This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h1617.HHS
DATE: 2/21/2024
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 1617 Behavioral Health Teaching Hospitals
SPONSOR(S): Garrison
TIED BILLS: IDEN./SIM. BILLS: SB 330
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Health & Human Services Committee DesRochers Calamas
2) Appropriations Committee
3) Education & Employment Committee
SUMMARY ANALYSIS
Demand for physicians across the United States is projected to grow faster than supply leading to a
potential nationwide shortfall of as many as 124,000 full-time employee physicians in 2034. This includes a
projected shortage of between 17,800 and 48,000 primary care physicians, between 15,800 and 30,200
surgeons, between 3,800 and 13,400 internal medicine and pediatric specialists, and between 10,300
and 35,600 physicians across the other specialties.
Current challenges to the recruitment and retainer of behavioral health providers include financial limitations
(e.g., resources, reimbursement rates, student debt), educational limitations (e.g., lack of training to serve
diverse populations, barriers to enter workforce), and workplace limitations (e.g., shortages in rural areas, high
workloads that lead to burnout). To increase the overall supply of behavioral health professionals, some states
may choose to act through partnerships with educational institutions and residency programs. These
partnerships can encourage students and early career professionals to practice in rural and underserved
communities.
HB 1617 creates the behavioral health teaching hospital designation for hospitals in Florida. Specifically, the
bill authorizes a hospital that partners with a university school of medicine to apply to AHCA for designation as
a behavioral health teaching hospital if the hospitals meets certain criteria. The bill also establishes the Florida
Center for Behavioral Health Workforce (Center) within the Louis de la Parte Florida Mental Health Institute at
the University of South Florida to address issues of workforce supply and demand in the behavioral health
professions, including the issues of recruitment, retention, and workforce resources.
The bill requires the Center to administer the Florida Behavioral Health Professions Scholarship and Grant
Program, which the bill simultaneously creates. The bill advises the scholarships are for students enrolled in
educational programs, including practicums, internships, and rotations, at designated behavioral teaching
hospitals in Florida. The bill advises the grants are to support the establishment of the students’ educational
programs. The bill subjects the scholarship and grant program to Legislative appropriation.
The bill requires The Department of Children and Families (DCF) to coordinate with the Center in contracting
for a two-part study on the behavioral health system in Florida and the state’s involuntary civil commitment
system.
The bill has a significant, indeterminate, negative fiscal impact on DCF and no fiscal impact on local
government.
The bill provides an effective date of July 1, 2024, except for the provision related to the DCF studies, which is
effective upon becoming law. STORAGE NAME: h1617.HHS PAGE: 2
DATE: 2/21/2024
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Mental Health Safety Net Services
In February 2023, over 32.3% of adults in the Florida self-reported symptoms of anxiety and or
depression. Mental illnesses can be acute or chronic and are diagnosable conditions that affect an
individual’s emotional, psychological, and social well-being, and often their behavior. These conditions
include depression, anxiety, schizophrenia, and mood or personality disorders, among others.
1
Magnifying the mental health crisis undercurrent, Florida’s drug overdose deaths per 100,000 people
increased from 15.4 in 2011 to 37.5 in 2021. Similarly, suicide is often linked to underlying mental
health conditions. Florida’s age-adjusted suicide rate in 2021 was 14.0 per 100,000 people.
2
The Substance Abuse and Mental Health Services Administration (SAMHSA) is the U.S. Department of
Health and Human Services’ agency that leads public health efforts to advance the behavioral health of
the nation.
3
Congress established SAMHSA in 1992 to make substance use and mental disorder
information, services, and research more accessible. To this end, state mental health agencies
(SMHAs) compile and report annual data as part of their application package for SAMHSA’s
Community Mental Health Block Grant.
The Department of Children and Families (DCF) Office of Substance Abuse and Mental Health is
Florida’s SMHA. The table below itemizes the federal block grants for mental health-related funding
that Florida received the last three years:
4
Federal SAMHSA Block Grants Funding: FFY 2021-2022 through 2022-2023 (in $ millions)
Substance Abuse Prevention
and Treatment Block Grant
Community Mental Health
Services Block Grant
Award Year (Oct 1 – Sept 30) FFY 2021-2022 FFY 2022-2023
Recurring 2021 $111,389,890 $47,760,577
Recurring 2022 $112,320,687 $55,973,788
Recurring 2023 $116,814,207 $65,481,738
The DCF table below records the number of unduplicated individuals served in community mental
health settings, state psychiatric hospitals, and residential treatment settings:
5
Number of Unduplicated Individuals Served in the Community
1
Mental Health in Florida, KFF (Mar. 2023) https://www.kff.org/statedata/mental-health-and-substance-use-state-fact-sheets/florida
(last visited Dec. 16, 2023).
2
Id.
3
Substance Abuse and Mental Health Services Administration, About Us, https://www.samhsa.gov/about-us (last visited Dec. 16,
2023).
4
Comprehensive, Multi-Year Review of the Revenues, Expenditures, and Financial Positions of the Managing Entities Including A
System of Care Analysis, Office of Substance Abuse and Mental Health, Florida Department of Children and Families, p. 13 (Nov. 1,
2023) https://www.myflfamilies.com/services/samh/publications (last visited Dec. 16, 2023).
5
Id. at p. 14. STORAGE NAME: h1617.HHS PAGE: 3
DATE: 2/21/2024
07/01/2021 – 06/30/2022 07/01/2022 – 06/30/2023
Service Setting Total Percentage Total Percentage
Community Mental Health 196,328 94.2% 242,849 93.6%
State Psychiatric Hospitals 4,436 2.1% 5,153 2.0%
Residential Treatment 7,640 3.7% 11,365 4.4%
Total 208,404 100% 259,367 100%
For FY 2022, Florida’s total SMHA mental health expenditures were $914,342,441. This total amounts
to $41.98 per capita. Florida’s SMHA system served 147,804 clients in community settings with 4,523
of those served in state hospitals. The 147,804 total clients represent a utilization rate of 6.8 per 1,000
people.
6
DCF administers a statewide system of safety-net services for substance abuse and mental health
(SAMH) prevention, treatment and recovery for children and adults who are otherwise unable to obtain
these services. SAMH programs include a range of prevention, acute interventions (e.g. crisis
stabilization), residential treatment, transitional housing, outpatient treatment, and recovery support
services. DCF provides services based upon state and federally-established priority populations,
administered by regional managing entities under contract with the Department of Health.
Behavioral Health Managing Entities
Managing entities are local, not-for-profit organizations with community boards that hold service
providers accountable for quality service delivery and leverage local resources to meet each county’s
behavioral health needs. Managing entities adapt and tailor funding from the state and federal
governments in response to evolving community trends on prevention, intervention, crisis support,
opioid, medication-assisted treatment, residential treatment, and outpatient services for adults, children,
and families.
7
Managing entities provide SAMH services to over 320,000 Floridians, including:
8
Substance-abusing mothers and women who are pregnant.
Families in the foster care system.
People who inject drugs.
Substance abusers who are infected with HIV.
Individuals with a serious mental illness.
Youth in the juvenile justice System.
Veterans.
Incarcerated individuals.
Chronically homeless individuals.
As the map below illustrates, DCF currently contracts with seven behavioral health managing entities
for the delivery of local SAMH services throughout Florida.
9
6
2022 Uniform Reporting System (URS) Table for Florida, Substance Abuse and Mental Health Services Administration, p. 3 (Nov. 21,
2023), https://www.samhsa.gov/data/report/2022-uniform-reporting-system-urs-table-florida (last visited Dec. 16, 2023).
7
The Florida Association of Managing Entities, Who We Are, https://flmanagingentities.com/who-we-are/ (last visited Feb. 11, 2024).
8
The Florida Association of Managing Entities, Who We Help, https://flmanagingentities.com/who-we-help/ (last visited Feb. 11, 2024).
9
Florida Association of Managing Entities, Map, https://flmanagingentities.com/map/ (last Feb. 11, 2024); Florida Department of
Children and Families, Managing Entities, https://www.myflfamilies.com/services/samh/providers/managing-entities (last visited Feb.
11, 2024). STORAGE NAME: h1617.HHS PAGE: 4
DATE: 2/21/2024
Managing entities must submit detailed plans to enhance crisis services based on the no-wrong-door
model
10
or to meet specific needs identified in DCF’s assessment of behavioral health services in this
state.
11
DCF must use performance-based contracts to award grants.
12
Managing entities are required to conduct a community behavioral health care needs assessment once
every three years in the geographic area served by the managing entity, which identifies needs by sub-
region.
13
The assessments must be submitted to DCF for inclusion in the state and district substance
abuse and mental health plan.
14
The Baker Act: Involuntary Commitment
The Florida Mental Health Act, commonly referred to as the Baker Act
15
, focuses on crisis services for
individuals with mental illness, much like an emergency department serves individuals experiencing a
medical emergency.
16
Under the Baker Act, DCF designates hospitals and crisis stabilization units as
receiving facilities to provide emergency mental health treatment.
17
The purpose of a crisis stabilization
unit is to stabilize and redirect a patient to the most appropriate and least restrictive community setting
10
The no-wrong-door model means a model for the delivery of acute care services to persons who have mental health or substance
use disorders, or both, which optimizes access to care, regardless of the entry point to the behavioral health care system. s.
394.4573(1)(d), F.S.
11
S. 394.4573(3), F.S.
12
Id.
13
S. 394.9082(5)(b), F.S.
14
S. 394.75(3), F.S.
15
The Baker Act is contained in Part I of ch. 394, F.S.
16
The Florida Department of Children and Families, The Baker Act, https://www.myflfamilies.com/crisis-services/baker-act (last visited
Feb. 11, 2024).
17
Florida Department of Children and Families, Baker Act Resources for Individuals & Families, https://www.myflfamilies.com/crisis-
services/baker-act/baker-act-resources-individuals-families (last visited Feb. 11, 2024). STORAGE NAME: h1617.HHS PAGE: 5
DATE: 2/21/2024
available. Similar to a hospital’s emergency department, a crisis stabilization unit provides services
regardless of a person’s ability to pay.
18
Emergency mental health examination and stabilization services may be provided on a voluntary or
involuntary basis.
19
An involuntary examination is required if there is reason to believe that the person
has a mental illness and, because of his or her mental illness, has refused voluntary examination, is
likely to refuse to care for him or herself to the extent that such refusal threatens to cause substantial
harm to that person’s well-being, and such harm is unavoidable through help of willing family members
or friends, or will cause serious bodily harm to him or herself or others in the near future based on
recent behavior.
20
In FY 2021-22, hospitals and crisis stabilization units in Florida conducted 170,048 involuntary
examinations for 115,239 individuals. As the table below indicates, the number of involuntary
examinations for FY 2021-22 is significantly less than the prior four years.
21
Baker Act Involuntary Examinations for the Past Five Fiscal Years
Fiscal Year (FY) Involuntary Exams
Year-to-Year Percent Change
Involuntary Exams Population
2021-2022 170,048 -12.65% 1.45%
2020-2021 194,680 -3.91% 1.75%
2019-2020 202,598 -3.98% 1.74%
2018-2019 210,992 2.53% 1.80%
2017-2018 205,781 2.92% 1.62%
While researchers cannot extrapolate from the data the reasons why the number of involuntary
examinations decreased, they emphasize that this decrease in involuntary examinations should not be
read to automatically erase some of the need for mental health crisis services. Instead, researchers
recommend an additional study to determine the impact of the following possible factors:
22
An increase in the use of DCF-funded services such as Care Coordination and Mobile
Response Teams;
Collaboration between DCF and the Administration for Health Care Administration (AHCA) to
identify and address high utilizers of crisis services;
Changes to law enforcement and designated receiving facility transportation processing
procedures;
An increase in the percentage of involuntary examinations by Crisis Intervention Team (CIT)
trained law enforcement officers; and
Workforce shortage for health professionals of all types.
The Commission on Mental Health and Substance Abuse
In 2021, the legislature created the Commission on Mental Health and Substance Abuse
(Commission).
23
The Commission consists of 19 members, which include the Secretaries of DCF and
18
S. 394.875(1)(a), F.S.
19
Ss. 394.4625 and 394.463, F.S.
20
S. 394.463(1), F.S.
21
Annette Christy, Kevin Jenkins, Sara Rhode, Sarah Bogovic, Lillian Deaton, and Charles Dion, Baker Act Reporting Center Fiscal
Year 2021-2022 Report. University of South Florida, Department of Mental Health Law and Policy, Baker Act Reporting Center, p. 4
(2023) https://www.usf.edu/cbcs/baker-act/documents/ba_usf_annual_report_2021_2022.pdf (last visited Feb. 12, 2024).
22
Id. at 5.
23
See Chapter 2021-170, L.O.F. STORAGE NAME: h1617.HHS PAGE: 6
DATE: 2/21/2024
the Agency of Health Care Administration (AHCA). The remaining members are appointed by the
Governor, the President of the Senate, and the Speaker of the House of Representatives.
24
Under current law, DCF is required to provide administrative and staff support services to the
Commission as it carries out its statutory functions.
25
State agencies are also required to assist the
Commission in a timely manner when needed.
26
The duties of the Commission include:
1. Conducting a review and evaluation of the management and functioning of existing publicly
supported mental health and substance abuse systems in DCF, AHCA, and all other relevant
state departments;
2. Considering the unique needs of people who are dually diagnosed;
3. Addressing access to, financing of, and scope of responsibility in the delivery of emergency
behavioral health care services;
4. Addressing the quality and effectiveness of current service delivery systems and professional
staffing and clinical structure of services, roles, and responsibilities of public and private
providers;
5. Addressing priority population groups for publicly funded services, identifying the
comprehensive delivery systems, needs assessment and planning activities, and local
government responsibilities for funding services;
6. Reviewing the implementation of ch. 2020-107, Laws of Fla.;
27
7. Identifying gaps in the provision of mental health and substance abuse services;
8. Providing recommendations on how managing entities may promote service continuity;
9. Making recommendations about the mission and objectives of state-supported mental health
and substance abuse services and the planning, management, staffing, financing, contracting,
coordination, and accountability of mechanisms best suited for the recommended mission and
objectives; and
10. Evaluating and making recommendations regarding the establishment of a permanent, agency-
level entity to manage mental health, behavioral health, substance abuse, and related services
statewide.
In January 2024, the Commission released their annual interim report to address statewide behavioral
health challenges. The Commission offered the following 12 recommendations:
28
1. Complete a gap analysis to provide a clear picture of the state’s behavioral health infrastructure.
2. Expand patient-centered behavioral health clinics to enable coordinated, comprehensive access
to behavioral healthcare services.
3. Establish regional collaboratives to address ongoing challenges at the local level.
4. Get the school districts and the managing entities to negotiate a memorandum of understanding
to coordinate a behavioral healthcare approach tailored for students.
5. Designate a single state agency to create a Multi-Agency Continuum of Care Collaborative.
6. Establish a statewide policy that recognizes the 988 Florida Suicide & Crisis Lifelines and
network providers (e.g., mobile response teams and crisis stabilization units) as part of the
behavioral health system of care.
7. Organize peer specialists so that they participate throughout the crisis care continuum.
8. Amend s. 394.462, F.S., to require transportation plans to address the protocols for transitions
between 988 providers, mobile response teams., and designated receiving facilities.
24
S. 394.9086(3), F.S.
25
S. 394.9086(1), F.S.
26
S. 394.9086(4)(b), F.S.
27
2020 House Bill 945 (Silvers) requires managing entities to implement of a coordinated system of mental health care for children and
expands the use of mobile response teams (MRT) across the state. It requires the Florida Mental Health Institute within the University
of South Florida to develop a model protocol for school use of MRTs. The bill also requires AHCA and DCF to identify children and
adolescents who are the highest users of crisis stabilization services and take action to meet the needs of such children. Lastly, the bill
requires AHCA to continually test the Medicaid managed care provider network databases to ensure behavioral health providers are
accepting enrollees and confirm that enrollees have access to behavioral health systems.
28
The Commission on Mental Health and Substance Use Disorder, Annual Interim Report (Jan. 1, 2024)
https://www.myflfamilies.com/services/samh/commission-mental-health-and-substance-use-disorder (last visited Feb. 12, 2024). STORAGE NAME: h1617.HHS PAGE: 7
DATE: 2/21/2024
9. Enhance the state system of data collection and create a publicly accessible data dashboard for
988 services.
10. Explore opportunities that support the regionalized expansion of Health Information Exchange
platforms that allow healthcare professionals and patients access medical records electronically.
11. Establish a Florida Behavioral Healthcare Data Repository.
12. Review the statutory requirements that direct the fiscal management process for behavioral
health services.
The Louis de la Parte Florida Mental Health Institute at the University of South Florida
The Florida Legislature established the Louis de la Parte Florida Mental Health Institute (FMHI) at the
University of South Florida (USF) in 2002.
29
FMHI provides technical assistance and support services
to mental health agencies and mental health professionals.
30
As a behavioral health services research
center, FMHI sponsors USF faculty or staff members pursuing applied research projects relating to
mental, addictive, or development disorders.
31, 32
In addition, FMHI provides direct services to other
government agencies.
33
Most recently, following the incident of mass violence at Marjory Stoneman
Douglas High School, the Florida Legislature directed FMHI to develop a statewide model protocol for
mobile response teams serving the mental health emergencies of children and adolescents at
schools.
34
Florida’s Behavioral Health Workforce
The United States Department of Health and Human Services (HHS) designates Health Professional
Shortage Areas (HPSAs) to identify areas and population groups that are experiencing a shortage of
health professionals. HPSAs measure the ratio of psychiatrists to the population; they do not account
for mental health services provided by clinical psychologists, clinical social workers, psychiatric nurse
specialists, and marriage and family therapists.
35
A prerequisite to a HPSA designation is an analysis of the population-to-provider ratio. For mental
health, the ratio threshold must be at 30,000 to 1 for a HPSA designation. As indicated by the chart
below, more than 10 million Floridians live in shortage areas:
36
The number of psychiatrists currently working in Florida’s HPSAs only meets 21.8% of the need for
mental health services in those HPSAs. Therefore, Florida needs 587 more psychiatrists to eliminate all
228 HPSA designations in Florida.
29
Ch. 2002-387, Laws of Fla.
30
S. 1004.44(1), F.S.
31
Louis de la Parte Florida Mental Health Institute, Affiliates, College of Behavioral & Community Sciences,
https://www.usf.edu/cbcs/fmhi/affiliates/index.aspx (last visited Jan. 7, 2024).
32
Louis de la Parte Florida Mental Health Institute, Research, College of Behavioral & Community Sciences,
https://www.usf.edu/cbcs/fmhi/research/index.aspx (last visited Jan. 7, 2024). FMHI’s applied research covers adult mental health,
autism and development disabilities, child welfare, children’s mental health systems of care, behavioral health in the criminal justice
system, integrated care, HIV/AIDS, elder mental health, substance use, trauma and violence, and veterans’ behavioral health and
homelessness.
33
S. 1004.44(3), F.S.
34
See S. 1004.44(4), F.S.
35
Mental Health Care Health Professional Shortage Areas (HPSAs), KFF (last revised Nov. 1, 2023) https://www.kff.org/other/state-
indicator/mental-health-care-health-professional-shortage-areas-
hpsas/?currentTimeframe=0&selectedRows=%7B%22states%22:%7B%22florida%22:%7B%7D%7D%7D&sortModel=%7B%22colId%
22:%22Location%22,%22sort%22:%22asc%22%7D (last visited Dec. 16, 2023).
36
Id. STORAGE NAME: h1617.HHS PAGE: 8
DATE: 2/21/2024
As the graphic below illustrates, HHS overlaid a county map of Florida with current HPSA scores. The
higher the score, the greater the need for psychiatrists.
37
37
Health Resources and Services Administration, HRSA Map Tool, United States Department of Health and Human Services,
https://data.hrsa.gov/maps/map-tool/ (last visited Feb. 12, 2024); Health Resources and Services Administration, Health Professional
Shortage Areas (HPSA) – Mental Health Map (last updated Feb. 12, 2024)
https://data.hrsa.gov/ExportedMaps/MapGallery/HPSAMH.pdf (last visited Feb. 12, 2024). STORAGE NAME: h1617.HHS PAGE: 9
DATE: 2/21/2024
Behavioral Health Teaching Hospitals
To increase the overall supply of behavioral health professionals, some states may choose to act
through partnerships with educational institutions and residency programs.
38
These partnerships can
encourage students and early career professionals to practice in rural and underserved communities.
39
Other states may support new and existing behavioral health educational initiatives at behavioral health
teaching hospitals with grant funding. For example, Massachusetts pledged at least $20 million for FY
2024 to establish new, or enhance existing, clinical supervision of students pursuing degrees in
behavioral health and behavioral health providers-in-training pursing certification or licensure.
Massachusetts’s clinical supervision incentive program provides grants to clinical supervisors working
in community-based settings who also provide unreimbursed supervision to students and clinicians-in-
training. Administered by the Executive Office for Health and Human Services, the grant program
prioritizes providers of diverse backgrounds and providers who practice in underserved and
geographically isolated areas.
40
McLean Hospital (Massachusetts) Model
A member of Mass General Brigham, McLean Hospital is an international mental health facility for
psychiatric treatment, education, and research.
41
Founded in 1811, McLean Hospital is the largest
psychiatric affiliate of Harvard Medical School and treats mental health conditions, such as depression,
anxiety, personality disorders, and substance use disorders.
42
The U.S. News & World Report currently
ranks McLean Hospital as the country’s best hospital for psychiatry.
43
McLean Hospital, in partnership with Harvard Medical School, provides clinical supervision of the
following persons through residencies,
44
fellowships,
45
and other educational training programs
46
:
Graduate and undergraduate students pursing degrees in behavioral health fields, including
psychiatric nursing.
College graduates interested in pursuing a career in mental health.
Post-doctoral professionals pursuing advanced competencies in treating addiction, older adult
mental health care, neurology and neuropsychiatry, and women’s mental health.
Clinical social workers pursuing advanced competencies in patient assessment, treatment,
crisis intervention, aftercare planning, and case management.
Theological students and spiritual leaders who provide mental health chaplaincy services.
38
National Conference of State Legislatures, State Strategies to Recruit and Retain the Behavioral Health Workforce, (last updated
May 20, 2022), https://www.ncsl.org/health/state-strategies-to-recruit-and-retain-the-behavioral-health-workforce (last visited Dec. 17,
2023).
39
Id.
40
Commonwealth of Massachusetts Session Law 2023-28, Line Item 4000-0054,
https://malegislature.gov/Laws/SessionLaws/Acts/2023/Chapter28 (last visited Jan. 7, 2024).
41
Mass General Brigham, International Patient Care: About McLean Hospital, https://www.massgeneralbrigham.org/en/patient-
care/international/about/mclean (last visited Dec. 17, 2023).
42
Id.
43
U.S. News and World Report, McLean Hospital, https://health.usnews.com/best-hospitals/area/ma/mclean-hospital-
6142120#rankings (last visited Jan. 7, 2024).
44
McLean Hospital, Residencies, https://www.mcleanhospital.org/training/residencies (last visited Dec. 17, 2023). McLean offers Adult
Psychiatry Residency Training in the fields of community psychiatry, global psychiatry, law and psychiatry, clinical research, mind-body
medicine, medical education, and psychodynamic psychotherapy. In addition, McLean offers Child and Adolescent Psychiatry
Residency Training to prepare students through clinical rotations at Mass General Hospital, McLean Hospital, Boston Juvenile Court
Clinic, and the local public-school systems.
45
McLean Hospital, Psychiatry Fellowships, https://www.mcleanhospital.org/training/psychiatry-fellowships (last visited Dec. 17, 2023).
46
McLean Hospital, Mental Health Clinical Pastoral Education Program, https://www.mcleanhospital.org/training/cpe (last visited Dec.
21, 2023). STORAGE NAME: h1617.HHS PAGE: 10
DATE: 2/21/2024
University of Washington Behavioral Health Teaching Hospital
Washington State recently enacted legislation focused on behavioral health care access and workforce
development to alleviate barriers to access and workforce shortages. In 2019, the Washington State
Legislature and the University of Washington School of Medicine partnered to pass House Bill 1593,
47
which established a Behavioral Health Teaching Facility (BHTF) to treat patients with behavioral health
needs and train an integrated behavioral health workforce. The state allocated $33.25 million to initiate
the design and building of the new teaching facility and budgeted a total of $224.5 million over four
years for the completion of BHTF.
48
Scheduled to open its doors in June 2024, the Behavioral Health Teaching Facility at the University of
Washington Medical Center Northwest Campus will be a new 191,000 square foot facility with 150
inpatient beds, a neuromodulation suite
49
serving both inpatient and outpatient needs, consultation
rooms to provide state-wide telepsychiatry consultation, and graduate medical education workspaces.
50
Tampa General Hospital and The University of South Florida
Tampa General Hospital (TGH) is a private, not-for-profit hospital licensed for 1,040 beds. TGH
employs more than 8,000 people and is one of the region’s largest employers. The U.S. News & World
Report for 2023-24 ranks TGH as among the top 50 hospitals nationwide in six specialties. TGH
partners with the USF Morsani College of Medicine to train more than 700 physician residents and
fellows assigned to TGH for specialty training.
51
In 2023, Florida appropriated $10,000,000 in nonrecurring General Revenue to establish Tampa
General Behavioral Health Hospital,
52
which is to be a new 96-bed inpatient behavioral health hospital
at TGH with the capacity to expand to 120 beds.
53
The appropriation contemplated that the USF
Morsani College of Medicine would provide the requisite faculty to help staff the behavioral health
hospital to provide inpatient and outpatient care, advance graduate medical education, and conduct
research.
54
Effect of Proposed Changes
Designated Behavioral Health Teaching Hospitals
HB 1617 creates the behavioral health teaching hospital designation for hospitals in Florida.
Specifically, the bill authorizes a hospital that partners with a university school of medicine to apply to
AHCA for designation as a behavioral health teaching hospital. To this end, the hospital receives the
designation if they meet the all of the following criteria:
47
Chapter 19-323, Laws of Washington State. https://lawfilesext.leg.wa.gov/biennium/2019-20/Pdf/Bills/Session%20Laws/House/1593-
S2.SL.pdf?q=20240209102341 (last visited Feb. 9, 2024).
48
The University of Washington, Executive Summary: UW Behavioral Health Teaching Facility/Project Definition Report (Oct. 23,
2020), https://facilities.uw.edu/files/media/uw-bhtf-project-definition-executive-summary_2020_1130.pdf (last visited Feb. 9, 2024);
Hannelore Sudermann, Crisis State, The University of Washington Magazine, (Sept. 2021)
https://magazine.washington.edu/feature/mental-health-needs-have-washington-in-a-state-of-crisis/ (last visited Feb. 9, 2024).
49
Neuromodulation is the process by which certain brain areas are activated electrically so that they may influence other brain areas to
reduce the tendency for seizures. Department of Neurology, Neuromodulation, The University of Florida,
https://neurology.ufl.edu/divisions/epilepsy/neuromodulation-vns-rns-dbs/ (last visited Feb. 9, 2024); see also College of Medicine, FSU
Neuromodulation Lab, The Florida State University, https://med.fsu.edu/kozellab/fsu-neuromodulation (last visited Feb 9, 2024).
50
The University of Washington, Executive Summary: UW Behavioral Health Teaching Facility/Project Definition Report (Oct. 23,
2020), https://facilities.uw.edu/files/media/uw-bhtf-project-definition-executive-summary_2020_1130.pdf (last visited Feb. 9, 2024).
51
About Tampa General Hospital, Tampa General Hospital, https://www.tgh.org/about-tgh (last visited Dec. 21, 2023).
52
The Florida House of Representatives, Conference Report on Senate Bill 2500, p. 124-25, Line Item 474B, (May 2023)
https://www.myfloridahouse.gov/Sections/Documents/loaddoc.aspx?FileName=CRA_.pdf&DocumentType=Amendments&BillNumber=
2500&Session=2023 (last visited Dec. 21, 2023).
53
The Florida House of Representatives, Appropriations Project Request – Fiscal Year 2023-24: HSE Form # 1969 Tampa General
Behavioral Health Hospital, p. 3 (Feb. 13, 2023) https://www.myfloridahouse.gov/api/document/apr?sessionid=99&name=1969AR.pdf
(last visited Dec. 21, 2023).
54
Id. STORAGE NAME: h1617.HHS PAGE: 11
DATE: 2/21/2024
Offers a psychiatric residency program accredited through the Residency Review Committee of
the Accreditation Council of Graduate Medical Education;
Offers a postdoctoral clinical psychology fellowship program accredited by the Amercian
Psychological Association.
Develop and maintain a consultation agreement with the Louis de la Parte Florida Mental Health
Institute at the University of South Florida, including with the Florida Center for Behavioral
Health Workforce;
Develop a plan with the partner, the university school of medicine, to:
o Promote a coordinated system of care of persons with behavioral health needs;
o Develop and offer integrated workforce development programs; and
o Coordinate and promote innovative partnerships that integrate the colleges and schools
of nursing, psychology, social work, pharmacy, public health, and other relevant
disciplines with existing local and regional programs, clinics, and resources.
The bill requires that hospitals applying for designation as a behavioral health teaching hospital
designation to apply and submit documentation in a manner determined by AHCA.
The Florida Center for Behavioral Health Workforce
The bill creates the Florida Center for Behavioral Health Workforce (Center) within the Louis de la Parte
Florida Mental Health Institute at the University of South Florida. The bill establishes the Center to
address issues of workforce supply and demand in the behavioral health professions, including the
issues of recruitment, retention, and workforce resources.
Goals of the Center
The bill creates three primary goals for the Center. The first goal relates to the development strategic
statewide plan for the behavioral health workforce. Specifically, the bill advises the Center to:
Conduct a statistically valid biennial data-driven analysis of the supply-demand of the behavioral
health workforce.
Develop recommendations and strategies to increase behavioral health faculty and educational
supervision, to support behavioral health faculty development, and to promote advanced
behavioral health education.
Develop best practices in the academic preparation and continuing education needs of qualified
behavioral health educators.
Collect data on behavioral health faculty, employment, distribution, and retention.
Pilot innovative projects to support the recruitment, distribution, and retention of qualified
behavioral health faculty employment and advancement.
Encourage and coordinate the development of academic-practice partnerships, to support
behavioral health faculty development and advancement.
Develop distance learning infrastructure for behavioral health education.
Advance faculty competencies in the pedagogy of teaching and the evidence-based use of
technology, simulation, and distance learning techniques.
The second goal relates to the enhancement and promotion of behavioral health professionals in
Florida. Specially, the bill advises the Center to develop and promote:
Behavioral health excellence programs.
Reward, recognition, and renewal activities.
Media and image-building efforts.
The third goal relates to the convention of various groups representative of the behavioral health
professions, healthcare providers, business and industry, consumers, lawmakers, and educators.
Specifically, the bill advises the Center to host these conventions to:
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Review and comment on data analysis prepared for the Center.
Recommend systemic changes, including strategies for implementation of recommended
changes.
Evaluate and report the results of these efforts to the Legislature and other entities
Data Access
The bill authorizes the Center to request any information held by any licensing board of the Florida
Department of Health (DOH) regarding a behavioral health professional licensed in Florida or licensed
via a multistate license as authorized by a professional multistate licensure compact. The bill allows the
Center to also request any information reported to any DOH licensing board by the employers of such
behavioral health professionals. If the Center requests this category of information from a licensing
board, the board must give the Center the information. However, DOH licensing boards may not share
a behavioral health professional’s personal identifying information.
Florida Behavioral Health Professions Scholarship and Grant Program
The bill requires the Center to administer the Florida Behavioral Health Professions Scholarship and
Grant Program, which the bill simultaneously creates. The bill advises the scholarships are for students
enrolled in educational programs, including practicums, internships, and rotations, at designated
behavioral teaching hospitals in Florida. The bill advises the grants are to support the establishment of
the students’ educational programs. The bill subjects the scholarship and grant program to Legislative
appropriation. To administer the scholarship and grant program, the bill requires the Center to:
Coordinate, facilitate, and oversee statewide implementation of the scholarship and grant
program.
Consult and collaborate with designated behavioral health teaching hospitals and affiliated
universities to identify eligible educational programs to offer the scholarship program.
Establish requirements, timelines, and processes for eligibility and application for scholarships
and grants.
Administer scholarship funds. The General Appropriations Act sets the annual amount of the
scholarship for eligible students.
Administer grant funds, subject to specific authorization by the General Appropriations Act.
Report on the implementation and administration of the scholarship and grant program by
planning, advising, and evaluating approved degree and certification programs and the
performance of students.
The bill requires the Center to identify indicators for the satisfactory progress of 1) students enrolled in
educational programs at designated behavioral health teaching hospitals and 2) the performance of
those educational programs.
Reporting
The bill requires the Center to submit an annual report to the Governor, the President of the Senate,
and the Speaker of the House of Representatives that details the activities of the Center in pursuit of its
goals and in the execution of its duties. The bill makes the annual report due by January 10 each year.
The bill requires the Center to submit a second annual report to the Governor, the President of the
Senate, and the Speaker of the House of Representatives that summarizes, at a minimum, 1) the
status of the statewide coordination and implementation of education programs at designated
behavioral health teaching hospitals in Florida and 2) the status of the Florida Behavioral Health
Professions Scholarship and Grant Program. The bill makes the first annual report of this kind due by
October 1, 2025, and the following annual reports are due by each October 1 every year after 2025.
The bill requires the Center to submit a third annual report to the Governor, the President of the Senate,
and the Speaker of the House of Representatives that makes statutory and budgetary
recommendations for improving the implementation and delivery of the Florida Behavioral Health STORAGE NAME: h1617.HHS PAGE: 13
DATE: 2/21/2024
Professions Scholarship and Grant Program. The Center must collaborate with the Board of Governors
(BOG), the State Board of Education, and other stakeholders to develop this annual report. The bill
makes this particular annual report due by December 1 each year.
The bill requires the BOG to expeditiously adopt any necessary regulations and rules, as applicable, in
consultation with the Center, to allow the Center to perform its responsibilities beginning in in the 2025-
2026 fiscal year.
The bill requires the State Board of Education to expeditiously adopt any necessary regulations and
rules, as applicable, in consultation with the Center, to allow the Center to perform its responsibilities
beginning in in the 2025-2026 fiscal year.
Studies
The bill requires DCF to coordinate with the Center in contracting for two studies.
First, the bill requires DCF to contract with a vendor to study Florida’s behavioral health system.
Specifically, DCF’s vendor must:
Analyze Florida’s behavioral health workforce and behavioral health education and training.
Evaluate best practices to establish behavioral health teaching hospitals.
Offer policy recommendations for recruiting, training, and retaining an integrated behavioral
health workforce.
Second, the bill requires DCF’s vendor to study Florida’s involuntary commitment system, with a focus
on inpatient bed capacity. Specifically, DCF’s vendor must:
Study bed capacity in the forensic and civil involuntary commitment settings and the policies
and processes for involuntary commitment.
Evaluate the fiscal costs of the requirement imposed on designated behavioral health teaching
hospitals to maintain civil commitment beds.
Offer policy recommendations for ensuring sufficient involuntary commitment bed capacity.
Offer recommendations for promoting coordination between Florida’s involuntary commitment
system, behavioral health teaching hospitals, and other integrated health programs.
The bill provides an effective date of July 1, 2024, except for the provision related to the DCF studies,
which is effective upon becoming law.
B. SECTION DIRECTORY:
Section 1: Creates Part VI of Chapter 395, F.S., to be entitled “Behavioral Health Teaching Hospitals.”
Section 2: Creates s. 395.901, F.S., relating to definitions.
Section 3: Creates s. 395.902, F.S., relating to designated behavioral health teaching hospitals.
Section 4: Amends s. 1004.44, F.S., relating to Louis de la Parte Florida Mental Health Institute.
Section 5: Creating an unnumbered section of law, relating to a two-part study.
Section 6: Providing effective dates.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
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DATE: 2/21/2024
The bill has a significant, indeterminate, negative fiscal impact on state government. The Florida
House of Representatives has not made an appropriation for the bill.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not Applicable. This bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
AHCA has sufficient rulemaking authority to implement the provisions of this bill.
BOG has sufficient rulemaking authority to implement the provisions of this bill.
The State Board of Education has sufficient rulemaking authority to implement the provisions of this bill.
DCF has sufficient rulemaking authority to implement the provisions of this bill.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES