CS for SB 330 Second Engrossed
2024330e2
1 A bill to be entitled
2 An act relating to behavioral health teaching
3 hospitals; creating part VI of ch. 395, F.S., entitled
4 “Behavioral Health Teaching Hospitals”; creating s.
5 395.901, F.S.; defining terms; providing legislative
6 findings and intent; creating s. 395.902, F.S.;
7 authorizing hospitals to apply for a behavioral health
8 teaching hospital designation beginning on a specified
9 date; specifying criteria a hospital must meet to
10 receive such designation; notwithstanding such
11 criteria, requiring the Agency for Health Care
12 Administration to designate specified existing
13 hospitals as behavioral health teaching hospitals;
14 requiring such hospitals to meet the designation
15 criteria within a specified timeframe; authorizing the
16 agency to designate additional behavioral health
17 teaching hospitals that meet the designation criteria;
18 requiring the agency to award behavioral health
19 teaching hospitals certain funds upon their
20 designation; requiring designated behavioral health
21 teaching hospitals to submit an annual report to the
22 agency and the Department of Children and Families;
23 specifying requirements for the report; providing for
24 expiration and renewal of behavioral health teaching
25 hospital designations; authorizing the agency to deny,
26 revoke, or suspend a designation at any time under
27 certain circumstances; authorizing the agency to adopt
28 rules; creating s. 395.903, F.S.; establishing a grant
29 program within the agency for the purpose of funding
30 designated behavioral health teaching hospitals;
31 providing an administrative process to receive,
32 evaluate, and rank applications that request grant
33 funds; authorizing the agency to submit a budget
34 amendment to the Legislature requesting the release of
35 grant funds to make awards; providing a carry forward
36 for a specified period for obligated funds not
37 disbursed in the same year in which the funds were
38 appropriated; authorizing the agency to adopt rules;
39 amending s. 409.909, F.S.; authorizing certain
40 residency positions to be allocated for designated
41 behavioral health teaching hospitals; amending s.
42 1004.44, F.S.; establishing the Florida Center for
43 Behavioral Health Workforce within the Louis de la
44 Parte Florida Mental Health Institute for a specified
45 purpose; specifying the goals and duties of the
46 center; authorizing the center to convene groups to
47 assist in its work; authorizing the center to request,
48 and requiring certain boards to provide, certain
49 information regarding behavioral health professionals
50 licensed or practicing in this state; requiring the
51 center to submit an annual report of certain
52 information to the Governor and the Legislature;
53 requiring the Board of Governors of the State
54 University System and the State Board of Education, in
55 consultation with the center, to adopt certain
56 regulations and rules, as applicable; requiring the
57 Department of Children and Families to contract for a
58 specified study of the state’s forensic, voluntary and
59 involuntary civil commitment, and statewide inpatient
60 psychiatric programs; requiring that the study be
61 completed by a specified date and include specified
62 information and recommendations; providing
63 appropriations; providing effective dates.
64
65 Be It Enacted by the Legislature of the State of Florida:
66
67 Section 1. Part VI of chapter 395, Florida Statutes,
68 consisting of ss. 395.901, 395.902, and 395.903, Florida
69 Statutes, is created and entitled “Behavioral Health Teaching
70 Hospitals.”
71 Section 2. Section 395.901, Florida Statutes, is created to
72 read:
73 395.901 Definitions; legislative findings and intent.—
74 (1) DEFINITIONS.—As used in this part, the term:
75 (a) “Agency” means the Agency for Health Care
76 Administration.
77 (b) “Behavioral health” means the prevention and treatment
78 of, and recovery from, any substance use disorder, mental health
79 disorder, or co-occurring disorder.
80 (c) “Behavioral health professions” means licensed or
81 certified professionals serving the needs of patients with
82 behavioral health disorders, including, but not limited to,
83 psychiatrists licensed under chapter 458 or chapter 459,
84 psychologists licensed under chapter 490, psychiatric nurses
85 licensed under chapter 464, and social workers, marriage and
86 family therapists, and mental health counselors licensed under
87 chapter 491.
88 (d) “Behavioral health teaching hospital” means a hospital
89 licensed under this chapter and designated as a behavioral
90 health teaching hospital by the agency under s. 395.902.
91 (e) “Department” means the Department of Children and
92 Families.
93 (2) LEGISLATIVE FINDINGS AND INTENT.—
94 (a) The Legislature finds that there is a critical shortage
95 of behavioral health professionals and recognizes the urgent
96 need to expand the existing behavioral health workforce, prepare
97 for an aging workforce, incentivize entry into behavioral health
98 professions, and train a modernized workforce in innovative
99 integrated care.
100 (b) The Legislature finds that there is a specific need to
101 support a behavioral health education system that not only
102 trains the next generation of professionals in innovative and
103 integrated care for those with behavioral health needs, but also
104 works to modernize the state’s overall behavioral health system
105 of care.
106 (c) The Legislature intends to identify and designate
107 multiple behavioral health teaching hospitals that work to
108 provide the necessary research, education, and services to
109 enhance the state’s behavioral health workforce and make that
110 workforce and system of care the national standard.
111 (d) The Legislature intends to create the Florida Center
112 for Behavioral Health Workforce within the Louis de la Parte
113 Florida Mental Health Institute at the University of South
114 Florida to address issues of workforce supply and demand in
115 behavioral health professions, including issues of recruitment,
116 retention, and workforce resources.
117 (e) The Legislature intends for designated behavioral
118 health teaching hospitals to:
119 1. Conduct state-of-the-art behavioral health research.
120 2. Provide leading-edge education and training in
121 innovative and integrated care for the state’s behavioral health
122 workforce.
123 3. Collaborate with other university colleges and schools
124 of medicine, nursing, psychology, social work, public health,
125 and other relevant disciplines to promote and enhance a
126 modernized behavioral health system of care.
127 4. Develop, implement, and promote public-private
128 partnerships throughout this state to support and enhance the
129 intent of this part.
130 5. Partner with the state to provide behavioral health
131 care, address regional and systemwide behavioral health needs,
132 and support the state in providing treatment and care for those
133 whose need and acuity has resulted in the need for long-term
134 voluntary services or involuntary civil commitment.
135 Section 3. Section 395.902, Florida Statutes, is created to
136 read:
137 395.902 Behavioral health teaching hospitals.—
138 (1) Beginning July 1, 2025, a licensed hospital may apply
139 to the agency for designation as a behavioral health teaching
140 hospital by submitting a form furnished by the agency and
141 providing documentation establishing eligibility.
142 (2) To be designated as a behavioral health teaching
143 hospital, a hospital must meet all of the following criteria:
144 (a) Operate as a teaching hospital as defined in s. 408.07.
145 (b) Offer a psychiatric residency program accredited
146 through the Residency Review Committee of the Accreditation
147 Council of Graduate Medical Education and offer, or have filed
148 an application for approval to establish, an accredited
149 postdoctoral clinical psychology fellowship program.
150 (c) Provide behavioral health services.
151 (d) Establish and maintain an affiliation with a university
152 in this state with one of the accredited Florida-based medical
153 schools listed under s. 458.3145(1)(i)1.-6., 8., or 10., to
154 create and maintain integrated workforce development programs
155 for students of the university’s colleges or schools of
156 medicine, nursing, psychology, social work, or public health
157 related to the entire continuum of behavioral health care,
158 including, at a minimum, screening, therapeutic and supportive
159 services, community outpatient care, crisis stabilization,
160 short-term residential treatment, and long-term care.
161 Notwithstanding paragraphs (4)(b) and (c), a university may
162 affiliate with only one hospital.
163 (e) Develop a plan to create and maintain integrated
164 workforce development programs with the affiliated university’s
165 colleges or schools and to supervise clinical care provided by
166 students participating in such programs.
167 (3) A designated behavioral health teaching hospital must:
168 (a) Within 90 days after receiving the designation, develop
169 and maintain a consultation agreement with the Florida Center
170 for Behavioral Health Workforce within the Louis de la Parte
171 Florida Mental Health Institute to establish best practices
172 related to integrated workforce development programs for the
173 behavioral health professions.
174 (b) Collaborate with the department and managing entities
175 as defined in s. 394.9082(2) to identify gaps in the regional
176 continuum of behavioral health care which are appropriate for
177 the behavioral health teaching hospital to address, either
178 independently or in collaboration with other organizations
179 providing behavioral health services, and which will facilitate
180 implementation of the plan developed under paragraph (2)(e).
181 (c) Within 90 days after receiving the designation, enter
182 into an agreement with the department to provide state treatment
183 facility beds when determined necessary by the department.
184 (d) Provide data related to the hospital’s integrated
185 workforce development programs and the services provided by the
186 hospital to the agency, the department, and the Office of
187 Reimagining Education and Career Help created under s. 14.36, as
188 determined by the agency, department, or the office.
189 (4) Notwithstanding subsections (1) and (2), within 30 days
190 after this act becomes a law, the agency shall designate the
191 following hospitals as behavioral health teaching hospitals:
192 (a) Tampa General Hospital, in affiliation with the
193 University of South Florida.
194 (b) UF Health Shands Hospital, in affiliation with the
195 University of Florida.
196 (c) UF Health Jacksonville, in affiliation with the
197 University of Florida.
198 (d) Jackson Memorial Hospital, in affiliation with the
199 University of Miami.
200
201 Within 90 days after receiving the designation, each behavioral
202 health teaching hospital designated under this subsection shall
203 submit documentation to the agency establishing compliance with
204 the requirements of paragraphs (2)(a)-(d) and submit the plan
205 required by paragraph (2)(e).
206 (5) Beginning July 1, 2025, the agency may designate
207 additional behavioral health teaching hospitals which meet the
208 criteria of subsection (2).
209 (6) Upon designating a behavioral health teaching hospital
210 under this section, the agency shall award the hospital funds as
211 follows:
212 (a) For up to 10 resident positions through the Slots for
213 Doctors Program established in s. 409.909. Notwithstanding that
214 section, the agency shall allocate $150,000 for each such
215 position.
216 (b) Through the Training, Education, and Clinicals in
217 Health Funding Program established in s. 409.91256 to offset a
218 portion of the costs of maintaining integrated workforce
219 development programs.
220 (7) By December 1 of each year, a designated behavioral
221 health teaching hospital must submit a report to the agency and
222 the department on the designated behavioral health teaching
223 hospital program, including, but not limited to, all of the
224 following:
225 (a) The number of psychiatric residents.
226 (b) The number of postdoctoral clinical psychology fellows.
227 (c) The status and details of the consultation agreement
228 with the Florida Center for Behavioral Health Workforce within
229 the Louis de la Parte Florida Mental Health Institute.
230 (d) The implementation status of the plan required by
231 paragraph (2)(e).
232 (e) Activities, agreements, and accomplishments of the
233 collaboration required by paragraph (3)(b).
234 (f) The number of any facility beds and patients served
235 under paragraph (3)(c).
236 (8) A behavioral health teaching hospital designation is
237 valid for 2 years. To renew the designation, a hospital must
238 submit an application for renewal to the agency on a form
239 established by the agency at least 90 days before the expiration
240 of the designation. The renewal process is subject to the time
241 periods and tolling provisions of s. 120.60. The agency may
242 deny, revoke, or suspend a designation at any time if a
243 behavioral health teaching hospital is not in compliance with
244 the requirements of this section.
245 (9) The agency may adopt rules necessary to implement this
246 section.
247 Section 4. Section 395.903, Florida Statutes, is created to
248 read:
249 395.903 Behavioral Health Teaching Hospital grant program.—
250 (1) There is established within the agency a grant program
251 for the purpose of funding designated behavioral health teaching
252 hospitals, subject to legislative appropriation. Grant funding
253 may be used for operations and expenses and for fixed capital
254 outlay, including, but not limited to, facility renovation and
255 upgrades.
256 (a)1. For the 2024-2025 fiscal year, the agency shall hold
257 a 30-day, open application period beginning November 1, 2024, to
258 accept applications from the behavioral health teaching
259 hospitals designated under s. 395.902(4), in a manner determined
260 by the agency. Applicants must include a detailed spending plan
261 with the application.
262 2. For the 2025-2026 and 2026-2027 fiscal years, the agency
263 shall hold a 30-day, open application period beginning October 1
264 of each year to accept applications from behavioral health
265 teaching hospitals designated under s. 395.902, in a manner
266 determined by the agency. Applicants must include a detailed
267 spending plan with the application. On or before January 1,
268 2025, and January 1, 2026, hospitals desiring to apply for
269 designation in the next fiscal year shall submit letters of
270 intent to the agency.
271 (b) The agency, in consultation with the department, shall
272 evaluate and rank grant applications based on compliance with s.
273 395.902(2) and the quality of the plan submitted under s.
274 395.902(2)(e) or plan implementation, as applicable, related to
275 achieving the purposes of the behavioral health teaching
276 hospital program. The agency, in consultation with the
277 department, shall make recommendations for grant awards and
278 distribution of available funding for such awards. The agency
279 shall submit the evaluation and grant award recommendations to
280 the President of the Senate and the Speaker of the House of
281 Representatives within 90 days after the open application period
282 closes.
283 (c) Notwithstanding ss. 216.181 and 216.292, the agency may
284 submit budget amendments, subject to the notice, review, and
285 objection procedures under s. 216.177, requesting the release of
286 the funds to make awards. The agency is authorized to submit
287 budget amendments relating to expenses under subsection (1)
288 under the grant program only within the 90 days after the open
289 application period closes.
290 (2) Notwithstanding s. 216.301 and pursuant to s. 216.351,
291 the balance of any appropriation from the General Revenue Fund
292 for the program which is not disbursed but which is obligated
293 pursuant to contract or committed to be expended by June 30 of
294 the fiscal year for which the funds are appropriated may be
295 carried forward for up to 8 years after the effective date of
296 the original appropriation.
297 (3) The agency may adopt rules necessary to implement this
298 section.
299 Section 5. Effective July 1, 2025, subsection (6) of
300 section 409.909, Florida Statutes, is amended to read:
301 409.909 Statewide Medicaid Residency Program.—
302 (6) The Slots for Doctors Program is established to address
303 the physician workforce shortage by increasing the supply of
304 highly trained physicians through the creation of new resident
305 positions, which will increase access to care and improve health
306 outcomes for Medicaid recipients.
307 (a) Notwithstanding subsection (4), the agency shall
308 annually allocate $100,000 to hospitals, and qualifying
309 institutions, and behavioral health teaching hospitals
310 designated under s. 395.902, for each newly created resident
311 position that is first filled on or after June 1, 2023, and
312 filled thereafter, and that is accredited by the Accreditation
313 Council for Graduate Medical Education or the Osteopathic
314 Postdoctoral Training Institution in an initial or established
315 accredited training program which is in a physician specialty or
316 subspecialty in a statewide supply-and-demand deficit.
317 (b) This program is designed to generate matching funds
318 under Medicaid and distribute such funds to participating
319 hospitals, and qualifying institutions, and behavioral health
320 teaching hospitals designated under s. 395.902, on a quarterly
321 basis in each fiscal year for which an appropriation is made.
322 Resident positions created under this subsection are not
323 eligible for concurrent funding pursuant to subsection (1).
324 (c) For purposes of this subsection, physician specialties
325 and subspecialties, both adult and pediatric, in statewide
326 supply-and-demand deficit are those identified as such in the
327 General Appropriations Act.
328 (d) Funds allocated pursuant to this subsection may not be
329 used for resident positions that have previously received
330 funding pursuant to subsection (1).
331 Section 6. Subsections (6) and (7) are added to section
332 1004.44, Florida Statutes, to read:
333 1004.44 Louis de la Parte Florida Mental Health Institute.
334 There is established the Louis de la Parte Florida Mental Health
335 Institute within the University of South Florida.
336 (6)(a) There is established within the institute the
337 Florida Center for Behavioral Health Workforce. The purpose of
338 the center is to support an adequate, highly skilled, resilient,
339 and innovative workforce that meets the current and future human
340 resources needs of the state’s behavioral health system in order
341 to provide high-quality care, services, and supports to
342 Floridians with, or at risk of developing, behavioral health
343 conditions through original research, policy analysis,
344 evaluation, and development and dissemination of best practices.
345 The goals of the center are, at a minimum, to research the
346 state’s current behavioral health workforce and future needs;
347 expand the number of clinicians, professionals, and other
348 workers involved in the behavioral health workforce; and enhance
349 the skill level and innovativeness of the workforce. The center
350 shall, at a minimum, do all of the following:
351 1. Describe and analyze the current workforce and project
352 possible future workforce demand, especially in critical roles,
353 and develop strategies for addressing any gaps. The center’s
354 efforts may include, but need not be limited to, producing a
355 statistically valid biennial analysis of the supply and demand
356 of the behavioral health workforce.
357 2. Expand pathways to behavioral health professions through
358 enhanced educational opportunities and improved faculty
359 development and retention. The center’s efforts may include, but
360 need not be limited to:
361 a. Identifying best practices in the academic preparation
362 and continuing education of behavioral health professionals.
363 b. Facilitating and coordinating the development of
364 academic-practice partnerships that support behavioral health
365 faculty employment and advancement.
366 c. Developing and implementing innovative projects to
367 support the recruitment, development, and retention of
368 behavioral health educators, faculty, and clinical preceptors.
369 d. Developing distance learning infrastructure for
370 behavioral health education and the evidence-based use of
371 technology, simulation, and distance learning techniques.
372 3. Promote behavioral health professions. The center’s
373 efforts may include, but need not be limited to:
374 a. Conducting original research on the factors affecting
375 recruitment, retention, and advancement of the behavioral health
376 workforce, such as designing and implementing a longitudinal
377 study of the state’s behavioral health workforce.
378 b. Developing and implementing innovative projects to
379 support the recruitment, development, and retention of
380 behavioral health workers.
381 (b) The center may:
382 1. Convene groups, including, but not limited to,
383 behavioral health clinicians, professionals, and workers, and
384 employers of such individuals; other health care providers;
385 individuals with behavioral health conditions and their
386 families; business and industry leaders, policymakers, and
387 educators to assist the center in its work; and
388 2. Request from any board as defined in s. 456.001 any
389 information held by the board regarding a behavioral health
390 professional licensed in this state or holding a multistate
391 license pursuant to a professional multistate licensure compact
392 or information reported to the board by employers of such
393 behavioral health professionals, other than personal identifying
394 information. The boards must provide such information to the
395 center upon request.
396 (c) By January 10 of each year, the center shall submit a
397 report to the Governor, the President of the Senate, and the
398 Speaker of the House of Representatives providing details of its
399 activities during the preceding calendar year in pursuit of its
400 goals and in the execution of its duties under paragraph (a).
401 The report submitted in 2025 must include an initial statewide
402 strategic plan for meeting the goals in subsection (6), which
403 must be updated in each subsequent report.
404 (7) The Board of Governors and the State Board of
405 Education, in consultation with the center, shall expeditiously
406 adopt any necessary regulations and rules, as applicable, to
407 allow the center to perform its responsibilities under
408 subsection (6) as soon as practicable.
409 Section 7. Effective upon this act becoming a law, the
410 Department of Children and Families must contract for a detailed
411 study of capacity for inpatient treatment services for adults
412 with serious mental illness and children with serious emotional
413 disturbance or psychosis in this state’s forensic inpatient,
414 safety-net voluntary and involuntary civil inpatient placement,
415 and Medicaid statewide inpatient psychiatric programs. The study
416 must include analyses of current capacity, current and projected
417 future demand, and the state’s current and projected future
418 ability to meet that demand, and must include recommendations
419 for enhancing the availability of inpatient treatment services
420 and for providing alternatives to such services. The study must
421 be completed by January 31, 2025, and must include, at a
422 minimum, all of the following:
423 (1) By facility and by program type, the current number and
424 allocation of beds for inpatient treatment, the number of
425 individuals admitted and discharged annually, and the lengths of
426 stays.
427 (2) By department region, the current number and allocation
428 of beds in receiving, treatment, and state treatment facilities
429 and residential treatment centers for children and adolescents
430 for inpatient treatment between forensic and civil placements,
431 the number of individuals admitted and discharged annually, the
432 types and frequency of diagnoses, and the lengths of stays.
433 (3) By department region, the current and projected future
434 demand for civil and forensic inpatient placements at receiving,
435 treatment, and state treatment facilities and residential
436 treatment centers for children and adolescents, any gaps in
437 current and projected future availability of these services
438 compared to current and projected future service demand, and the
439 number of inpatient beds needed by facility type and placement
440 type to meet current and projected future demand.
441 (4) By agency region, the number of individuals admitted
442 and discharged annually, the types and frequency of diagnoses,
443 and the lengths of stays for Medicaid statewide inpatient
444 psychiatric program services, the current and projected future
445 demand for these services, any gaps in current and projected
446 future availability of these services compared to current and
447 projected future service demand, and the number of inpatient
448 beds needed by facility type to meet current and projected
449 future demand.
450 (5) Policy recommendations for ensuring sufficient bed
451 capacity for inpatient treatment at treatment facilities, state
452 treatment facilities, or receiving facilities, or at residential
453 treatment centers for children and adolescents, and for
454 enhancing services that could prevent the need for involuntary
455 inpatient placements.
456 (6) A gap analysis as recommended by the Commission on
457 Mental Health and Substance Use Disorder in the annual interim
458 report dated January 1, 2024.
459 Section 8. For the 2024-2025 fiscal year, the sum of $5
460 million in recurring funds from the General Revenue Fund is
461 appropriated to the Louis de la Parte Florida Mental Health
462 Institute for the operation of the Florida Center for Behavioral
463 Health Workforce as created by this act.
464 Section 9. For the 2024-2025 fiscal year, the sums of
465 $2,557,800 in recurring funds from the General Revenue Fund and
466 $3,442,200 in recurring funds from the Medical Care Trust Fund
467 are appropriated to the Agency for Health Care Administration
468 for the Slots for Doctors Program established in s. 409.909,
469 Florida Statutes, for up to 10 newly created resident positions
470 for each designated behavioral health teaching hospital
471 designated under s. 395.902(4), Florida Statutes, as created by
472 this act. Notwithstanding s. 409.909, Florida Statutes, the
473 agency shall allocate $150,000 for each newly created position.
474 Section 10. For the 2024-2025 fiscal year, the sum of $2
475 million in recurring funds from the General Revenue Fund is
476 appropriated to the Agency for Health Care Administration to
477 implement the Training, Education, and Clinicals in Health
478 (TEACH) Funding Program established in s. 409.91256, Florida
479 Statutes, as created by SB 7016, 2024 Regular Session.
480 Notwithstanding s. 409.91256(5)(b), Florida Statutes, as created
481 by SB 7016, 2024 Regular Session, the funds appropriated under
482 this section shall be equally distributed to the behavioral
483 health teaching hospitals designated under s. 395.902(4),
484 Florida Statutes, as created by this act.
485 Section 11. For the 2024-2025 fiscal year, the nonrecurring
486 sum of $300 million from the General Revenue Fund is
487 appropriated to the Agency for Health Care Administration for
488 the behavioral health teaching hospital grant program as created
489 in s. 395.903, Florida Statutes. Grant funds shall be awarded
490 over a 3-year period. Notwithstanding s. 216.301, Florida
491 Statutes, and pursuant to s. 216.351, Florida Statutes, funds
492 appropriated for this purpose which are not disbursed by June 30
493 shall be carried forward for up to 8 years after the effective
494 date of the original appropriation.
495 (1) For the 2024-2025 fiscal year, the Agency for Health
496 Care Administration is authorized to award grants in an amount
497 not to exceed $100 million to the behavioral health teaching
498 hospitals designated under s. 395.902(4), Florida Statutes, as
499 created by this act.
500 (2) For the 2025-2026 fiscal year, the Agency for Health
501 Care Administration is authorized to award grants in an amount
502 not to exceed $100 million to behavioral health teaching
503 hospitals designated under s. 395.902, Florida Statutes, as
504 created by this act.
505 (3) For the 2026-2027 fiscal year, the Agency for Health
506 Care Administration is authorized to award grants up to the
507 amount of the original appropriation which has not yet been
508 awarded as of June 30, 2026, to behavioral health teaching
509 hospitals designated under s. 395.902, Florida Statutes, as
510 created by this act.
511 Section 12. Except as otherwise expressly provided in this
512 act and except for this section, which shall take effect upon
513 this act becoming a law, this act shall take effect July 1,
514 2024.