Florida Senate - 2024                        COMMITTEE AMENDMENT
       Bill No. SB 330
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/14/2024           .                                

       The Appropriations Committee on Health and Human Services (Boyd)
       recommended the following:
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Part VI of chapter 395, Florida Statutes,
    6  consisting of ss. 395.901 and 395.902, Florida Statutes, is
    7  created and entitled Behavioral Health Teaching Hospitals.
    8         Section 2. Section 395.901, Florida Statutes, is created to
    9  read:
   10         395.901 Behavioral health teaching hospitals.—
   11         (1)DEFINITIONS.—As used in this part, the term:
   12         (a)“Agency” means the Agency for Health Care
   13  Administration.
   14         (b)“Behavioral health teaching hospital” means a
   15  community-based hospital licensed under this chapter which has
   16  partnered with a university school of medicine and offers
   17  integrated behavioral health education as specified in s.
   18  395.902.
   20         (a)The Legislature finds that there is a critical shortage
   21  of behavioral health professionals and recognizes the urgent
   22  need to expand the existing behavioral health workforce, prepare
   23  for an aging workforce, incentivize entry into behavioral health
   24  professions, and train a modernized workforce in innovative
   25  integrated care.
   26         (b)The Legislature finds there is a specific need to
   27  support a behavioral health education system that not only
   28  trains the next generation of professionals in innovative and
   29  integrated care for those with behavioral health needs, but also
   30  works to modernize the state’s overall behavioral health system
   31  of care.
   32         (c)Therefore, the Legislature intends to identify and
   33  designate multiple behavioral health teaching hospitals that
   34  work to provide the necessary research, education, and services
   35  to not only enhance this state’s behavioral health workforce,
   36  but to make that workforce and system of care the national
   37  standard. The Legislature intends to establish pilot designated
   38  behavioral health teaching hospitals with the intent to develop
   39  and implement a statewide model.
   40         (d) The Legislature further intends to create the Florida
   41  Center for Behavioral Health Workforce within the Louis de la
   42  Parte Florida Mental Health Institute to address issues of
   43  workforce supply and demand in behavioral health professions,
   44  including issues of recruitment, retention, and workforce
   45  resources.
   46         (e)The Legislature intends for designated behavioral
   47  health teaching hospitals to:
   48         1.Focus on state-of-the-art behavioral health research.
   49         2.Provide leading-edge education and training for this
   50  state’s behavioral health workforce in innovative and integrated
   51  care.
   52         3.Collaborate with other university colleges and schools
   53  of nursing, psychology, social work, pharmacy, public health,
   54  and other relevant disciplines to promote and enhance a
   55  modernized behavioral health system of care.
   56         4.Develop, implement, and promote public-private
   57  partnerships throughout this state to support and enhance the
   58  intent of this part.
   59         5.Partner with the state to provide inpatient and
   60  outpatient behavioral health care, address system-wide
   61  behavioral health needs, and support the state in providing
   62  treatment and care for those whose need and acuity has resulted
   63  in the need for long-term voluntary or involuntary civil
   64  commitment.
   65         Section 3. Section 395.902, Florida Statutes, is created to
   66  read:
   67         395.902Designated behavioral health teaching hospitals.—
   68         (1)To be designated as a behavioral health teaching
   69  hospital, a hospital must meet all of the following criteria:
   70         (a)Offer a psychiatric residency program accredited
   71  through the Residency Review Committee of the Accreditation
   72  Council of Graduate Medical Education.
   73         (b)Offer an accredited postdoctoral clinical psychology
   74  fellowship program.
   75         (c)Develop and maintain a consultation agreement with the
   76  Louis de la Parte Florida Mental Health Institute as established
   77  in s. 1004.44, including with the Florida Center for Behavioral
   78  Health Workforce.
   79         (d)As part of its partnership with a university school of
   80  medicine, develop and submit a plan to the Department of
   81  Children and Families and the Florida Center for Behavioral
   82  Health Workforce that meets all of the following criteria:
   83         1.Promotes the development of integrated behavioral health
   84  workforce educational programs, including, but not limited to,
   85  practicums and internships for clinical and nonclinical
   86  behavioral and physical health professions.
   87         2.Promotes a coordinated system of care which offers
   88  inpatient and outpatient treatment and services for individuals
   89  with behavioral health needs, including, but not limited to,
   90  prevention, community inpatient care, crisis stabilization,
   91  short-term residential treatment, screening, therapeutic and
   92  supportive services, and long-term care.
   93         3.Coordinates and promotes innovative partnerships that
   94  integrate colleges and schools of nursing, psychology, social
   95  work, pharmacy, public health, and other relevant disciplines
   96  with existing local and regional programs, clinics, and
   97  resources.
   98         4.Develops processes to identify local gaps in access to
   99  inpatient care.
  100         5.Partners with the Department of Children and Families
  101  and Managing Entities to build capacity in safety net inpatient
  102  and outpatient behavioral health services.
  103         6.Provides bed capacity to support state hospital needs,
  104  when needed.
  105         (2)Notwithstanding subsection (1), to accomplish the
  106  stated intent of this section to develop and implement a
  107  statewide model of a behavioral health teaching hospital, the
  108  following partnerships are designated as behavioral health
  109  teaching hospitals without meeting the required criteria of this
  110  section as 3-year pilots, expected to meet all criteria and
  111  requirements of subsection (1) by July 1, 2027:
  112         1.The University of South Florida Morsani College of
  113  Medicine and Tampa General Hospital.
  114         2.The University of Florida School of Medicine and UF
  115  Health Shands Hospitals in Gainesville and Jacksonville.
  116         3.The University of Miami Miller School of Medicine and
  117  Jackson Memorial Hospital.
  118         (3)(a)A designated behavioral health teaching hospital
  119  must annually report to the Department of Children and Families
  120  by December 1, the current status of the designated behavioral
  121  health teaching hospital program, including, but not limited to
  122  the:
  123         1.Number of psychiatric residents.
  124         2.Number of postdoctoral clinical psychology fellows.
  125         3.Status and details of the consultation agreement with
  126  the Louis de la Parte Florida Mental Health Institute and
  127  Florida Center for Behavioral Health Workforce.
  128         4.Status and implementation details of the plan required
  129  under paragraph (1)(d).
  130         (b)Upon completion of the 3-year pilot on July 1, 2027,
  131  the Department of Children and Families, in collaboration with
  132  the Florida Center for Behavioral Health Workforce, the pilot
  133  behavioral health teaching hospitals, and other relevant
  134  stakeholders must submit a report to the President of the
  135  Senate, Speaker of the House of Representatives, and Governor by
  136  July 1, 2028. This report must, at a minimum:
  137         1.Evaluate the effectiveness of the behavioral health
  138  teaching hospital model.
  139         2.Discuss barriers to the implementation and operation of
  140  the model.
  141         3.Recommend policy changes to enhance the model to better
  142  meet the intent of the Legislature.
  143         4.Evaluate and recommend whether the state should maintain
  144  the original designated pilot behavioral teaching hospital
  145  locations or detail the necessity for and recommend the
  146  expansion of the model to new partnership sites.
  147         Section 4. Subsection (1) and paragraph (d) of subsection
  148  (2) of section 409.91256, Florida Statutes, as created by SB
  149  7016, Regular Session 2024, is amended to read:
  150         409.91256 Training, Education, and Clinicals in Health
  151  (TEACH) Funding Program.—
  152         (1) PURPOSE AND INTENT.—The Training, Education, and
  153  Clinicals in Health (TEACH) Funding Program is created to
  154  provide a high-quality educational experience while supporting
  155  participating federally qualified health centers, community
  156  mental health centers, rural health clinics, behavioral health
  157  teaching hospitals, and certified community behavioral health
  158  clinics by offsetting administrative costs and loss of revenue
  159  associated with training residents and students to become
  160  licensed health care practitioners. Further, it is the intent of
  161  the Legislature to use the program to support the state Medicaid
  162  program and underserved populations by expanding the available
  163  health care workforce.
  164         (2) DEFINITIONS.—As used in this section, the term:
  165         (d) “Qualified facility” means a federally qualified health
  166  center, a community mental health center, rural health clinic,
  167  behavioral health teaching hospital, or a certified community
  168  behavioral health clinic.
  169         Section 5. Subsections (6), (7), and (8) are added to
  170  section 1004.44, Florida Statutes, to read:
  171         1004.44 Louis de la Parte Florida Mental Health Institute.
  172  There is established the Louis de la Parte Florida Mental Health
  173  Institute within the University of South Florida.
  174         (6)(a)There is established, within the institute, the
  175  Florida Center for Behavioral Health Workforce to address issues
  176  of workforce supply and demand in behavioral health professions,
  177  including issues of recruitment, retention, and workforce
  178  resources.
  179         (b)The primary goals for the center are to:
  180         1.Design and implement a longitudinal study of the state's
  181  behavioral health workforce that, at a mimimum:
  182         a.Produces a statistically valid biennial data-driven
  183  analysis of the supply and demand of the behavioral health
  184  workforce. To achieve such goal, the center must:
  185         (I)Identify and define specific professions to be
  186  considered "behavioral health professions" for analysis.
  187         (II)Establish and maintain a database on the supply and
  188  demand of behavioral health professionals in this state, to
  189  include current supply and demand; and
  190         (III) Analyze the current and future supply and demand in
  191  the state.
  192         b. Develops recommendations and strategies to increase the
  193  state's behavioral health workforce, behavioral health
  194  profession training and education programs, and behavioral
  195  health profession faculty development.
  196         c. Develops best practices in the academic preparation and
  197  continuing education needs of behavioral health professionals.
  198         d. Collects data on behavioral health professions,
  199  employment, distribution, and retention.
  200         2.Develop a strategic statewide plan for the state's
  201  behavioral health workforce that:
  202         a. Pilots innovative projects to support the recruitment,
  203  development, and retention of qualified behavioral health
  204  professionals, to include behavioral health educators, faculty,
  205  and clinical preceptors.
  206         b. Encourages and coordinates the development of academic
  207  practice partnerships that support behavioral health faculty
  208  employment and advancement.
  209         c. Develops distance learning infrastructure for behavioral
  210  health education and the evidence-based use of technology,
  211  simulation, and distance learning techniques.
  212         d. Enhance and promote behavioral health professions and
  213  professionals in this state by developing and promoting:
  214         (I)Behavioral health excellence programs.
  215         (II)Reward, recognition, and renewal activities.
  216         (III)Media and image-building efforts.
  217         3. Convene various groups representative of behavioral
  218  health professions, other health care providers, business and
  219  industry, consumers, lawmakers, educators, and the Commission on
  220  Mental Health and Substance Use Disorder to:
  221         a. Review and comment on the center's behavioral health
  222  workforce data analysis;
  223         b. Provide an overview of the state's behavioral health
  224  infrastructure and perform a gap analysis to recommend systemic
  225  changes, including strategies for implementation of recommended
  226  changes;
  227         c.Develop a strategic plan to implement the
  228  recommendations of the Commission on Mental Health and Substance
  229  Use Disorder to:
  230         (I)Strengthen community networks and cross-agency
  231  collaboration;
  232         (II)Enhance the state's crisis care continuum;
  233         (III)Improve data collection and management processes; and
  234         (IV)Optimize financial management of the behavioral health
  235  system of care.
  236         d.Evaluate how to best promote, integrate, and incentivize
  237  the establishment and growth of the behavioral health teaching
  238  hospital model.
  239         4. Evaluate and report the results of these efforts to the
  240  Legislature and other entities.
  241         (c) The center may request from any board as defined in s.
  242  456.001, and the board must provide to the center upon its
  243  request, any information held by the board regarding a
  244  behavioral health professional licensed in this state or holding
  245  a multistate license pursuant to a professional multistate
  246  licensure compact or information reported to the board by
  247  employers of such behavioral health professionals, other than
  248  personal identifying information.
  249         (d) By January 10 of each year, the center shall submit a
  250  report to the Governor, the President of the Senate, and the
  251  Speaker of the House of Representatives providing details of its
  252  activities during the preceding calendar year in pursuit of its
  253  goals and in the execution of its duties under paragraph (b).
  254         (7) The Board of Governors and the State Board of
  255  Education, in consultation with the center, shall expeditiously
  256  adopt any necessary regulations and rules, as applicable, to
  257  allow the center to perform its responsibilities as soon as
  258  practicable.
  259         Section 6. Effective upon this act becoming a law, the
  260  Department of Children and Families must contract for a detailed
  261  study of Florida’s forensic, voluntary and involuntary civil
  262  commitment, and statewide inpatient psychiatric programs bed
  263  capacity. The study must be completed by January 31, 2025, and
  264  at a minimum include the following:
  265         (1)An analysis of bed capacity in forensic, voluntary and
  266  involuntary civil commitment, and statewide inpatient
  267  psychiatric programs.
  268         (2)Policy recommendations for ensuring sufficient bed
  269  capacity in those settings.
  270         (3)An evaluation of maintaining civil commitment beds as a
  271  requirement for designation as a behavioral health teaching
  272  hospital, to include potential costs related to capital outlay,
  273  enhanced bed rate, and staffing requirements.
  274         (4)Recommendations for promoting coordination between
  275  Florida’s civil commitment system and behavioral health teaching
  276  hospitals.
  277         (5)Recommendations to build capacity for safety net
  278  inpatient and outpatient services that will mitigate involuntary
  279  commitments.
  280         Section 7. Except as otherwise expressly provided in this
  281  act, this act shall take effect July 1, 2024.
  283  ================= T I T L E  A M E N D M E N T ================
  284  And the title is amended as follows:
  285         Delete everything before the enacting clause
  286  and insert:
  287                        A bill to be entitled                      
  288         An act relating to behavioral health teaching
  289         hospitals; creating part VI of ch. 395, F.S., entitled
  290         “Behavioral Health Teaching Hospitals”; creating s.
  291         395.901, F.S.; defining the terms “agency” and
  292         “behavioral health teaching hospital”; providing
  293         legislative findings and intent; creating s. 395.902,
  294         F.S.; specifying criteria that a hospital must meet to
  295         receive such designation; naming specified pilot
  296         sites; requiring an annual report; requireing report
  297         upon completion of the 3-year pilot; amending s.
  298         1004.44, F.S.; establishing the Florida Center for
  299         Behavioral Health Workforce within the Louis de la
  300         Parte Florida Mental Health Institute for a specified
  301         purpose; specifying the primary goals of the center;
  302         requiring the center to establish and maintain a
  303         database on the supply and demand of behavioral health
  304         professionals in this state for a specified purpose;
  305         authorizing the center to request, and requiring
  306         certain boards to provide, certain information
  307         regarding behavioral health professionals licensed or
  308         practicing in this state; requiring the center to
  309         submit an annual report of certain information to the
  310         Governor and the Legislature; requiring the Department
  311         of Children and Families to contract for a study of
  312         the state’s involuntary commitment bed capacity;
  313         specifying requirements for the study; providing
  314         effective dates.