmates to adjust to the conditions of societypresented to them when their terms ofincarceration end.9. Provide for assisting substance abuseimpaired persons primarily through healthand other rehabilitative services in order torelieve the police, courts, correctionalinstitutions, and other criminal justiceagencies of a burden that interferes withtheir ability to protect people, apprehendoffenders, and maintain safe and orderlycommunities.10. Establish a clear framework for thecomprehensive provision of substanceabuse services in the context of acoordinated and orderly system.11. Freedom of religion of all citizens shallbe inviolate. Nothing in this act shall giveany governmental entity jurisdiction toregulate religious, spiritual, or ecclesiasticalservices.Client RightsThe Marchman Act provides an array ofstatutorily protected rights of personsseeking and or receiving substance abuseservices as well as due process rights ofthose persons for whom involuntaryinterventions are sought. These include:1.INDIVIDUAL DIGNITY must berespected at all times and upon alloccasions, including any occasion when theclient is admitted, retained, or transported.Substance abuse clients who are notaccused of a crime or delinquent act maynot be detained or incarcerated in jails,detention centers, or training schools of thestate, except for purposes of protectivecustody in strict accordance with thischapter. A client may not be deprived of anyconstitutional right.2.NONDISCRIMINATORY SERVICESService providers may not deny a clientaccess to substance abuse services solelyon the basis of race, gender, ethnicity, age,sexual preference, HIV status, prior servicedeparturesagainstmedicaladvice,disability, or number of relapse episodes.Service providers may not deny a client whotakes medication prescribed by a physicianaccess to substance abuse services solelyon that basis. Service providers who receivestate funds to provide substance abuseservices may not, provided space andsufficient state resources are available,deny a client access to services basedsolely on inability to pay.3. QUALITY SERVICES. Each client mustbe delivered services suited to his or herneeds, administered skillfully, safely,humanely, with full respect for his or herMarchman Act Handbookpage 9

dignity and personal integrity, and inaccordance with all statutory and regulatoryrequirements. Each client in treatment mustbe afforded the opportunity to participate inthe formulation and periodic review of his orher individualized treatment or service planto the extent of his or her ability to soparticipate. It is the policy of the state to usethe least restrictive and most appropriateservices available, based on the needs andthe best interests of the client andconsistent with optimum care of the client.Each client must be afforded the opportunityto participate in activities designed toenhance self-image.4. COMMUNICATION. Each client has theright to communicate freely and privatelywith other persons within the limitationsimposed by service provider policy.Because the delivery of services can onlybe effective in a substance abuse freeenvironment, close supervision of eachclient'scommunicationsandcorrespondence is necessary, particularly inthe initial stages of treatment, and theservice provider must therefore setreasonable rules for telephone, mail, andvisitation rights, giving primary considerationto the well-being and safety of clients, staff,and the community. It is the duty of theservice provider to inform the client and hisor her family if the family is involved at thetime of admission about the provider's rulesrelatingtocommunicationsandcorrespondence.5. CARE AND CUSTODY OF PERSONALEFFECTS. A client has the right to possessclothing and other personal effects. Theservice provider may take temporarycustody of the client's personal effects onlywhen required for medical or safetyreasons, with the reason for taking custodyand a list of the personal effects recorded inthe client's clinical record.6. EDUCATION OF MINORS. Each minorclient in a residential service component isguaranteededucationandtrainingappropriate to his or her needs. The serviceprovider shall coordinate with localeducation agencies to ensure that educationand training is provided to each minor clientin accordance with other applicable lawsandregulationsandthatparentalresponsibilities related to such educationand training are established within theprovisions of such applicable laws andregulations. Nothing in this chapter may beconstrued to relieve any local educationauthority of its obligation under law toprovide a free and appropriate education toevery child.7. CONFIDENTIALITYOFCLIENTRECORDS. The records of serviceproviders which pertain to the identity,diagnosis, and prognosis of and serviceprovision to any individual client areconfidential in accordance with this chapterand with applicable federal confidentialityregulations and are exempt from theprovisions of s. 119.07(1) and s. 24(a), Art. Iof the State Constitution. Such records maynot be disclosed without the written consentof the client to whom they pertain exceptthat appropriate disclosure may be madewithout such consent:8. COUNSEL. Each client must beinformed that he or she has the right to berepresented by counsel in any involuntaryproceeding for assessment, stabilization, ortreatment and that he or she, or if the clientis a minor his or her parent, legal guardian,or legal custodian, may apply immediatelyto the court to have an attorney appointed ifhe or she cannot afford one.9. HABEAS CORPUS. At any time, andwithout notice, a client involuntarily retainedby a provider, or the client's parent,guardian, custodian, or attorney on behalf ofthe client, may petition for a writ of habeascorpus to question the cause and legality ofsuch retention and request that the courtissue a writ for the client's release.10. LIABILITY AND IMMUNITY. Serviceprovider personnel who violate or abuse anyright or privilege of a client under thisMarchman Act Handbookpage 10

chapter are liable for damages asdetermined by law. All persons acting ingood faith, reasonably, and withoutnegligenceinconnectionwiththepreparation or execution of ts or the apprehension, detention,discharge, examination, transportation, ortreatment of a person under the provisionsof this chapter shall be free from all liability,civil or criminal, by reason of such acts.Voluntary Admissionpetitions to the circuit court. The three noncourt procedures are: However, the law also offers two courtrelated procedures, including: A person, whether adult or minor, whowishes to enter treatment for substanceabuse may apply to a service providerfor voluntary admission.Within thefinancial and space capabilities of

Marchman Act Handbook page 5 Overview Development and Use of Marchman Act Handbook Use of Handbook This Handbook is intended to be used for information purposes only. The information presented herein is not legally binding and does no