Florida Senate - 2024 SENATOR AMENDMENT
Bill No. CS for SB 330
Ì844930$Î844930
LEGISLATIVE ACTION
Senate . House
.
.
.
Floor: 1/AD/2R .
02/28/2024 10:44 AM .
—————————————————————————————————————————————————————————————————
—————————————————————————————————————————————————————————————————
Senator Boyd moved the following:
1 Senate Amendment (with title amendment)
2
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, 395.902, and 395.903, Florida
7 Statutes, is created and entitled “Behavioral Health Teaching
8 Hospitals.”
9 Section 2. Section 395.901, Florida Statutes, is created to
10 read:
11 395.901 Definitions; legislative findings and intent.—
12 (1) DEFINITIONS.—As used in this part, the term:
13 (a) “Agency” means the Agency for Health Care
14 Administration.
15 (b) “Behavioral health” means the prevention and treatment
16 of, and recovery from, any substance use disorder, mental health
17 disorder, or co-occurring disorder.
18 (c) “Behavioral health professions” means licensed or
19 certified professionals serving the needs of patients with
20 behavioral health disorders, including, but not limited to,
21 psychiatrists licensed under chapter 458 or chapter 459,
22 psychologists licensed under chapter 490, psychiatric nurses
23 licensed under chapter 464, and social workers, marriage and
24 family therapists, and mental health counselors licensed under
25 chapter 491.
26 (d) “Behavioral health teaching hospital” means a hospital
27 licensed under this chapter and designated as a behavioral
28 health teaching hospital by the agency under s. 395.902.
29 (e) “Department” means the Department of Children and
30 Families.
31 (2) LEGISLATIVE FINDINGS AND INTENT.—
32 (a) The Legislature finds that there is a critical shortage
33 of behavioral health professionals and recognizes the urgent
34 need to expand the existing behavioral health workforce, prepare
35 for an aging workforce, incentivize entry into behavioral health
36 professions, and train a modernized workforce in innovative
37 integrated care.
38 (b) The Legislature finds that there is a specific need to
39 support a behavioral health education system that not only
40 trains the next generation of professionals in innovative and
41 integrated care for those with behavioral health needs, but also
42 works to modernize the state’s overall behavioral health system
43 of care.
44 (c) The Legislature intends to identify and designate
45 multiple behavioral health teaching hospitals that work to
46 provide the necessary research, education, and services to
47 enhance the state’s behavioral health workforce and make that
48 workforce and system of care the national standard.
49 (d) The Legislature intends to create the Florida Center
50 for Behavioral Health Workforce within the Louis de la Parte
51 Florida Mental Health Institute at the University of South
52 Florida to address issues of workforce supply and demand in
53 behavioral health professions, including issues of recruitment,
54 retention, and workforce resources.
55 (e) The Legislature intends for designated behavioral
56 health teaching hospitals to:
57 1. Conduct state-of-the-art behavioral health research.
58 2. Provide leading-edge education and training in
59 innovative and integrated care for the state’s behavioral health
60 workforce.
61 3. Collaborate with other university colleges and schools
62 of medicine, nursing, psychology, social work, public health,
63 and other relevant disciplines to promote and enhance a
64 modernized behavioral health system of care.
65 4. Develop, implement, and promote public-private
66 partnerships throughout this state to support and enhance the
67 intent of this part.
68 5. Partner with the state to provide behavioral health
69 care, address regional and systemwide behavioral health needs,
70 and support the state in providing treatment and care for those
71 whose need and acuity has resulted in the need for long-term
72 voluntary services or involuntary civil commitment.
73 Section 3. Section 395.902, Florida Statutes, is created to
74 read:
75 395.902 Behavioral health teaching hospitals.—
76 (1) Beginning July 1, 2025, a licensed hospital may apply
77 to the agency for designation as a behavioral health teaching
78 hospital by submitting a form furnished by the agency and
79 providing documentation establishing eligibility.
80 (2) To be designated as a behavioral health teaching
81 hospital, a hospital must meet all of the following criteria:
82 (a) Operate as a teaching hospital as defined in s. 408.07.
83 (b) Offer a psychiatric residency program accredited
84 through the Residency Review Committee of the Accreditation
85 Council of Graduate Medical Education and an accredited
86 postdoctoral clinical psychology fellowship program.
87 (c) Provide behavioral health services.
88 (d) Establish an affiliation with a university in this
89 state to create and maintain integrated workforce development
90 programs for students of the university’s colleges or schools of
91 medicine, nursing, psychology, social work, and public health
92 related to the entire continuum of behavioral health care,
93 including, at a minimum, screening, therapeutic and supportive
94 services, community outpatient care, crisis stabilization,
95 short-term residential treatment, and long-term care.
96 (e) Develop a plan to create and maintain integrated
97 workforce development programs with the affiliated university’s
98 colleges or schools and to supervise clinical care provided by
99 students participating in such programs.
100 (3) A designated behavioral health teaching hospital must:
101 (a) Within 90 days after receiving the designation, develop
102 and maintain a consultation agreement with the Florida Center
103 for Behavioral Health Workforce within the Louis de la Parte
104 Florida Mental Health Institute to establish best practices
105 related to integrated workforce development programs for the
106 behavioral health professions.
107 (b) Collaborate with the department and managing entities
108 as defined in s. 394.9082(2) to identify gaps in the regional
109 continuum of behavioral health care which are appropriate for
110 the behavioral health teaching hospital to address, either
111 independently or in collaboration with other organizations
112 providing behavioral health services, and which will facilitate
113 implementation of the plan developed under paragraph (2)(e).
114 (c) Within 90 days after receiving the designation, enter
115 into an agreement with the department to provide state treatment
116 facility beds when determined necessary by the department.
117 (d) Provide data related to the hospital’s integrated
118 workforce development programs and the services provided by the
119 hospital to the agency, the department, and the Office of
120 Reimagining Education and Career Help created under s. 14.36, as
121 determined by the agency, department, or the office.
122 (4) Notwithstanding subsections (1) and (2), within 30 days
123 after this act becomes a law, the agency shall designate the
124 following hospitals as behavioral health teaching hospitals:
125 (a) Tampa General Hospital, in affiliation with the
126 University of South Florida.
127 (b) UF Health Shands Hospital, in affiliation with the
128 University of Florida.
129 (c) UF Health Jacksonville, in affiliation with the
130 University of Florida.
131 (d) Jackson Memorial Hospital, in affiliation with the
132 University of Miami.
133
134 Within 90 days after receiving the designation, each behavioral
135 health teaching hospital designated under this subsection shall
136 submit documentation to the agency establishing compliance with
137 the requirements of paragraphs (2)(a)-(d) and submit the plan
138 required by paragraph (2)(e).
139 (5) The agency may designate up to four additional
140 behavioral health teaching hospitals by July 1, 2027, taking
141 into account equitable distribution of such hospitals by
142 geographical service area and behavioral health services access.
143 (6) Upon designating a behavioral health teaching hospital
144 under this section, the agency shall award the hospital funds as
145 follows:
146 (a) For up to 10 resident positions through the Slots for
147 Doctors Program established in s. 409.909. Notwithstanding that
148 section, the agency shall allocate $150,000 for each such
149 position.
150 (b) Through the Training, Education, and Clinicals in
151 Health Funding Program established in s. 409.91256 to offset the
152 costs of maintaining integrated workforce development programs.
153 (7) By December 1 of each year, a designated behavioral
154 health teaching hospital must submit a report to the agency and
155 the department on the designated behavioral health teaching
156 hospital program, including, but not limited to, all of the
157 following:
158 (a) The number of psychiatric residents.
159 (b) The number of postdoctoral clinical psychology fellows.
160 (c) The status and details of the consultation agreement
161 with the Florida Center for Behavioral Health Workforce within
162 the Louis de la Parte Florida Mental Health Institute.
163 (d) The implementation status of the plan required by
164 paragraph (2)(e).
165 (e) Activities, agreements, and accomplishments of the
166 collaboration required by paragraph (3)(b).
167 (f) The number of any facility beds and patients served
168 under paragraph (3)(c).
169 (8) A behavioral health teaching hospital designation is
170 valid for 2 years. To renew the designation, a hospital must
171 submit an application for renewal to the agency on a form
172 established by the agency at least 90 days before the expiration
173 of the designation. The renewal process is subject to the time
174 periods and tolling provisions of s. 120.60. The agency may
175 deny, revoke, or suspend a designation at any time if a
176 behavioral health teaching hospital is not in compliance with
177 the requirements of this section.
178 (9) The agency may adopt rules necessary to implement this
179 section.
180 Section 4. Section 395.903, Florida Statutes, is created to
181 read:
182 395.903 Behavioral Health Teaching Hospital grant program.—
183 (1) There is established within the agency a grant program
184 for the purpose of funding designated behavioral health teaching
185 hospitals, subject to legislative appropriation. Grant funding
186 may be used for operations and expenses and fixed capital
187 outlay, including, but not limited to, facility renovation and
188 upgrades.
189 (a)1. For the 2024-2025 fiscal year, the agency shall hold
190 a 30-day, open application period beginning November 1, 2024, to
191 accept applications from the behavioral health teaching
192 hospitals designated under s. 395.902(4), in a manner determined
193 by the agency. Applicants must include a detailed spending plan
194 with the application.
195 2. For the 2025-2026 and 2026-2027 fiscal years, subject to
196 the availability of funds, the agency shall hold a 30-day, open
197 application period beginning October 1 of each year to accept
198 applications from behavioral health teaching hospitals
199 designated under s. 395.902, in a manner determined by the
200 agency. Applicants must include a detailed spending plan with
201 the application.
202 (b) The agency, in consultation with the department, shall
203 evaluate and rank grant applications based on compliance with s.
204 395.902(2) and the quality of the plan submitted under s.
205 395.902(2)(e) or plan implementation, as applicable, related to
206 achieving the purposes of the behavioral health teaching
207 hospital program. The agency, in consultation with the
208 department, shall make recommendations for grant awards and
209 distribution of available funding for such awards. The agency
210 shall submit the evaluation and grant award recommendations to
211 the President of the Senate and the Speaker of the House of
212 Representatives within 90 days after the open application period
213 closes.
214 (c) Notwithstanding ss. 216.181 and 216.292, the agency may
215 submit budget amendments, subject to the notice, review, and
216 objection procedures under s. 216.177, requesting the release of
217 the funds to make awards. The agency is authorized to submit
218 budget amendments relating to expenses under subsection (1)
219 under the grant program only within the 90 days after the open
220 application period closes.
221 (2) Notwithstanding s. 216.301 and pursuant to s. 216.351,
222 the balance of any appropriation from the General Revenue Fund
223 for the program which is not disbursed but which is obligated
224 pursuant to contract or committed to be expended by June 30 of
225 the fiscal year for which the funds are appropriated may be
226 carried forward for up to 8 years after the effective date of
227 the original appropriation.
228 (3) The agency may adopt rules necessary to implement this
229 section.
230 Section 5. Subsections (6) and (7) are added to section
231 1004.44, Florida Statutes, to read:
232 1004.44 Louis de la Parte Florida Mental Health Institute.
233 There is established the Louis de la Parte Florida Mental Health
234 Institute within the University of South Florida.
235 (6)(a) There is established within the institute the
236 Florida Center for Behavioral Health Workforce. The purpose of
237 the center is to support an adequate, highly skilled, resilient,
238 and innovative workforce that meets the current and future human
239 resources needs of the state’s behavioral health system in order
240 to provide high-quality care, services, and supports to
241 Floridians with, or at risk of developing, behavioral health
242 conditions through original research, policy analysis,
243 evaluation, and development and dissemination of best practices.
244 The goals of the center are, at a minimum, to research the
245 state’s current behavioral health workforce and future needs;
246 expand the number of clinicians, professionals, and other
247 workers involved in the behavioral health workforce; and enhance
248 the skill level and innovativeness of the workforce. The center
249 shall, at a minimum, do all of the following:
250 1. Describe and analyze the current workforce and project
251 possible future workforce demand, especially in critical roles,
252 and develop strategies for addressing any gaps. The center’s
253 efforts may include, but need not be limited to, producing a
254 statistically valid biennial analysis of the supply and demand
255 of the behavioral health workforce.
256 2. Expand pathways to behavioral health professions through
257 enhanced educational opportunities and improved faculty
258 development and retention. The center’s efforts may include, but
259 need not be limited to:
260 a. Identifying best practices in the academic preparation
261 and continuing education of behavioral health professionals.
262 b. Facilitating and coordinating the development of
263 academic-practice partnerships that support behavioral health
264 faculty employment and advancement.
265 c. Developing and implementing innovative projects to
266 support the recruitment, development, and retention of
267 behavioral health educators, faculty, and clinical preceptors.
268 d. Developing distance learning infrastructure for
269 behavioral health education and the evidence-based use of
270 technology, simulation, and distance learning techniques.
271 3. Promote behavioral health professions. The center’s
272 efforts may include, but need not be limited to:
273 a. Conducting original research on the factors affecting
274 recruitment, retention, and advancement of the behavioral health
275 workforce, such as designing and implementing a longitudinal
276 study of the state’s behavioral health workforce.
277 b. Developing and implementing innovative projects to
278 support the recruitment, development, and retention of
279 behavioral health workers.
280 (b) The center may:
281 1. Convene groups, including, but not limited to,
282 behavioral health clinicians, professionals, and workers, and
283 employers of such individuals; other health care providers;
284 individuals with behavioral health conditions and their
285 families; business and industry leaders, policymakers, and
286 educators to assist the center in its work; and
287 2. Request from any board as defined in s. 456.001 any
288 information held by the board regarding a behavioral health
289 professional licensed in this state or holding a multistate
290 license pursuant to a professional multistate licensure compact
291 or information reported to the board by employers of such
292 behavioral health professionals, other than personal identifying
293 information. The boards must provide such information to the
294 center upon request.
295 (c) By January 10 of each year, the center shall submit a
296 report to the Governor, the President of the Senate, and the
297 Speaker of the House of Representatives providing details of its
298 activities during the preceding calendar year in pursuit of its
299 goals and in the execution of its duties under paragraph (a).
300 The report submitted in 2025 must include an initial statewide
301 strategic plan for meeting the goals in subsection (6), which
302 must be updated in each subsequent report.
303 (7) The Board of Governors and the State Board of
304 Education, in consultation with the center, shall expeditiously
305 adopt any necessary regulations and rules, as applicable, to
306 allow the center to perform its responsibilities under
307 subsection (6) as soon as practicable.
308 Section 6. Effective upon this act becoming a law, the
309 Department of Children and Families must contract for a detailed
310 study of capacity for inpatient treatment services for adults
311 with serious mental illness and children with serious emotional
312 disturbance or psychosis in this state’s forensic inpatient,
313 safety-net voluntary and involuntary civil inpatient placement,
314 and Medicaid statewide inpatient psychiatric programs. The study
315 must include analyses of current capacity, current and projected
316 future demand, and the state’s current and projected future
317 ability to meet that demand, and must include recommendations
318 for enhancing the availability of inpatient treatment services
319 and for providing alternatives to such services. The study must
320 be completed by January 31, 2025, and must include, at a
321 minimum, all of the following:
322 (1) By facility and by program type, the current number and
323 allocation of beds for inpatient treatment, the number of
324 individuals admitted and discharged annually, and the lengths of
325 stays.
326 (2) By department region, the current number and allocation
327 of beds in receiving, treatment, and state treatment facilities
328 and residential treatment centers for children and adolescents
329 for inpatient treatment between forensic and civil placements,
330 the number of individuals admitted and discharged annually, the
331 types and frequency of diagnoses, and the lengths of stays.
332 (3) By department region, the current and projected future
333 demand for civil and forensic inpatient placements at receiving,
334 treatment, and state treatment facilities and residential
335 treatment centers for children and adolescents, any gaps in
336 current and projected future availability of these services
337 compared to current and projected future service demand, and the
338 number of inpatient beds needed by facility type and placement
339 type to meet current and projected future demand.
340 (4) By agency region, the number of individuals admitted
341 and discharged annually, the types and frequency of diagnoses,
342 and the lengths of stays for Medicaid statewide inpatient
343 psychiatric program services, the current and projected future
344 demand for these services, any gaps in current and projected
345 future availability of these services compared to current and
346 projected future service demand, and the number of inpatient
347 beds needed by facility type to meet current and projected
348 future demand.
349 (5) Policy recommendations for ensuring sufficient bed
350 capacity for inpatient treatment at treatment facilities, state
351 treatment facilities, or receiving facilities, or at residential
352 treatment centers for children and adolescents, and for
353 enhancing services that could prevent the need for involuntary
354 inpatient placements.
355 (6) A gap analysis as recommended by the Commission on
356 Mental Health and Substance Use Disorder in the annual interim
357 report dated January 1, 2024.
358 Section 7. For the 2024-2025 fiscal year, the sum of $5
359 million in recurring funds from the General Revenue Fund is
360 appropriated to the Louis de la Parte Florida Mental Health
361 Institute for the operation of the Florida Center for Behavioral
362 Health Workforce as created by this act.
363 Section 8. (1) For the 2024-2025 fiscal year, the sums of
364 $2,557,800 in recurring funds from the General Revenue Fund and
365 $3,442,200 in recurring funds from the Medical Care Trust Fund
366 are appropriated to the Agency for Health Care Administration
367 for the Slots for Doctors Program established in s. 409.909,
368 Florida Statutes, for up to 10 newly created resident positions
369 for each designated behavioral health teaching hospital
370 designated under s. 395.902(4), Florida Statutes, as created by
371 this act. Notwithstanding s. 409.909, Florida Statutes, the
372 agency shall allocate $150,000 for each newly created position.
373 (2) For the 2024-2025 fiscal year, the sums of $2,557,800
374 in recurring funds from the General Revenue Fund and $3,442,200
375 in recurring funds from the Medical Care Trust Fund are
376 appropriated to the Agency for Health Care Administration for
377 the Slots for Doctors Program established in s. 409.909, Florida
378 Statutes, for up to 10 newly created resident positions for each
379 designated behavioral health teaching hospital designated under
380 s. 395.902, Florida Statutes, other than those designated under
381 s. 395.902(4), Florida Statutes, if any, as created by this act.
382 Notwithstanding s. 409.909, Florida Statutes, the agency shall
383 allocate $150,000 for each newly created position. The funds
384 shall be held in reserve. Upon designation of a behavioral
385 health teaching hospital, the Agency for Health Care
386 Administration shall submit budget amendments to request release
387 of the funds pursuant to chapter 216, Florida Statutes.
388 Section 9. (1) For the 2024-2025 fiscal year, the sum of $2
389 million in recurring funds from the General Revenue Fund is
390 appropriated to the Agency for Health Care Administration to
391 implement the Training, Education, and Clinicals in Health
392 (TEACH) Funding Program established in s. 409.91256, Florida
393 Statutes, as created by SB 7016, 2024 Regular Session.
394 Notwithstanding s. 409.91256(5)(b), Florida Statutes, as created
395 by SB 7016, 2024 Regular Session, the funds appropriated under
396 this section shall be equally distributed to the behavioral
397 health teaching hospitals designated under s. 395.902(4),
398 Florida Statutes, as created by this act.
399 (2) For the 2024-2025 fiscal year, the sum of $2 million in
400 recurring funds from the General Revenue Fund is appropriated to
401 the Agency for Health Care Administration to implement TEACH
402 Funding Program established in s. 409.91256, Florida Statutes,
403 as created by SB 7016, 2024 Regular Session. Notwithstanding s.
404 409.91256(5)(b), Florida Statutes, as created by SB 7016, 2024
405 Regular Session, the funds appropriated pursuant to this section
406 shall be equally distributed to the behavioral health teaching
407 hospitals designated under section 395.902, Florida Statutes,
408 other than those designated under s. 395.902(4), Florida
409 Statutes, as created by this act. The funds shall be held in
410 reserve. Upon designation of a behavioral health teaching
411 hospital, the Agency for Health Care Administration shall submit
412 budget amendments to request release of the funds pursuant to
413 chapter 216, Florida Statutes. The agency is authorized to
414 submit a final budget amendment in the last quarter of the
415 fiscal year to provide an adjustment in the amount of funds
416 provided to behavioral health teaching hospitals based upon the
417 number of designations finalized during the fiscal year.
418 Section 10. For the 2024-2025 fiscal year, the nonrecurring
419 sum of $300 million from the General Revenue Fund is
420 appropriated to the Agency for Health Care Administration for
421 the behavioral health teaching hospital grant program as created
422 in s. 395.902(7), Florida Statutes. Grant funds shall be awarded
423 over a 3-year period. Notwithstanding s. 216.301, Florida
424 Statutes, and pursuant to s. 216.351, Florida Statutes, funds
425 appropriated for this purpose which are not disbursed by June 30
426 shall be carried forward for up to 8 years after the effective
427 date of the original appropriation.
428 (1) For the 2024-2025 fiscal year, the Agency for Health
429 Care Administration is authorized to award grants in an amount
430 not to exceed $100 million to the behavioral health teaching
431 hospitals designated under s. 395.902(4), Florida Statutes, as
432 created by this act.
433 (2) For the 2025-2026 fiscal year, the Agency for Health
434 Care Administration is authorized to award grants in an amount
435 not to exceed $100 million to behavioral health teaching
436 hospitals designated under s. 395.902, Florida Statutes, as
437 created by this act.
438 (3) For the 2026-2027 fiscal year, the Agency for Health
439 Care Administration is authorized to award grants up to the
440 amount of the original appropriation which has not yet been
441 awarded as of June 30, 2026, to behavioral health teaching
442 hospitals designated under s. 395.902, Florida Statutes, as
443 created by this act.
444 Section 11. Except as otherwise expressly provided in this
445 act and except for this section, which shall take effect upon
446 this act becoming a law, this act shall take effect July 1,
447 2024.
448
449 ================= T I T L E A M E N D M E N T ================
450 And the title is amended as follows:
451 Delete everything before the enacting clause
452 and insert:
453 A bill to be entitled
454 An act relating to behavioral health teaching
455 hospitals; creating part VI of ch. 395, F.S., entitled
456 “Behavioral Health Teaching Hospitals”; creating s.
457 395.901, F.S.; defining terms; providing legislative
458 findings and intent; creating s. 395.902, F.S.;
459 authorizing hospitals to apply for a behavioral health
460 teaching hospital designation beginning on a specified
461 date; specifying criteria a hospital must meet to
462 receive such designation; notwithstanding such
463 criteria, requiring the Agency for Health Care
464 Administration to designate specified existing
465 hospitals as behavioral health teaching hospitals;
466 requiring such hospitals to meet the designation
467 criteria within a specified timeframe; authorizing the
468 agency to designate a specified number of additional
469 behavioral health teaching hospitals by a specified
470 date, taking into account specified factors; requiring
471 the agency to award behavioral health teaching
472 hospitals certain funds upon their designation;
473 requiring designated behavioral health teaching
474 hospitals to submit an annual report to the agency and
475 the Department of Children and Families; specifying
476 requirements for the report; providing for expiration
477 and renewal of behavioral health teaching hospital
478 designations; authorizing the agency to deny, revoke,
479 or suspend a designation at any time under certain
480 circumstances; authorizing the agency to adopt rules;
481 creating s. 395.903, F.S.; establishing a grant
482 program within the agency for the purpose of funding
483 designated behavioral health teaching hospitals;
484 providing an administrative process to receive,
485 evaluate, and rank applications that request grant
486 funds; authorizing the agency to submit a budget
487 amendment to the Legislature requesting the release of
488 grant funds to make awards; providing a carry forward
489 for a specified period for obligated funds not
490 disbursed in the same year in which the funds were
491 appropriated; authorizing the agency to adopt rules;
492 amending s. 1004.44, F.S.; establishing the Florida
493 Center for Behavioral Health Workforce within the
494 Louis de la Parte Florida Mental Health Institute for
495 a specified purpose; specifying the goals and duties
496 of the center; authorizing the center to convene
497 groups to assist in its work; authorizing the center
498 to request, and requiring certain boards to provide,
499 certain information regarding behavioral health
500 professionals licensed or practicing in this state;
501 requiring the center to submit an annual report of
502 certain information to the Governor and the
503 Legislature; requiring the Board of Governors of the
504 State University System and the State Board of
505 Education, in consultation with the center, to adopt
506 certain regulations and rules, as applicable;
507 requiring the Department of Children and Families to
508 contract for a specified study of the state’s
509 forensic, voluntary and involuntary civil commitment,
510 and statewide inpatient psychiatric programs;
511 requiring that the study be completed by a specified
512 date and include specified information and
513 recommendations; providing appropriations; providing
514 effective dates.