For Receiving Facilities

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Data Reporting Requirements

What to Submit

The Baker Act specifies that the following must be submitted to DCF within five working days. [The statutory reference relevant to submission of each type of form is listed for each form.]

Report of Law Enforcement Officers Initiating Involuntary Examination (CF-MH 3052a) [394.463(2)(a)2]
Certificate of Professional Initiating Involuntary Examination (CF-MH 3052b) [394.463(2)(a)3]
Ex-parte Order for Involuntary Examination (CF-MH 3001) [394.463(2)(a)1]

Baker Act receiving facilities are required to include a Cover Sheet to the Department of Children and Families (CF-MH 3118) with the 3052a, 3052b and 3001 forms as specified in Florida Administrative Code [F.A.C. 65E-5.280(5)].

Forms 3052a, 3052b, and 3118 are mandatory forms that may not be changed. The form for ex-parte orders for involuntary examination (3001) is a suggested form, such that jurisdictions are allowed to revise this form. Each Baker Act receiving facility is assigned a unique FMHI number as some facilities have similar names or change their name over time. The FMHI number allows for such revisions without impeding data analysis.

What NOT to Submit

Baker Act receiving facilities are not required to submit forms for longer term placement such as involuntary inpatient\outpatient petitions and orders, voluntary examinations, or Marchman Act assessments.

Other Data Reporting Requirements

Other data reporting requirements in the Baker Act, include submission of the following:

Data submitted by publicly funded receiving facilities annual to DCF as specified in F.S. 394.461(4)(a)
Data submitted by publicly funded receiving facilities to the Managing Entity for the Acute Care Services Utilization Database as specified in F.S. 394.9082(10)
Copies submitted by the administrator of the treatment facility of involuntary services certificates and state mental health discharge forms to the Managing Entity that serves the county in which the person will reside as specified in F.S. 394.4655(3)(a)3(c)1

The Baker Act Reporting Center does not analyze Marchman Act forms/data. There are additional data reporting requirements in the Marchman Act such as submission of forms/data to the Managing Entity as specified in F.S. 397.697(4).

Please note that this is not an exhaustive list of all data reporting requirements in the Baker Act and Marchman Act. Providers may contact the Managing Entity (ME) or DCF contact for guidance on data submission requirements to the ME and\or DCF.