ENROLLED 2024 Legislature CS for SB 330, 2nd Engrossed 2024330er 1 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,andqualifying 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,andqualifying 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.