In Re: Amendments to Florida Probate Rules - 2023 Legislation

Supreme Court of Florida ____________ No. SC2023-1477 ____________ IN RE: AMENDMENTS TO FLORIDA PROBATE RULES—2023 LEGISLATION. December 14, 2023 PER CURIAM. The Florida Bar’s Probate Rules Committee has filed a fast- track report proposing amendments to Florida Probate Rules 5.630 (Petition for Approval of Acts), 5.649 (Guardian Advocate), 5.904 (Forms for Initial and Annual Guardianship Plans), 5.905 (Form for Petition, Notice, and Order for Appointment of Guardian Advocate of the Person), 5.906 (Letters of Guardian Advocacy), and 5.920 (Forms Related to Injunction for Protection Against Exploitation of a Vulnerable Adult). 1 The Committee also proposes the addition of new rule 5.631 (Petition for Approval by Professional Guardian for Order Not to Resuscitate or to Withhold Life-Prolonging Procedures). 1. We have jurisdiction. See art. V, § 2(a), Fla. Const.; see also Fla. R. Gen. Prac. & Jud. Admin. 2.140(e). The proposed amendments are in response to recently enacted legislation. See chs. 2021-221, 2023-213, 2023-287, Laws of Fla. The Board of Governors of The Florida Bar unanimously approved the proposed amendments. Having considered the Committee’s report and the relevant legislation, we hereby amend the Florida Probate Rules as proposed by the Committee. Some of the more significant changes are discussed below. Rule 5.630(a) (Contents) is amended to include a reference to section 744.422, Florida Statutes. Also, in response to the repeal of section 744.441(2), Florida Statutes, by chapter 2023-287, section 6, Laws of Florida, subdivisions (a)(2) and (d) (Hearings) of rule 5.630 are deleted and the remaining subdivisions are reorganized accordingly. New rule 5.631 is added in response to the enactment of section 744.4431, Florida Statutes, by chapter 2023-287, section 5, Laws of Florida. The new rule addresses the procedure for seeking approval by the professional guardian for an order not to resuscitate or to withhold life-prolonging procedures. Rule 5.649 is amended to include new subdivision (a)(10). The new subdivision requires that a petition for appointment of a -2- guardian advocate state whether authority is sought to seek periodic support of the person with a developmental disability. And lastly, rule 5.904(c) (Initial Guardianship Plan for Adult) and (d) (Annual Guardianship Plan for Adult) are amended to require a guardian to list any preexisting orders not to resuscitate, healthcare surrogate decisions, living wills, or anatomical gifts. Accordingly, the Florida Probate Rules are amended as reflected in the appendix to this opinion. New language is indicated by underscoring; deletions are indicated by struck-through type. The amendments shall take effect immediately upon the release of this opinion. Because the amendments were not published for comment prior to their adoption, interested persons have 75 days from the date of this opinion in which to file comments with the Court. 2 2. All comments must be filed with the Court on or before February 27, 2024, with a certificate of service verifying that a copy has been served on the Committee Chair, Alexandra V. Rieman, GAPS Legal, PLLC, 1580 Sawgrass Corporate Parkway Suite 130, Fort Lauderdale, Florida 33323-2860, alex@gapsattorneys.com, and on the Bar Staff Liaison to the Committee, Heather Savage Telfer, 651 E. Jefferson Street, Tallahassee, Florida 32399-2300, rules@floridabar.org, as well as a separate request for oral argument if the person filing the comment wishes to participate in oral argument, which may be scheduled in this case. The -3- It is so ordered. MUÑIZ, C.J., and CANADY, LABARGA, COURIEL, GROSSHANS, FRANCIS, and SASSO, JJ., concur. THE FILING OF A MOTION FOR REHEARING SHALL NOT ALTER THE EFFECTIVE DATE OF THESE AMENDMENTS. Original Proceeding – Florida Probate Rules Alexandra V. Rieman, Chair, Florida Probate Rules Committee, Fort Lauderdale, Florida, Joshua E. Doyle, Executive Director, The Florida Bar, Tallahassee, Florida, and Heather Savage Telfer, Bar Liaison, The Florida Bar, Tallahassee, Florida, for Petitioner Committee Chair has until March 19, 2024, to file a response to any comments filed with the Court. If filed by an attorney in good standing with The Florida Bar, the comment must be electronically filed via the Florida Courts E-Filing Portal (Portal). If filed by a nonlawyer or a lawyer not licensed to practice in Florida, the comment may be, but is not required to be, filed via the Portal. Any person unable to submit a comment electronically must mail or hand-deliver the originally signed comment to the Florida Supreme Court, Office of the Clerk, 500 South Duval Street, Tallahassee, Florida 32399-1927. -4- APPENDIX RULE 5.630. PETITION FOR APPROVAL OF ACTS (a) Contents. (1) When authorization or confirmation of any act of the guardian is required under sections 744.422 or 744.441(1), Florida Statutes, application shallmust be made by verified petition stating the facts showing: (A1) the expediency or necessity for the action; (B2) a description of any property involved; (C3) the price and terms of any sale, mortgage, or other contract; (D4) whether the ward has been adjudicated incapacitated to act with respect to the rights to be exercised; (E5) whether the action requested conforms to the guardianship plan; and (F6) the basis for the relief sought. (2) When authorization or confirmation of any act of the guardian is required under section 744.441(2), Florida Statutes, application shall be made by verified petition attaching any affidavits and supporting documentation, including any living will, and stating the facts showing: (A) the name and location of the ward; (B) the names, relationship to the ward, and addresses if known to the guardian, of: (i) the ward’s spouse and adult children, (ii) the ward’s parents, -5- (iii) the ward’s next of kin, (iv) any guardian and any court-appointed health care decision-maker, (v) any person designated by the ward in a living will or other document to exercise the ward’s health care decision in the event of the ward’s incapacity, (vi) the administrator of the hospital, nursing home, or other facility where the ward is located, (vii) the ward’s principal treating physician and other physicians known to have provided any medical opinion or advice about any condition of the ward relevant to this petition, and (viii) all other persons the guardian believes may have information concerning the expressed wishes of the ward; and (C) facts sufficient to establish the need for the relief requested. (b) Notice. No notice of a petition to authorize sale of perishable personal property or of property rapidly deteriorating shall beis required. Notice of a petition to perform any other act requiring a court order shallmust be given to the ward, to the next of kin, if any, and to those persons who have filed requests for notices and copies of pleadings. (c) Order. (1) If the act is authorized or confirmed, the order shallmust describe the permitted act and authorize the guardian to perform it or confirm its performance. (2) If a sale or mortgage is authorized or confirmed, the order shallmust describe the property. If a sale is to be private, the order shallmust specify the price and the terms of the sale. If a sale -6- is to be public, the order shallmust state that the sale shallwill be made to the highest bidder and that the court reserves the right to reject all bids. (3) If the guardian is authorized to bring an action to contest the validity of all or part of a revocable trust, the order shallmust contain a finding that the action appears to be in the ward’s best interests during the ward’s probable lifetime. If the guardian is not authorized to bring such an action, the order shallmust contain a finding concerning the continued need for a guardian and the extent of the need for delegation of the ward’s rights. (d) Hearings. A preliminary hearing on any petition filed under section 744.441(2), Florida Statutes, shall be held within 72 hours after the filing of the petition. At that time, the court shall review the petition and supporting documentation. In its discretion, the court shall either: (1) rule on the relief requested immediately after the preliminary hearing; or (2) conduct an evidentiary hearing not later than 4 days after the preliminary hearing and rule on the relief requested immediately after the evidentiary hearing. Committee Notes Rule History 1975 – 2020 Revision: [No Change] 2023 Revision: Subdivisions (a)(2) and (d) were deleted as section 744.441(2), Florida Statutes was repealed. Reference to section 744.422, Florida Statutes, was added to subdivision (a) to address its enactment. Statutory References § 393.12, Fla. Stat. Capacity; appointment of guardian advocate. -7- § 736.0207, Fla. Stat. Trust contests. § 744.3215, Fla. Stat. Rights of persons determined incapacitated. § 744.422, Fla. Stat. Petition for support for a dependent adult child. § 744.441, Fla. Stat. Powers of guardian upon court approval. § 744.447, Fla. Stat. Petition for authorization to act. § 744.451, Fla. Stat. Order. Rule References [No Change] RULE 5.631. PETITION FOR APPROVAL BY PROFESSIONAL GUARDIAN FOR ORDER NOT TO RESUSCITATE OR TO WITHHOLD LIFE-PROLONGING PROCEDURES (a) Contents. (1) When authorization for any act of the professional guardian is required under section 744.4431, Florida Statutes, application must be made by verified petition stating the facts showing: (A) a description of the proposed action or decision for which court approval is sought; (B) documentation of the authority of the professional guardian to make health care decisions on behalf of the ward; (C) a statement regarding any known objections to the relief sought; -8- (D) a description of the ward’s known wishes, including all advance directives executed by the ward, or, if there is no indication of the ward’s wishes, a description of why the relief sought is in the best interests of the ward; (E) a description of exigent circumstances that exist which necessitate immediate relief; and (F) a description of the circumstances requiring the proposed action or decision, which must include supporting documents that are consistent with sections 765.305, 765.401(3), or 765.404, Florida Statutes. (b) Notice. Notice of the petition and of any hearing must be served on the ward, the ward’s attorney, if any, the ward’s next of kin, and any other interested persons which includes persons who have filed requests for notices and copies of pleadings. The provision of notice may be waived by the court. (c) Hearing. (1) The court must hold a hearing if: (A) the ward or the ward’s attorney, if any, objects to the petition; (B) the ward’s next of kin or an interested person objects for any reason authorized by section 765.105(1), Florida Statutes; (C) the professional guardian, the ward, or the ward’s attorney, if any, requests a hearing; or (D) the petition has insufficient information for the court to make a determination. (2) On a showing a hearing is required and exigent circumstances exist, a preliminary hearing on the petition must be held with 72 hours of filing. At the conclusion of the hearing, the -9- court must rule on the petition or set it for an evidentiary hearing within 4 days. (d) Order. (1) If the petition is granted, the order must describe the permitted act and authorize the professional guardian to perform the act. (2) If the petition is denied, the order must state the reasons for the denial. Committee Notes Rule History 2023 Revision: Rule adopted to address the enactment of section 744.4431, Florida Statutes. Statutory References § 744.4431, Fla. Stat. Guardianship power regarding life- prolonging procedures. Rule References Fla. Prob. R. 5.040 Notice. Fla. Prob. R. 5.041 Service of pleadings and documents. Fla. Prob. R. 5.060 Request for notices and copies of pleadings. Fla. R. Gen. Prac. & Jud. Admin. 2.516 Service of pleadings and documents. RULE 5.649. GUARDIAN ADVOCATE (a) Petition for Appointment of Guardian Advocate. A petition to appoint a guardian advocate for a person with a - 10 - developmental disability may be executed by an adult person who is a resident of this state. The petition must be verified by the petitioner and must state: (1) - (2) [No Change] (3) that the petitioner believes that the person needs a guardian advocate and the factual information on which suchthe belief is based; (4) – (7) [No Change] (8) whether the petitioner has knowledge, information, or belief that the person with a developmental disability has executed a designation of health case surrogate or other advance directive under chapter 765, Florida Statutes, or a durable power of attorney under chapter 709, Florida Statutes, and if the person with a development disability has executed any of the foregoing documents, an explanation as to why the documents are insufficient to meet the needs of the individual; and (9) whether the petitioner has knowledge, information, or belief that the person with a developmental disability has a preneed guardian designation; and (10) whether authority is sought to seek periodic support of the person with a developmental disability. (b) [No Change] (c) Counsel. Within 3 days after a petition has been filed, the court must appoint an attorney to represent a person with a developmental disability who is the subject of a petition to appoint a guardian advocate. The person with a developmental disability may substitute his or herthe person’s own attorney for the attorney appointed by the court. (d) Order. If the court finds the person with a developmental disability requires the appointment of a guardian advocate, the - 11 - order appointing the guardian advocate must contain findings of facts and conclusions of law, including: (1) – (5) [No Change] (6) if an advance directive exists and the court determines that the appointment of a guardian advocate is necessary, the authority, if any, the guardian advocate shall exercises over the health care surrogate; (7) – (9) [No Change] (e) Issuance of Letters. UponAfter compliance with all of the foregoing, letters of guardian advocacy must be issued to the guardian advocate. Committee Notes Rule History 2008 – 2020 Revision: [No Change] 2023 Revision: Subdivision (a)(10) added to address statutory changes to sections 393.12(2)(b) and (3)(b), Florida Statutes. Committee notes revised. Statutory References [No Change] Rule References [No Change] - 12 - RULE 5.904. FORMS FOR INITIAL AND ANNUAL GUARDIANSHIP PLANS (a) Initial Guardianship Plan for Minor. In the Circuit Court of the Judicial Circuit, in and for County, Florida Probate Division Case No. In Re: Guardianship of Minor Ward INITIAL GUARDIANSHIP PLAN FOR MINOR .....(Guardian’s name)....., the guardian of the person of .....(ward’s name)....., submits the following annual plan for the period beginning on .....(beginning date)..... and ending on .....(ending date)....., for the benefit of the ward. 1. The ward’s address at the time of filing this plan is: 2. The medical, dental, mental, or personal care services for the welfare of the ward that will be provided during the upcoming year are: Provider Type of Service to be Provided - 13 - 3. The social and personal services to be provided for the welfare of the ward during the upcoming year are: 4. The place and kind of residential setting best suited for the needs of the ward is: 5. The physical and/or mental examinations necessary to determine the ward’s medical, dental, and mental health treatment needs are: 6. Education of the ward: Name and address of the school the ward will attend: Grade level of ward: Description of classes the ward will attend: 7. Consulting with ward (Check one1): ( ) a. The ward is under age 14; OR ( ) b. The guardian attests that the guardian has consulted with the ward (if ward is 14 years of age or older) and, to the extent reasonable, honored the ward’s wishes consistent with the rights retained by the ward under the plan, and to the maximum extent reasonable, the plan is in accordance with the wishes of the ward. 8. This initial plan does not restrict the physical liberty of the ward more than is reasonably necessary to protect the ward from serious physical injury, illness, or disease and provides the - 14 - ward with medical care and mental health treatment for the ward’s physical and mental health. (Please use additional sheets if necessary.) Under penalties of perjury, I declare that I have completed and read the foregoing, and the facts set forth are true, to the best of my knowledge and belief. Signed on .....(date)...... [A certificate of service is required if ward is 14 years of age or older.] [I certify that the foregoing document has been furnished to .....(name, address used for service, mailing address, and e-mail address)..... by (e-mail) (delivery) (mail) (fax) on .....(date)…...] Guardian’s Signature Guardian’s Printed Name: Guardian’s Address: Guardian’s Phone Number: Guardian’s E-mail Address: If the guardian is represented by counsel, the attorney must comply with Florida Rule of General Practice and Judicial Administration 2.515. - 15 - (b) Annual Guardianship Plan for Minor. In the Circuit Court of the Judicial Circuit, in and for County, Florida Probate Division Case No. In Re: Guardianship of Minor Ward ANNUAL GUARDIANSHIP PLAN FOR MINOR .....(Guardian’s name)....., the guardian of the person of .....(ward’s name)....., submits the following annual plan for the period beginning on .....(beginning date)..... and ending on .....(ending date)...... 1. The ward’s address at the time of filing this plan is: . During the prior 12 months, the ward resided at (include dates, names, addresses, and length of stay at each location): Date Name Address Length of stay 2. List any professional treatment (medical or dental) given to the ward during the prior 12 months: Date Provider Treatment provided - 16 - Date Provider Treatment provided 3. A report from the physician who examined the ward no more than 180 days before the beginning of the applicable reporting period that contains an evaluation of the ward’s physical and mental conditions has been filed with this plan. [See subdivision (e) of this rule for a format for a physician’s report.] 4. The plan for providing medical or dental services in the coming year: 5. A summary of the ward’s school progress report: 6. A description of the ward’s social development, including how well the ward communicates and maintains interpersonal relationships: 7. The social needs of the ward are: 8. Consulting with ward (Check one1): ( ) a. The ward is under age 14; OR - 17 - ( ) b. The guardian attests that the guardian has consulted with the ward (if ward is 14 years of age or older) and, to the extent reasonable, honored the ward’s wishes consistent with the rights retained by the ward under the plan, and to the maximum extent reasonable, the plan is in accordance with the wishes of the ward. (Please use additional sheets if necessary.) Under penalties of perjury, I declare that I have completed and read the foregoing, and the facts set forth are true, to the best of my knowledge and belief. Signed on .....(date)...... [A certificate of service is required if ward is 14 years of age or older.] [I certify that the foregoing document has been furnished to .....(name, address used for service, mailing address, and e-mail address)..... by .....(e-mail) (delivery) (mail) (fax)..... on .....(date)…...] Guardian’s Signature Guardian’s Printed Name: Guardian’s Address: Guardian’s Phone Number: Guardian’s E-mail Address: - 18 - (c) Initial Guardianship Plan for Adult. In the Circuit Court of the Judicial Circuit, in and for County, Florida Probate Division Case No. In Re: Guardianship of Respondent’s Name Person with Developmental Disability INITIAL GUARDIANSHIP PLAN (Initial Report of Guardian/Guardian Advocate) .....(Guardian’s name)....., the guardian of the person/guardian advocate of .....(ward’s name)....., the ward, submits the following initial plan: During the period beginning .....(beginning date)....., and ending on .....(ending date)....., the guardian proposes the following plan for the benefit of the ward. 1. The medical, mental, or personal care services for the welfare of the ward that will be provided during the upcoming year are: Provider Type of Service to be Provided - 19 - 2. The social and personal services to be provided for the welfare of the ward during the upcoming year are: 3. The place and kind of residential setting best suited for the needs of the ward is: 4. Describe the health and accident insurance and any other private or governmental benefits to which the ward may be entitled to meet any part of the costs of medical, mental health, or related services provided to the ward: 5. The physical and/or mental examinations necessary to determine the ward’s medical, and mental health treatment needs are: 6. The guardian/guardian advocate hereby attests that the guardian/guardian advocate has consulted with the ward and, to the extent reasonable, honored the ward’s wishes consistent with the rights retained by the ward under the plan, and to the maximum extent reasonable, the plan is in accordance with the wishes of the ward. 7. This initial plan does not restrict the physical liberty of the ward more than is reasonably necessary to protect the ward from serious physical injury, illness, or disease and provides the ward with medical care and mental health treatment for the ward’s physical and mental health. (Please use additional sheets if necessary.) - 20 - 8. The following is a list of preexisting orders not to resuscitate, health care surrogate decision, living will, or anatomical gift. Steps Taken to Suspended by Locate any Court (Yes or Preexisting # Title Date No) Document 1. 2. 3. (Please use additional sheets if necessary.) Under penalties of perjury, I declare that I have completed and read the foregoing, and the facts set forth are true, to the best of my knowledge and belief. Signed on .....(date)...... [A certificate of service is required unless ward has been declared totally incapacitated.] [I certify that the foregoing document has been furnished to .....(name, address used for service, mailing address, and e-mail address)..... by .....(e-mail) (delivery) (mail) (fax)..... on .....(date)…...] Guardian’s Signature Guardian’s Printed Name: Guardian’s Address: Guardian’s Phone Number: Guardian’s E-mail Address: - 21 - (d) Annual Guardianship Plan for Adult. In the Circuit Court of the Judicial Circuit, in and for County, Florida Probate Division Case No. In Re: Guardianship of Respondent’s Name Person with Developmental Disability ANNUAL GUARDIANSHIP PLAN OF GUARDIAN/ GUARDIAN ADVOCATE OF THE PERSON .....(Guardian’s name)....., the guardian of the person/guardian advocate of .....(ward’s name)....., the ward, submits the following annual plan for the period beginning .....(beginning date)..... ending .....(ending date)...... 1. The ward’s address at the time of filing this plan is: 2. During the prior 12 months, the ward resided or was maintained at (include dates, names, addresses, and length of stay at each location): Date Name Address Length of stay 3. The residential setting best suited for the current needs of the ward is (Check one1): - 22 - ( ) a. group home; ( ) b. assisted living; ( ) c. nursing home; ( ) d. live with parents; ( ) e. at ward’s private residence; or ( ) f. other: 4. Plans for ensuring that the ward is in the best residential setting to meet the ward’s needs during the coming year are as follows: 5. The following is a list of any medical treatment given to the ward during the preceding year: Date Provider Treatment provided 6. Attached is a report of a physician who examined the ward no more than 90 days before the end of the report period, including that physician’s evaluation of the ward’s condition and a statement of the current level of capacity of the ward. 7. The plan for provision of medical, dental, mental health, and rehabilitative services (for example, occupational therapy, physical therapy, speech therapy, applied behavioral analysis) in the coming year is: Date Provider Service provided - 23 - 8. The following information is submitted concerning the social condition of the ward: a. The ward is currently using the following social and personal services (include name, services rendered, and address of each provider), including any groups in which the ward is participating in: Date Provider Service provided b. The following is a statement of the social skills of the ward, including how well the ward maintains interpersonal relationships with others: c. The following is a description of the social needs of the ward, if any: 9. The following is a summary of activities during the preceding year designed to increase the capacity of the ward, including involvement in groups or group activities: 10. Is the ward now capable of having some or all of the ward’s rights restored? ( ) If yes, identify the rights that should be restored: 11. Do you plan to seek the restoration of any rights to the ward? - 24 - ( ) If yes, identify the rights that you are seeking to be restored: 12. This plan has or has not been reviewed with the ward. (Please use additional sheets where necessary.) 13. The following is a list of preexisting orders not to resuscitate, health care surrogate designation, living will, or anatomical gift. Steps Taken to Suspended by Locate any Court? (Yes Preexisting # Title Date or No) Document 1. 2. 3. (Please use additional sheets if necessary.) Under penalties of perjury, I declare that I have completed and read the foregoing, and the facts set forth are true, to the best of my knowledge and belief. Signed on .....(date)...... [A certificate of service is required unless ward has been declared totally incapacitated.] [I certify that the foregoing document has been furnished to .....(name, address used for service, mailing address, and e-mail address)..... by .....(e-mail) (delivery) (mail) (fax)..... on .....(date).…..] Guardian’s Signature Guardian’s Printed Name: - 25 - Guardian’s Address: Guardian’s Phone Number: Guardian’s E-mail Address: If the guardian is represented by counsel, the attorney must comply with Florida Rule of General Practice and Judicial Administration 2.515 (every document of a party represented by an attorney shallmust be signed by at least one1 attorney of record). - 26 - (e) Physician’s Report. In the Circuit Court of the Judicial Circuit, in and for County, Florida Probate Division Case No. In Re: Guardianship of Respondent’s Name Person with Developmental Disability PHYSICIAN’S REPORT (Required by section 744.3675, Florida Statutes) 1. Name of Physician: Address: 2. Name of ward: 3. Date of examination: 4. Purpose of examination: a. Regular checkup: b. Treatment for: 5. Evaluation of ward’s condition: (Specify mental and physical condition at time of examination) - 27 - 6. Description of ward’s capacity to live independently: 7. The ward does does not continue to need assistance of a guardian. 8. Is the ward capable of being restored to capacity at this time? Yes No Are there any rights that can be restored at this time? Check any rights that can be restored: ( ) a. to marry; ( ) b. to vote; ( ) c. to personally apply for government benefits; ( ) d. to have a driver license; ( ) e. to travel; ( ) f. to seek or retain employment; ( ) g. to contract; ( ) h. to sue and defend lawsuits; ( ) i. to apply for government benefits; ( ) j. to manage property or to make any gift or disposition of property; ( ) k. to determine his or herthe ward’s residence; - 28 - ( ) l. to consent to medical and mental health treatment; or ( ) m. to make decisions about his or herthe ward’s social environment or other social aspects of his or herthe ward’s life. 9. Date of this report: 10. Signature of physician completing this report: APPENDIX A INSTRUCTIONS TO GUARDIANS AND GUARDIAN ADVOCATES FOR FILING ANNUAL PLANS 1. Fill in the name of the Ccounty wherein which the case is filed on the second blank line at the top where it reads “IN AND FOR COUNTY.” 2. Print the name of the ward on the line just below the “In Re: Guardianship of” caption. 3. Put the case number in the space marked “CASE NO.” in the upper right-hand corner (same as court file number). 4. On the first blank line after the title of the document (Annual Plan), print the guardian’s name. 5. On the next blank line, print the ward’s name. 6. Write in the dates for the period of time of the plan. This period should end on the last day of the month of the month you were appointed and begin a full year before that. If you do not know your plan period, please see the chart below. Please call the Cclerk’s Ooffice or the appropriate Ccourt Sstaff in the county wherein which you are filing, if you cannot determine the plan period after reviewing the chart. - 29 - 7. Type or print answers to all of the questions on the plan. If the question does not apply to your ward’s circumstances, write in the phrase “not applicable.” Fill in all the blanks. If your ward has a habilitation plan (produced by the social worker or the Florida Department of Children and Families) and it has changed, please provide a copy of the habilitation plan as an attachment to the annual plan. If the habilitation plan has not changed then do not file a copy. 8. In paragraph 9, if your ward participates in groups, include that information in this paragraph. 9. Sign your name, and print your name, address, e-mail address, and phone number where indicated. If there are co- guardian advocates, both must sign the plan. 10. Make a copy of the plan for your records in the event there is a problem and work from it for next year’s plan. Make a copy of any attachments to the plan, as well. 11. Mail or hand deliver the original plan to the Clerk of Court of yourthe county wherein which the case is filed. You MUST also send a copy of the plan to your attorney, if you have an attorney, so that the attorney will know that you have filed the plan and will have a copy of the plan in case there is a problem. APPENDIX B [No Change] - 30 - RULE 5.905. FORM FOR PETITION,; NOTICE,; AND ORDER FOR APPOINTMENT OF GUARDIAN ADVOCATE OF THE PERSON (a) Petition. FORM FOR USE IN PETITION FOR APPOINTMENT OF GUARDIAN ADVOCATE OF THE PERSON PURSUANT TOUNDER FLORIDA PROBATE RULE 5.649 In the Circuit Court of the Judicial Circuit, in and for County, Florida Probate Division Case No. In Re: Guardianship Advocacy of Respondent’s Name Person with Developmental Disability PETITION FOR APPOINTMENT OF GUARDIAN ADVOCATE OF THE PERSON Petitioner, , files this petition pursuant tounder section 393.12, Florida Statutes, and Florida Probate Rule 5.649 and alleges that: 1. The petitioner, proposed guardian advocate .....(name)....., is years of age, whose residential address is and post office address is - 31 - . The relationship of the petitioner to the respondent is . 2. .....(Respondent’s name)..... is a person with a developmental disability who was born on and who is years of age, who resides in County, Florida. The residential address of the respondent is and the post office address is . 3. The petitioner believes that respondent needs a guardian advocate: a. due to the following developmental disability: ( ) i. intellectual disability; ( ) ii cerebral palsy; ( ) iii. autism; ( ) iv. spina bifida; ( ) v. Down syndrome; ( ) vi. Phelan-McDermid syndrome; or ( ) vii. Prader-Willi syndrome, which manifested prior tobefore the age of 18. b. The developmental disability has resulted in the following substantial handicaps: 4. The exact areas in which the person with the developmental disability lacks the ability to make informed decisions about his/herthe person’s care and treatment services or - 32 - to meet the essential requirements for his/herthe person’s physical health or safety are as follows: ( ) a. to apply for government benefits; ( ) b. to determine residency; ( ) c. to consent to medical and mental health treatment; ( ) d. to make decisions about social environment/social aspects of life; and ( ) e. to make decisions regarding education; and ( ) f. to bring an independent action for support. 5. There are no alternatives to guardian advocacy, such as trust agreements, powers of attorney, designation of health care surrogate, or other advanced directive, known to petitioner that would sufficiently address the problems of the respondent in whole or in part. Thus, it is necessary that a guardian advocate be appointed to exercise some but not all of the rights of respondent. 6. The names and addresses of the next of kin of the respondent are: Name Address Relationship 7. The proposed guardian advocate .....(name)....., whose residence address is and whose post office address is ; is over the age of 18 and otherwise qualified under the laws of the State of Florida to act as guardian advocate of the person of respondent. The proposed guardian advocate is not a professional guardian. The relationship of the proposed guardian advocate with the providers of health care services, residential services, or other services to the respondent is (if none, indicate: NONE): - 33 - 8. The petitioner(s) allege(s) that to their knowledge, information, and belief, respondent has or has NOT executed an advance directive under chapter 765, Florida Statutes, (designated health case surrogate or other advance directive) or a durable power of attorney under chapter 709, Florida Statutes. 9. (If a Co-Guardian Advocate sought, complete this paragraph.) Petitioner requests that be appointed co-guardian advocate of the person of respondent. The proposed co-guardian advocate .....(name)....., who is years of age, whose residence is ; whose post office address is ; is over the age of 18 and otherwise qualified under the laws of the State of Florida to act as guardian advocate of the person of respondent. The proposed co-guardian advocate is not a professional guardian. The relationship of the proposed co-guardian advocate with the providers of health care services, residential services, or other services to the respondent is (if none, indicate: NONE): The relationship and previous association of the proposed co- guardian advocate to the respondent is . The proposed co-guardian advocate should be appointed because: Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. Signed .....(date)...... Signature: Proposed Guardian Advocate Name: Address: - 34 - Phone Number: E-mail Address: Signature: Proposed Co-Guardian Advocate Name: Address: Phone Number: E-mail Address: - 35 - (b) Notice. The notice of the filing of the petition for the appointment of guardian advocate of the person and notice of hearing must be served with the petition for appointment of guardian advocate of the person pursuant tounder subdivision (a) of this rule. FORM FOR NOTICE OF FILING OF A PETITION FOR APPOINTMENT OF GUARDIAN ADVOCATE OF THE PERSON PURSUANT TOUNDER SECTION 393.12(4), FLORIDA STATUTES, AND NOTICE OF HEARING In the Circuit Court of the Judicial Circuit, in and for County, Florida Probate Division Case No. In Re: Guardian Advocacy of Respondent’s Name Person with Developmental Disability NOTICE OF FILING OF A PETITION FOR APPOINTMENT OF GUARDIAN ADVOCATE AND NOTICE OF HEARING TO: .....(Respondent)....., .....(attorney for respondent)....., .....(next of kin)....., .....(healthcare surrogate)....., and .....(agent under durable power of attorney)...... YOU ARE NOTIFIED that a petition for appointment of guardian advocate of the person has been filed. A copy of the petition for appointment of guardian advocate of the person is - 36 - attached to this notice. There will be a hearing on the petition as follows: You are to appear before the Honorable ...................., Judge, at .....(time)....., on .....(date)....., at the county courthouse of .................... County, in ...................., Florida for the hearing of this petition. The reason for this hearing is to inquire into the capacity of the respondent, the person with a developmental disability, to exercise the rights enumerated in the petition. (See § 744.102(12)(b), Fla. Stat.) The respondent has the right to be represented by counsel of his or herthe respondent’s own choice and the court has initially appointed the following attorney to represent the respondent: Attorney for the respondent: .....(name)....., .....(address)......, .....(phone)....., .....(e-mail)...... Respondent has the right to substitute an attorney of his or herthe respondent’s own choice in place of the attorney appointed by the court. Signed .....(date)...... Signature: Signature: Proposed Guardian Advocate Proposed Co-Guardian Advocate (if any) Name: Name: Address: Address: Phone Number: Phone Number: E-mail Address: E-mail Address: CERTIFICATE OF SERVICE - 37 - I CERTIFY that a copy of the foregoing notice of filing petition to appoint guardian advocate and notice of hearing and a copy of the petition for appointment of guardian advocate of the person was served on all persons indicated above, including on the attorney for the respondent, on .....(date)...... Signature: Signature: Proposed Guardian Advocate Proposed Co-Guardian Advocate (if any) Name: Name: Address: Address: Phone Number: Phone Number: E-mail Address: E-mail Address: If you are a person with a disability who needs any accommodation in order to participate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact [identify applicable court personnel by name, address, and telephone number] at least 7 days before your scheduled court appearance, or immediately upon receiving this notification if the time before the scheduled appearance is less than 7 days; if you are hearing or voice impaired, call 711. - 38 - (c) Order. In the Circuit Court of the Judicial Circuit, in and for County, Florida Probate Division Case No. In Re: Guardianship of Respondent’s Name Person with Developmental Disability ORDER APPOINTING GUARDIAN ADVOCATE UpoOn consideration of the petition for the appointment of guardian advocate of the person, the court finds that .....(respondent’s name)..... has a developmental disability of a nature that requires the appointment of guardian advocate of the person based upon the following findings of fact and conclusions of law: 1. The nature and scope of the person’s lack of decision- making ability are: 2. The exact areas in which the person lacks decision- making ability to make informed decisions about care and treatment services or to meet the essential requirements for his/herthe respondent’s health and safety are specified in number 4. 3. The specific legal disabilities to which the person with a developmental disability is subject to are: - 39 - 4. The powers and duties delegated to the guardian advocate are: ( ) a. to apply for government benefits; ( ) b. to determine residency; ( ) c. to consent to medical and mental health treatment; ( ) d. to make decisions about social environment/social aspects of life; and ( ) e. to make decisions regarding education; and ( ) f. to bring an independent action for support. 5. There are no alternatives to guardian advocacy, such as trust agreements, powers of attorney, designation of health care surrogate, or other advanced directive, known to petitioner that would sufficiently address the problems of the respondent in whole or in part. Thus, it is necessary that a guardian advocate be appointed to exercise some but not all of the rights of respondent. 6. Without first obtaining specific authority from the court, as stated in section 744.3725, Florida Statutes, the guardian advocate may not exercise any authority over any health care surrogate appointed by any valid advance directive executed by the disabled person, pursuant tounder Chapter 765, Florida Statutes, except upon further order of this Court. ORDERED AND ADJUDGED: 1. .....(Name)..... is qualified to serve as guardian advocate and is hereby appointed as guardian advocate of the person of .....(respondent’s name)...... - 40 - 2. The guardian advocate shallwill exercise only the rights that the court has found the disabled person incapable of exercising on his or herthe disabled person’s own behalf, as outlined herein above. Said rights are specifically delegated to the guardian advocate. ORDERED this .....(date)...... Judge - 41 - RULE 5.906. LETTERS OF GUARDIAN ADVOCACY FORM LETTERS OF GUARDIAN ADVOCACY In the Circuit Court of the Judicial Circuit, in and for County, Florida Probate Division Case No. In Re: Guardian Advocacy of Respondent’s Name Person with Developmental Disability LETTERS OF GUARDIAN ADVOCATE (CO-GUARDIAN ADVOCATES) OF THE PERSON TO ALL WHOM IT MAY CONCERN: WHEREAS, .....(guardian advocate’s name(s))..... has/have been appointed guardian advocate(s) of the person of .....(the ward)....., a person with a developmental disability who lacks the decision-making capacity to do some of the tasks necessary to take care of his/herthe ward’s person; and NOW, THEREFORE, I, the undersigned, declare that .....(guardian advocate’s name(s))..... is/are duly qualified under the laws of the State of Florida to act as guardian advocate of the person of .....(the ward)...., with full power to exercise the following powers and duties on behalf of the person with a developmental disability: ( ) 1. to apply for government benefits; - 42 - ( ) 2. to determine residency; ( ) 3. to consent to medical and mental health treatment; and ( ) 4. to make decisions about social environment and social aspects of life; and ( ) 5. to make decisions regarding education; and ( ) 6. to bring an independent action for support. Without first obtaining specific authority from the court, pursuant tounder sections 744.3215(4) and 744.3725, Florida Statutes, the guardian advocate (co-guardian advocates) may not: a. commit the respondent to a facility, institution, or licensed service provider without formal placement proceedings pursuant tounder Chapter 393, Florida Statutes; b. consent to the participation of the respondent in any experimental biomedical or behavior procedure, exam, study, or research; c. consent to the performance of sterilization or abortion procedure on the respondent; d. consent to termination of life support systems provided for the respondent; e. initiate a petition for dissolution of marriage for the ward; or f. exercise any authority over any health care surrogate appointment by a valid advance directive executed by the disabled person, pursuant tounder Chapter 765, Florida Statutes, except upon further order of this court. The respondent shall retains all legal rights except those that are specifically granted to the guardian advocate (co-guardian advocates) pursuant tounder court order. - 43 - ORDERED this .....(date)...... Judge - 44 - RULE 5.920. FORMS RELATED TO INJUNCTION FOR PROTECTION AGAINST EXPLOITATION OF A VULNERABLE ADULT (a) Petition for Injunction. Petitioners should take steps to protect confidential information within the petition for injunction pursuant tounder Florida Rule of General Practice and Judicial Administration 2.420 and minimize sensitive information within the petition for injunction pursuant tounder Florida Rule of General Practice and Judicial Administration 2.425. IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA In re: Protection of Case No.: Adversary Proceeding Vulnerable Adult , Petitioner, and , Respondent. PETITION FOR INJUNCTION FOR PROTECTION AGAINST EXPLOITATION OF A VULNERABLE ADULT UNDER SECTION 825.1035, FLORIDA STATUTES Before me, the undersigned authority, personally appeared petitioner who has been sworn and says that the following statements are true: 1. The vulnerable adult, , whose age is , who resides at (address): - 45 - 2. Section 825.101(14), Florida Statutes, provides that a vulnerable adult is a person whose ability to perform the normal activities of daily living or to provide for his or herthe vulnerable adult’s own care or protection is impaired due to a mental, emotional, sensory, long-term physical, or developmental disability or dysfunction, or brain damage, or the infirmities of aging. Please describe the vulnerable adult’s inability to perform the normal activities of daily living. 3. The petitioner’s relationship to the vulnerable adult is: , and the petitioner has the right to bring the petition because: 4. The respondent, , resides at (last known address): 5. The respondent’s last known place of employment is: 6. The physical description of the respondent is: Race: Sex: Date of Birth: Height: Weight: Eye Color: Hair Color: Distinguishing Marks/Scars: 7. Aliases of the respondent are: 8. The respondent is associated with the vulnerable adult as follows: 9. The following describes other causes of action: (a) there is/are 1 or more cause(s) of action currently pending between the petitioner and the respondent, - 46 - and/or a proceeding under the Florida Guardianship Code, chapter 744, Florida Statutes, concerning the vulnerable adult. Describe causes of action here: (b) Related case numbers and county where filed, if available: (c) there are previous or pending attempts by the petitioner to obtain an injunction for protection against exploitation of the vulnerable adult in this or any other circuit. Describe attempts here: (d) The results of any such attempts: 10. The following describes the petitioner’s knowledge of: (a) Any reports made to a government agency, such as the Department of Elder Affairs or the Department of Children and Families: (b) Any investigations performed by a government agency relating to abuse, neglect, or exploitation of the vulnerable adult: and (c) The results of any such reports or investigations: 11. The petitioner knows or has reasonable cause to believe the vulnerable adult is either a victim of exploitation or is in imminent danger of becoming a victim of exploitation, because the - 47 - respondent (include a description of any incidents or threats of exploitation by the respondent here): 12. The following describes: (a) The petitioner’s knowledge of the vulnerable adult’s dependence on the respondent for care: (b) Alternative provisions for the vulnerable adult’s care in the absence of the respondent, if necessary: (c) Available resources the vulnerable adult has for such alternative provisions: ; and (d) The vulnerable adult’s willingness to use such alternative provisions: 13. The petitioner knows the vulnerable adult maintains assets, accounts, or lines of credit at the following institutions: Institution Address Account Number - 48 - Institution Address Account Number 14. If petitioner is seeking to freeze assets of the vulnerable adult, petitioner believes that the vulnerable adult’s assets to be frozen are (check one1): Worth less than $1,500 Worth from $1,500 to $5,000 Worth more than $5,000 15. The petitioner genuinely fears imminent exploitation of the vulnerable adult by the respondent. 16. The petitioner seeks an injunction for the protection of the vulnerable adult, including (mark appropriate section or sections): Prohibiting the respondent from having any direct or indirect contact with the vulnerable adult. Immediately restraining the respondent from committing any acts of exploitation against the vulnerable adult. Freezing the below assets, accounts, and/or lines of credit of the vulnerable adult, listed below even if titled jointly with the respondent, or in the respondent’s name only, in the court’s discretion. Institution Address Account Number - 49 - Institution Address Account Number Providing any terms the court deems necessary for the protection of the vulnerable adult or his or herthe vulnerable adult’s assets, including any injunctions or directives to law enforcement agencies, including: 17. If the court enters an injunction freezing assets, accounts, and credit lines: (a) the petitioner believes that the critical expenses of the vulnerable adult will be paid for or provided by the following persons or entities: OR (b) The petitioner requests that the following expenses be paid notwithstanding the freezing of assets, accounts, or lines of credit from the following institution(s): I ACKNOWLEDGE THAT PURSUANT TOUNDER SECTION 415.1034, FLORIDA STATUTES, ANY PERSON WHO KNOWS, OR HAS REASONABLE CAUSE TO SUSPECT, THAT A VULNERABLE - 50 - ADULT HAS BEEN OR IS BEING ABUSED, NEGLECTED, OR EXPLOITED HAS A DUTY TO IMMEDIATELY REPORT SUCH KNOWLEDGE OR SUSPICION TO THE CENTRAL ABUSE HOTLINE. I HAVE REPORTED THE ALLEGATIONS IN THIS PETITION TO THE CENTRAL ABUSE HOTLINE. I HAVE READ EACH STATEMENT MADE IN THIS PETITION AND EACH SUCH STATEMENT IS TRUE AND CORRECT. I UNDERSTAND THAT THE STATEMENTS MADE IN THIS PETITION ARE BEING MADE UNDER PENALTY OF PERJURY PUNISHABLE AS PROVIDED IN SECTION 837.02, FLORIDA STATUTES. Signature of Party Printed Name: Address: City, State, Zip: Telephone Number: Designated E-mail Address(es): STATE OF FLORIDA COUNTY OF Sworn to or affirmed and signed before me on .....(date)...... Printed Name Notary Public or Deputy Clerk Personally known or Produced identification Type of identification produced: - 51 - (b) Temporary Protective Injunction Against Exploitation of a Vulnerable Adult. IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA In re: Case No.: Vulnerable Adult , Petitioner, and , Respondent. TEMPORARY PROTECTIVE INJUNCTION AGAINST EXPLOITATION OF A VULNERABLE ADULT AND NOTICE OF HEARING This cause came before the court, which has jurisdiction over the parties and subject matter under state law. The court having reviewed the petition and affidavits and considered argument of counsel, finds as follows: 1. Reasonable notice and opportunity to be heard was given to the respondent in a manner sufficient to protect his or her due process rights. Date of service OR 2. The court conducted its review ex parte. 3. An immediate and present danger of exploitation of the vulnerable adult exists. 4. There is a likelihood of irreparable harm and unavailability of an adequate legal remedy. - 52 - 5. There is a substantial likelihood of success on the merits. 6. The threatened injury to the vulnerable adult outweighs possible harm to the respondent. 7. Granting a temporary injunction will not disserve the public interest. 8. This injunction provides for the vulnerable adult’s physical or financial safety. 9. These findings were based on the following facts: Accordingly, it is hereby ADJUDGED that: The petitioner’s request for a temporary protective injunction is GRANTED. This injunction is valid for 15 days from the date of this order or . The full hearing is set for .....(date)....., at .....(time)...... The hearing will be held before the Honorable at , Florida. It is further ordered that: The respondent shall not commit any act of exploitation against the vulnerable adult. The respondent will have no contact with vulnerable adult. The vulnerable adult is awarded temporarily exclusive use and possession of any dwelling he or shethe vulnerable adult shares with the respondent. The respondent is barred from entering the residence of the vulnerable adult. The vulnerable adult’s assets, accounts, and/or credit lines are hereby frozen until further court order except: - 53 - Institution(s) served on .....(date)...... The following institution(s) holding the vulnerable adult’s assets shallmust use his or herthe vulnerable adult’s unencumbered assets to pay the clerk of court the following filing fee: $75.00 (if assets are between $1,500–$5,000) OR $200.00 (if assets are more than $5,000). If the court enters an injunction, these fees will be taxed as costs against the respondent. Law enforcement is hereby directed to: Other relief: This injunction is valid and enforceable in all Florida counties, does not affect title to real property, and law enforcement may use their section 901.15(6), Florida Statutes, arrest powers to enforce its terms. DONE and ORDERED on .....(date)..... at .....(time)...... Judge CC: All parties and counsel of record COPIES TO: (Check those that apply) - 54 - Petitioner: by U. S. Mail by hand delivery in open court (Petitioner must acknowledge receipt in writing on the original order—see below.) Vulnerable Adult (if not petitioner) by U. S. Mail by hand delivery in open court Respondent: forwarded to Sheriff for service by U. S. Mail by hand delivery in open court (Respondent must acknowledge receipt in writing on the original order—see below.) by certified mail (May only be used when respondent is present at the hearing and Rrespondent fails or refuses to acknowledge the receipt of a certified copy of this injunction.) Other: Petitioner’s Attorney: by e-mail Respondent’s Attorney: by e-mail I CERTIFY the foregoing is a true copy of the original as it appears on file in the office of the clerk of the circuit court of County, Florida, and that I have furnished copies of this order as indicated above on .....(date)...... CLERK OF THE CIRCUIT COURT By: Deputy Clerk - 55 - If you are a person with a disability who needs any accommodation in order to participate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact [identify applicable court personnel by name, address, and telephone number] at least 7 days before your scheduled court appearance, or immediately upon receiving this notification if the time before the scheduled appearance is less than 7 days; if you are hearing or voice impaired, call 711. - 56 - (c) Order Denying Injunction and Notice of Hearing. IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA In re: Case No.: Vulnerable Adult , Petitioner, and , Respondent. ORDER DENYING REQUEST FOR TEMPORARY INJUNCTION AND SETTING HEARING ON PETITION FOR INJUNCTION FOR PROTECTION AGAINST EXPLOITATION OF A VULNERABLE ADULT A petition for injunction for protection against exploitation of a vulnerable adult has been reviewed. This court has jurisdiction over the parties and of the subject matter. Based upon the facts stated in the petition, the court finds: The facts supporting the denial of the request for an ex parte injunction are: The court finds that based upon the facts, as stated in the petition alone and without a hearing in the matter, there is no - 57 - appearance of an immediate and present danger of exploitation of a vulnerable adult. IT IS THEREFORE ORDERED: The request for a temporary injunction for protection against exploitation of a vulnerable adult is denied. A hearing is scheduled on the petition for injunction for protection against exploitation of a vulnerable adult. The petitioner has the right to promptly amend any petition consistent with court rules. NOTICE OF HEARING A hearing is scheduled regarding this matter on .....(date)....., at .....(time)....., when the court will fully hear the allegations in the petition for injunction for protection against exploitation of a vulnerable adult. The hearing will be before The Honorable .....(name)....., at the following .....(address)....., Florida. All witnesses and evidence, if any, must be presented at this time. IF EITHER PETITIONER OR RESPONDENT DO NOT APPEAR AT THE FINAL HEARING, HE OR SHETHE PETITIONER OR RESPONDENT WILL BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED IN THIS MATTER. Nothing in this order limits petitioner’s rights to dismiss the petition. DONE AND ORDERED in, Florida, on .....(date)...... JUDGE COPIES TO: Sheriff of County CERTIFICATE OF SERVICE: Petitioner: by U. S. Mail by e-mail to designated e-mail address(es) - 58 - Respondent will be served by sheriff. Vulnerable Adult will be served by sheriff. The financial institution will be served by sheriff. (If any assets, accounts, or lines of credit are requested to be frozen, insert names of the financial institutions.) I CERTIFY the foregoing is a true copy of the original as it appears on file in the office of the clerk of the circuit court of County, Florida, and that I have furnished copies of this order as indicated above. CLERK OF THE CIRCUIT COURT (SEAL) By: Deputy Clerk or Judicial Assistant If you are a person with a disability who needs any accommodation in order to participate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact [identify applicable court personnel by name, address, and telephone number] at least 7 days before your scheduled court appearance, or immediately upon receiving this notification if the time before the scheduled appearance is less than 7 days; if you are hearing or voice impaired, call 711. - 59 - (d) Final Protective Injunction. IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA In re: Case No.: Vulnerable Adult , Petitioner, and , Respondent. PERMANENT INJUNCTION FOR PROTECTION AGAINST EXPLOITATION OF A VULNERABLE ADULT This cause came before the court, which has jurisdiction over the parties and subject matter under state law. The court having reviewed the petition and affidavits and considered the testimony presented and argument of counsel, finds as follows: 1. Reasonable notice and opportunity to be heard was given to the respondent in a manner sufficient to protect his or herthe respondent’s due process rights. Respondent was served with the petition for injunction, notice of hearing, and temporary protective injunction, if issued. 2. A hearing was held on .....(date)...... 3. The vulnerable adult is a victim of exploitation or in imminent danger of becoming an exploitation victim. 4. There is a likelihood of irreparable harm and unavailability of an adequate legal remedy. - 60 - 5. The threatened injury to the vulnerable adult outweighs possible harm to the respondent. 6. With regard to freezing the respondent’s assets, accounts, and/or lines of credit that were the proceeds of exploitation, there is probable cause that exploitation has occurred and a substantial likelihood that such assets, accounts, and/or lines of credit will be returned to the vulnerable adult. 7. This injunction provides for the vulnerable adult’s physical or financial safety. 8. These findings were based on the following facts: Accordingly, it is hereby ADJUDGED that: The petitioner’s request for a protective injunction is GRANTED. This injunction remains in effect until it has been modified or dissolved, and it is further ordered that: The respondent shallmust not commit any acts of exploitation against, or have any direct or indirect contact with, the vulnerable adult. The vulnerable adult is awarded exclusive use and possession of any dwelling he or shethe vulnerable adult shares with the respondent. The respondent is excluded from the residence of the vulnerable adult. The respondent shallmust, at his or herthe respondent’s own expense, participate in all relevant treatment, intervention, or counseling services to be paid for by the respondent. - 61 - Unless ownership is unclear, any temporarily frozen assets, accounts, and credit lines of the vulnerable adult are to be returned to the vulnerable adult. If not already paid pursuant tounder the order granting temporary protective injunction against exploitation of a vulnerable adult, a final cost judgment is hereby entered against respondent and in favor of the clerk of courts in the amount of (check one1): $75.00 (if assets are between $1,500–$5,000) OR $200.00 (if assets are more than $5,000). All for which let execution issue forthwith. If the amount set forth above has already been paid to the clerk of courts, a final cost judgment is hereby entered against respondent and in favor of the vulnerable adult in the amount set forth above, all for which let execution issue forthwith. Any other costs associated with this judgment, including filing fees and service charges, are to be paid by the respondent. Other: This injunction is valid and enforceable in all Florida counties, does not affect title to real property, and law enforcement may use section 901.15(6), Florida Statutes, arrest powers to enforce its terms. DONE and ORDERED on .....(date)...... - 62 - Judge CC: All parties and counsel of record COPIES TO: (Check those that apply) Petitioner: by U. S. Mail by hand delivery in open court (Petitioner must acknowledge receipt in writing on the original order—see below.) Vulnerable Adult (if not petitioner) by U. S. Mail by hand delivery in open court Respondent: forwarded to Sheriff for service by U. S. Mail by hand delivery in open court (Respondent must acknowledge receipt in writing on the original order—see below.) by certified mail (May only be used when respondent is present at the hearing and respondent fails or refuses to acknowledge the receipt of a certified copy of this injunction.) Department of Agriculture and Consumer Services Other: Petitioner’s Attorney: by e-mail Respondent’s Attorney: by e-mail - 63 - I CERTIFY the foregoing is a true copy of the original as it appears on file in the office of the clerk of the circuit court of County, Florida, and that I have furnished copies of this order as indicated above on .....(date)...... CLERK OF THE CIRCUIT COURT By: Deputy Clerk - 64 -