Florida Senate - 2023 SB 914 By Senator Garcia 36-01202B-23 2023914__ 1 A bill to be entitled 2 An act relating to suicide prevention; amending s. 3 111.09, F.S.; defining the term affiliated first 4 responder organization; revising the definition of 5 the term first responder peer; amending s. 112.1815, 6 F.S.; authorizing certain diagnoses to be made through 7 telehealth; amending s. 394.9086, F.S.; revising the 8 purposes of the Commission on Mental Health and 9 Substance Abuse to include an assessment of the 10 states suicide prevention infrastructure; revising 11 the duties of the commission to include duties 12 relating to the states suicide prevention 13 infrastructure; requiring the commission to submit 14 annual interim reports for a specified timeframe; 15 revising the date by which the commission must submit 16 its final report; extending the repeal date of the 17 commission; providing an effective date. 18 19 Be It Enacted by the Legislature of the State of Florida: 20 21 Section 1.Subsection (1) of section 111.09, Florida 22 Statutes, is amended to read: 23 111.09Peer support for first responders. 24 (1)For purposes of this section, the term: 25 (a)Affiliated first responder organization includes, but 26 is not limited to, any of the following organizations: 27 1.Regularly organized volunteer firefighting departments 28 or associations. 29 2.Regularly organized volunteer ambulance services. 30 3.Combination fire departments, as that term is defined in 31 s. 633.135(1). 32 (b)First responder has the same meaning as provided in 33 s. 112.1815 and includes 911 public safety telecommunicators as 34 defined in s. 401.465. 35 (c)(b)First responder peer means a person who: 36 1.Is not a health care practitioner as defined in s. 37 456.001. 38 2.Has experience working as or with a first responder, 39 including active, volunteer, and retired first responders, 40 regarding any physical or emotional conditions or issues 41 associated with the first responders employment. 42 3.Has been designated by the first responders employing 43 agency or affiliated first responder organization to provide 44 peer support as provided in this section and has received 45 training for this purpose. 46 (d)(c)Peer support means the provision of physical, 47 moral, or emotional support to a first responder by a first 48 responder peer for the purpose of addressing physical or 49 emotional conditions or other issues associated with being a 50 first responder. 51 (e)(d)Peer support communication means electronic, oral, 52 or written communication, made with a mutual expectation of 53 confidentiality while a first responder peer is providing peer 54 support in his or her official capacity. 55 Section 2.Paragraph (a) of subsection (5) of section 56 112.1815, Florida Statutes, is amended to read: 57 112.1815Firefighters, paramedics, emergency medical 58 technicians, and law enforcement officers; special provisions 59 for employment-related accidents and injuries. 60 (5)(a)For the purposes of this section and chapter 440, 61 and notwithstanding sub-subparagraph (2)(a)3. and ss. 440.093 62 and 440.151(2), posttraumatic stress disorder, as described in 63 the Diagnostic and Statistical Manual of Mental Disorders, Fifth 64 Edition, published by the American Psychiatric Association, 65 suffered by a first responder is a compensable occupational 66 disease within the meaning of subsection (4) and s. 440.151 if: 67 1.The posttraumatic stress disorder resulted from the 68 first responder acting within the course of his or her 69 employment as provided in s. 440.091; and 70 2.The first responder is examined and subsequently 71 diagnosed with such disorder by a licensed psychiatrist, in 72 person or through telehealth as that term is defined in s. 73 456.47, who is an authorized treating physician as provided in 74 chapter 440 due to one of the following events: 75 a.Seeing for oneself a deceased minor; 76 b.Directly witnessing the death of a minor; 77 c.Directly witnessing an injury to a minor who 78 subsequently died before or upon arrival at a hospital emergency 79 department; 80 d.Participating in the physical treatment of an injured 81 minor who subsequently died before or upon arrival at a hospital 82 emergency department; 83 e.Manually transporting an injured minor who subsequently 84 died before or upon arrival at a hospital emergency department; 85 f.Seeing for oneself a decedent whose death involved 86 grievous bodily harm of a nature that shocks the conscience; 87 g.Directly witnessing a death, including suicide, that 88 involved grievous bodily harm of a nature that shocks the 89 conscience; 90 h.Directly witnessing a homicide regardless of whether the 91 homicide was criminal or excusable, including murder, mass 92 killing as defined in 28 U.S.C. s. 530C, manslaughter, self 93 defense, misadventure, and negligence; 94 i.Directly witnessing an injury, including an attempted 95 suicide, to a person who subsequently died before or upon 96 arrival at a hospital emergency department if the person was 97 injured by grievous bodily harm of a nature that shocks the 98 conscience; 99 j.Participating in the physical treatment of an injury, 100 including an attempted suicide, to a person who subsequently 101 died before or upon arrival at a hospital emergency department 102 if the person was injured by grievous bodily harm of a nature 103 that shocks the conscience; or 104 k.Manually transporting a person who was injured, 105 including by attempted suicide, and subsequently died before or 106 upon arrival at a hospital emergency department if the person 107 was injured by grievous bodily harm of a nature that shocks the 108 conscience. 109 Section 3.Subsection (2), paragraph (a) of subsection (4), 110 and subsections (5) and (6) of section 394.9086, Florida 111 Statutes, are amended to read: 112 394.9086Commission on Mental Health and Substance Abuse. 113 (2)PURPOSES.The purposes of the commission are to examine 114 the current methods of providing mental health and substance 115 abuse services in the state and to improve the effectiveness of 116 current practices, procedures, programs, and initiatives in 117 providing such services; identify any barriers or deficiencies 118 in the delivery of such services; assess the adequacy of the 119 current infrastructure of Floridas National Suicide Prevention 120 Lifeline (NSPL) system and other components of the states 121 crisis response services; and recommend changes to existing 122 laws, rules, and policies necessary to implement the 123 commissions recommendations. 124 (4)DUTIES. 125 (a)The duties of the Commission on Mental Health and 126 Substance Abuse include the following: 127 1.Conducting a review and evaluation of the management and 128 functioning of the existing publicly supported mental health and 129 substance abuse systems and services in the department, the 130 Agency for Health Care Administration, and all other departments 131 which administer mental health and substance abuse services. 132 Such review shall include, at a minimum, a review of current 133 goals and objectives, current planning, services strategies, 134 coordination management, purchasing, contracting, financing, 135 local government funding responsibility, and accountability 136 mechanisms. 137 2.Considering the unique needs of persons who are dually 138 diagnosed. 139 3.Addressing access to, financing of, and scope of 140 responsibility in the delivery of emergency behavioral health 141 care services. 142 4.Addressing the quality and effectiveness of current 143 mental health and substance abuse services delivery systems, and 144 professional staffing and clinical structure of services, roles, 145 and responsibilities of public and private providers, such as 146 community mental health centers; community substance abuse 147 agencies; hospitals, including emergency services departments; 148 law enforcement agencies; and the judicial system. 149 5.Addressing priority population groups for publicly 150 funded mental health and substance abuse services, identifying 151 the comprehensive mental health and substance abuse services 152 delivery systems, mental health and substance abuse needs 153 assessment and planning activities, and local government funding 154 responsibilities for mental health and substance abuse services. 155 6.Reviewing the implementation of chapter 2020-107, Laws 156 of Florida. 157 7.Identifying any gaps in the provision of mental health 158 and substance use disorder services. 159 8.Providing recommendations on how behavioral health 160 managing entities may fulfill their purpose of promoting service 161 continuity and work with community stakeholders throughout this 162 state in furtherance of supporting the NSPL system and other 163 crisis response services. 164 9.Conducting an overview of the current infrastructure of 165 the NSPL system. 166 10.Analyzing the current capacity of crisis response 167 services available throughout this state, including services 168 provided by mobile response teams and centralized receiving 169 facilities. The analysis must include information on the 170 geographic area and the total population served by each mobile 171 response team along with the average response time to each call 172 made to a mobile response team; the number of calls that a 173 mobile response team was unable to respond to due to staff 174 limitations, travel distance, or other factors; and the veteran 175 status and age groups of individuals served by mobile response 176 teams. 177 11.Evaluating and making recommendations to improve 178 linkages between the NSPL infrastructure and crisis response 179 services within this state. 180 12.Identifying available mental health block grant funds 181 that can be used to support the NSPL and crisis response 182 infrastructure within this state, including any available 183 funding through opioid settlements or through the American 184 Rescue Plan Act of 2021, Pub. L. No. 117-2; the Coronavirus Aid, 185 Relief, and Economic Security (CARES) Act, Pub. L. No. 116-136; 186 or other federal legislation. 187 13.In consultation with the Agency for Health Care 188 Administration, identifying sources of funding available through 189 the Medicaid program specifically for crisis response services, 190 including funding that may be available by seeking approval of a 191 Section 1115 waiver submitted to the Centers for Medicare and 192 Medicaid Services. 193 14.9.Making recommendations regarding the mission and 194 objectives of state-supported mental health and substance abuse 195 services and the planning, management, staffing, financing, 196 contracting, coordination, and accountability mechanisms which 197 will best foster the recommended mission and objectives. 198 15.10.Evaluating and making recommendations regarding the 199 establishment of a permanent, agency-level entity to manage 200 mental health, substance abuse, and related services statewide. 201 At a minimum, the evaluation must consider and describe the: 202 a.Specific duties and organizational structure proposed 203 for the entity; 204 b.Resource needs of the entity and possible sources of 205 funding; 206 c.Estimated impact on access to and quality of services; 207 d.Impact on individuals with behavioral health needs and 208 their families, both those currently served through the affected 209 systems providing behavioral health services and those in need 210 of services; and 211 e.Relation to, integration with, and impact on providers, 212 managing entities, communities, state agencies, and systems 213 which provide mental health and substance abuse services in this 214 state. Such recommendations must ensure that the ability of such 215 other agencies and systems to carry out their missions and 216 responsibilities is not impaired. 217 (5)REPORTS.Beginning By January 1, 2023, and annually 218 thereafter through January 1, 2025, the commission shall submit 219 an interim report to the President of the Senate, the Speaker of 220 the House of Representatives, and the Governor containing its 221 findings and recommendations on how to best provide and 222 facilitate mental health and substance abuse services in the 223 state. The commission shall submit its final report to the 224 President of the Senate, the Speaker of the House of 225 Representatives, and the Governor by September 1, 2026 2023. 226 (6)REPEAL.This section is repealed September 1, 2026 227 2023, unless saved from repeal through reenactment by the 228 Legislature. 229 Section 4.This act shall take effect July 1, 2023.