ENROLLED 2023 Legislature CS for SB 914 2023914er 1 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.; renaming the 8 Commission on Mental Health and Substance Abuse as the 9 Commission on Mental Health and Substance Use 10 Disorder; revising the purposes of the commission to 11 include an assessment of the states suicide 12 prevention infrastructure; revising the membership and 13 duties of the commission; requiring the commission to 14 submit annual interim reports to the Governor and 15 Legislature for a specified timeframe; revising the 16 date by which the commission must submit its final 17 report; extending the repeal date of the commission; 18 providing an effective date. 19 20 Be It Enacted by the Legislature of the State of Florida: 21 22 Section 1.Subsection (1) of section 111.09, Florida 23 Statutes, is amended to read: 24 111.09Peer support for first responders. 25 (1)For purposes of this section, the term: 26 (a)Affiliated first responder organization includes, but 27 is not limited to, any of the following organizations: 28 1.Regularly organized volunteer firefighting departments 29 or associations. 30 2.Regularly organized volunteer ambulance services. 31 3.Combination fire departments, as that term is defined in 32 s. 633.135(1). 33 (b)First responder has the same meaning as provided in 34 s. 112.1815 and includes 911 public safety telecommunicators as 35 defined in s. 401.465. 36 (c)(b)First responder peer means a person who: 37 1.Is not a health care practitioner as defined in s. 38 456.001. 39 2.Has experience working as or with a first responder, 40 including active, volunteer, and retired first responders, 41 regarding any physical or emotional conditions or issues 42 associated with the first responders employment. 43 3.Has been designated by the first responders employing 44 agency or affiliated first responder organization to provide 45 peer support as provided in this section and has received 46 training for this purpose. 47 (d)(c)Peer support means the provision of physical, 48 moral, or emotional support to a first responder by a first 49 responder peer for the purpose of addressing physical or 50 emotional conditions or other issues associated with being a 51 first responder. 52 (e)(d)Peer support communication means electronic, oral, 53 or written communication, made with a mutual expectation of 54 confidentiality while a first responder peer is providing peer 55 support in his or her official capacity. 56 Section 2.Paragraph (a) of subsection (5) of section 57 112.1815, Florida Statutes, is amended to read: 58 112.1815Firefighters, paramedics, emergency medical 59 technicians, and law enforcement officers; special provisions 60 for employment-related accidents and injuries. 61 (5)(a)For the purposes of this section and chapter 440, 62 and notwithstanding sub-subparagraph (2)(a)3. and ss. 440.093 63 and 440.151(2), posttraumatic stress disorder, as described in 64 the Diagnostic and Statistical Manual of Mental Disorders, Fifth 65 Edition, published by the American Psychiatric Association, 66 suffered by a first responder is a compensable occupational 67 disease within the meaning of subsection (4) and s. 440.151 if: 68 1.The posttraumatic stress disorder resulted from the 69 first responder acting within the course of his or her 70 employment as provided in s. 440.091; and 71 2.The first responder is examined and subsequently 72 diagnosed with such disorder by a licensed psychiatrist, in 73 person or through telehealth as that term is defined in s. 74 456.47, who is an authorized treating physician as provided in 75 chapter 440 due to one of the following events: 76 a.Seeing for oneself a deceased minor; 77 b.Directly witnessing the death of a minor; 78 c.Directly witnessing an injury to a minor who 79 subsequently died before or upon arrival at a hospital emergency 80 department; 81 d.Participating in the physical treatment of an injured 82 minor who subsequently died before or upon arrival at a hospital 83 emergency department; 84 e.Manually transporting an injured minor who subsequently 85 died before or upon arrival at a hospital emergency department; 86 f.Seeing for oneself a decedent whose death involved 87 grievous bodily harm of a nature that shocks the conscience; 88 g.Directly witnessing a death, including suicide, that 89 involved grievous bodily harm of a nature that shocks the 90 conscience; 91 h.Directly witnessing a homicide regardless of whether the 92 homicide was criminal or excusable, including murder, mass 93 killing as defined in 28 U.S.C. s. 530C, manslaughter, self 94 defense, misadventure, and negligence; 95 i.Directly witnessing an injury, including an attempted 96 suicide, to a person who subsequently died before or upon 97 arrival at a hospital emergency department if the person was 98 injured by grievous bodily harm of a nature that shocks the 99 conscience; 100 j.Participating in the physical treatment of an injury, 101 including an attempted suicide, to a person who subsequently 102 died before or upon arrival at a hospital emergency department 103 if the person was injured by grievous bodily harm of a nature 104 that shocks the conscience; or 105 k.Manually transporting a person who was injured, 106 including by attempted suicide, and subsequently died before or 107 upon arrival at a hospital emergency department if the person 108 was injured by grievous bodily harm of a nature that shocks the 109 conscience. 110 Section 3.Subsections (1), (2), and (3), paragraph (a) of 111 subsection (4), and subsections (5) and (6) of section 394.9086, 112 Florida Statutes, are amended to read: 113 394.9086Commission on Mental Health and Substance Use 114 Disorder Abuse. 115 (1)CREATION.The Commission on Mental Health and Substance 116 Use Disorder Abuse, a commission as defined in s. 20.03(10), is 117 created adjunct to the department. The department shall provide 118 administrative and staff support services relating to the 119 functions of the commission. 120 (2)PURPOSES.The purposes of the commission are to examine 121 the current methods of providing mental health and substance use 122 disorder abuse services in the state and to improve the 123 effectiveness of current practices, procedures, programs, and 124 initiatives in providing such services; identify any barriers or 125 deficiencies in the delivery of such services; assess the 126 adequacy of the current infrastructure of Floridas 988 Suicide 127 and Crisis Lifeline system and other components of the states 128 crisis response services; and recommend changes to existing 129 laws, rules, and policies necessary to implement the 130 commissions recommendations. 131 (3)MEMBERSHIP; TERM LIMITS; MEETINGS. 132 (a)The commission shall be composed of 20 19 members as 133 follows: 134 1.A member of the Senate, appointed by the President of 135 the Senate. 136 2.A member of the House of Representatives, appointed by 137 the Speaker of the House of Representatives. 138 3.The Secretary of Children and Families or his or her 139 designee. 140 4.The Secretary of the Agency for Health Care 141 Administration or his or her designee. 142 5.A person living with a mental health disorder, appointed 143 by the President of the Senate. 144 6.A family member of a consumer of publicly funded mental 145 health services, appointed by the President of the Senate. 146 7.A representative of the Louis de la Parte Florida Mental 147 Health Institute within the University of South Florida, 148 appointed by the President of the Senate. 149 8.A representative of a county school district, appointed 150 by the President of the Senate. 151 9.A representative of mental health courts, appointed by 152 the Governor. 153 10.A representative of a treatment facility, as defined in 154 s. 394.455, appointed by the Speaker of the House of 155 Representatives. 156 11.A representative of a managing entity, as defined in s. 157 394.9082(2), appointed by the Speaker of the House of 158 Representatives. 159 12.A representative of a community substance use disorder 160 abuse provider, appointed by the Speaker of the House of 161 Representatives. 162 13.A psychiatrist licensed under chapter 458 or chapter 163 459 practicing within the mental health delivery system, 164 appointed by the Speaker of the House of Representatives. 165 14.A psychologist licensed under chapter 490 practicing 166 within the mental health delivery system, appointed by the 167 Governor. 168 15.A mental health professional licensed under chapter 169 491, appointed by the Governor. 170 16.An emergency room physician, appointed by the Governor. 171 17.A representative from the field of law enforcement, 172 appointed by the Governor. 173 18.A representative from the criminal justice system, 174 appointed by the Governor. 175 19.A representative of a child welfare agency involved in 176 the delivery of behavioral health services, appointed by the 177 Governor. 178 20.A representative of the statewide Florida 211 Network 179 as described in s. 408.918, appointed by the Governor. 180 (4)DUTIES. 181 (a)The duties of the Commission on Mental Health and 182 Substance Use Disorder abuse include the following: 183 1.Conducting a review and evaluation of the management and 184 functioning of the existing publicly supported mental health and 185 substance use disorder abuse systems and services in the 186 department, the Agency for Health Care Administration, and all 187 other departments which administer mental health and substance 188 use disorder abuse services. Such review shall include, at a 189 minimum, a review of current goals and objectives, current 190 planning, services strategies, coordination management, 191 purchasing, contracting, financing, local government funding 192 responsibility, and accountability mechanisms. 193 2.Considering the unique needs of persons who are dually 194 diagnosed. 195 3.Addressing access to, financing of, and scope of 196 responsibility in the delivery of emergency behavioral health 197 care services. 198 4.Addressing the quality and effectiveness of current 199 mental health and substance use disorder abuse services delivery 200 systems, and professional staffing and clinical structure of 201 services, roles, and responsibilities of public and private 202 providers, such as community mental health centers; community 203 substance use disorder abuse agencies; hospitals, including 204 emergency services departments; law enforcement agencies; and 205 the judicial system. 206 5.Addressing priority population groups for publicly 207 funded mental health and substance use disorder abuse services, 208 identifying the comprehensive mental health and substance use 209 disorder abuse services delivery systems, mental health and 210 substance use disorder abuse needs assessment and planning 211 activities, and local government funding responsibilities for 212 mental health and substance use disorder abuse services. 213 6.Reviewing the implementation of chapter 2020-107, Laws 214 of Florida. 215 7.Identifying any gaps in the provision of mental health 216 and substance use disorder services. 217 8.Providing recommendations on how behavioral health 218 managing entities may fulfill their purpose of promoting service 219 continuity and work with community stakeholders throughout this 220 state in furtherance of supporting the 988 Suicide and Crisis 221 Lifeline system and other crisis response services. 222 9.Conducting an overview of the current infrastructure of 223 the 988 Suicide and Crisis Lifeline system. 224 10.Analyzing the current capacity of crisis response 225 services available throughout this state, including services 226 provided by mobile response teams and centralized receiving 227 facilities. The analysis must include information on the 228 geographic area and the total population served by each mobile 229 response team along with the average response time to each call 230 made to a mobile response team; the number of calls that a 231 mobile response team was unable to respond to due to staff 232 limitations, travel distance, or other factors; and the veteran 233 status and age groups of individuals served by mobile response 234 teams. 235 11.Evaluating and making recommendations to improve 236 linkages between the 988 Suicide and Crisis Lifeline 237 infrastructure and crisis response services within this state. 238 12.Identifying available mental health block grant funds 239 that can be used to support the 988 Suicide and Crisis Lifeline 240 and crisis response infrastructure within this state, including 241 any available funding through opioid settlements or through the 242 American Rescue Plan Act of 2021, Pub. L. No. 117-2; the 243 Coronavirus Aid, Relief, and Economic Security (CARES) Act, Pub. 244 L. No. 116-136; or other federal legislation. 245 13.In consultation with the Agency for Health Care 246 Administration, identifying sources of funding available through 247 the Medicaid program specifically for crisis response services, 248 including funding that may be available by seeking approval of a 249 Section 1115 waiver submitted to the Centers for Medicare and 250 Medicaid Services. 251 14.9.Making recommendations regarding the mission and 252 objectives of state-supported mental health and substance use 253 disorder abuse services and the planning, management, staffing, 254 financing, contracting, coordination, and accountability 255 mechanisms which will best foster the recommended mission and 256 objectives. 257 15.10.Evaluating and making recommendations regarding the 258 establishment of a permanent, agency-level entity to manage 259 mental health, substance use disorder abuse, and related 260 services statewide. At a minimum, the evaluation must consider 261 and describe the: 262 a.Specific duties and organizational structure proposed 263 for the entity; 264 b.Resource needs of the entity and possible sources of 265 funding; 266 c.Estimated impact on access to and quality of services; 267 d.Impact on individuals with behavioral health needs and 268 their families, both those currently served through the affected 269 systems providing behavioral health services and those in need 270 of services; and 271 e.Relation to, integration with, and impact on providers, 272 managing entities, communities, state agencies, and systems 273 which provide mental health and substance use disorder abuse 274 services in this state. Such recommendations must ensure that 275 the ability of such other agencies and systems to carry out 276 their missions and responsibilities is not impaired. 277 16.Evaluating and making recommendations regarding skills 278 based training that teaches participants about mental health and 279 substance use disorder issues, including, but not limited to, 280 Mental Health First Aid models. 281 (5)REPORTS.Beginning By January 1, 2023, and annually 282 thereafter through January 1, 2025, the commission shall submit 283 an interim report to the President of the Senate, the Speaker of 284 the House of Representatives, and the Governor containing its 285 findings and recommendations on how to best provide and 286 facilitate mental health and substance use disorder abuse 287 services in the state. The commission shall submit its final 288 report to the President of the Senate, the Speaker of the House 289 of Representatives, and the Governor by September 1, 2026 2023. 290 (6)REPEAL.This section is repealed September 1, 2026 291 2023, unless saved from repeal through reenactment by the 292 Legislature. 293 Section 4.This act shall take effect July 1, 2023.