This document does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h1617z.DOCX
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HOUSE OF REPRESENTATIVES STAFF FINAL BILL ANALYSIS
BILL #: CS/HB 1617 Behavioral Health Teaching Hospitals
SPONSOR(S): Health & Human Services Committee, Garrison and others
TIED BILLS: IDEN./SIM. BILLS: CS/SB 330
FINAL HOUSE FLOOR ACTION: 114 Y’s
0 N’s GOVERNOR’S ACTION: Approved
SUMMARY ANALYSIS
CS/HB 1617 passed the House on March 6, 2024, as CS/SB 330 as amended. The Senate concurred in the
House amendment to the Senate bill and subsequently passed the bill as amended on March 6, 2024.
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
incentivize workforce development partnerships between hospitals and universities.
CS/HB 1617 creates a behavioral health teaching hospital program within the Agency for Health Care
Administration (AHCA). It requires AHCA to designate four named hospitals as behavioral health teaching
hospitals within 30 days after the act becomes law. It establishes standards for behavioral health teaching
hospitals for those four, and for future behavioral health teaching hospitals, which AHCA may designate
starting July 1, 2025. The bill requires AHCA to award each behavioral health teaching hospital funds for up to
10 new residency slots and for workforce development programs. The bill establishes a competitive grant
program for behavioral health teaching hospitals based on the quality of the hospitals’ integrated workforce
development plans and of their implementation of those plans.
The bill establishes the Florida Center for Behavioral Health Workforce (Center) within the Louis de la Parte
Florida Institute for Mental Health at the University of South Florida. The bill authorizes the Center to perform
original research, policy analysis, and to develop and share best practices that advance the behavioral health
professions.
The bill requires the Department of Children and Families (DCF) to conduct a comprehensive, systematic study
of the behavioral health supply-and-demand relationship in Florida by January 31, 2025.
The bill appropriates $300 million in nonrecurring funds for the grant program, for use in $100 million
increments over the next three fiscal years, $6 million in recurring funds for residencies through the Slots for
Doctors Program for the first four designated hospitals, $2 million in recurring funds for workforce development
programs through the Training, Education and Clinicals in Health Funding Program for the first four designated
hospitals, and $5 million to operate the Center. The bill has no fiscal impact to local government.
The bill was approved by the Governor on March 21, 2024, ch. 2024-12, L.O.F., and will become effective on
July 1, 2024; except for provisions related to the DCF study which are effective upon the act becoming law,
and amendments to s. 409.909, F.S., related to the Slots for Doctors Program which are effective July 1, 2025.
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I. SUBSTANTIVE INFORMATION
A. EFFECT OF 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 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 the
state mental health agency in Florida. 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.
The table below itemizes the federal block grants for mental health-related funding that Florida received
the last three years:
4
Federal SAMHSA Block Grant Funding: FFY 2021-2022 - 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
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).
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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
FY 2021-22 FY 2022-23
Service Setting Total Percentage Total Percentage
Community Mental Health 196,328 94.2% 242,849 93.6%
State 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 federal FY 2022, Florida’s total mental health expenditures were $914,342,441. This total amounts
to $41.98 per capita. Florida’s safety net 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
Behavioral Health Managing Entities
DCF provides SAMH services based upon state and federally-established priority populations,
administered by regional managing entities under contract with the Department of Health. 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
5
Id. at p. 14.
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/sites/default/files/reports/rpt42746/Florida.pdf (last visited Mar. 15, 2024).
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).
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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
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.
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Involuntary Commitment: The Baker Act
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
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 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 indicate reduced need for mental health crisis services. Rather, 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;
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).
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.
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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.
Commission on Mental Health and Substance Abuse
In 2021, the legislature created the Commission on Mental Health and Substance Abuse (Commission)
within DCF.
23
The Commission consists of 19 members, which include the Secretaries of DCF and 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
The duties of the Commission include:
25
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.;
26
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.
27
1. Complete a gap analysis to provide a clear picture of the state’s behavioral health infrastructure.
23
See Chapter 2021-170, L.O.F.
24
S. 394.9086(3), F.S.
25
S. 394.9086(4)(a), F.S.
26
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.
27
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).
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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.
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 Louis de la Parte Florida Mental Health Institute (FMHI) at the University of South Florida (USF)
provides technical assistance and support services to mental health agencies and mental health
professionals.
28
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.
29
In addition, FMHI provides direct services to other government agencies.
30
Current law also requires
FMHI to develop a statewide model protocol for mobile response teams serving the mental health
emergencies of children and adolescents at schools.
31
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.
32
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:
33
28
S. 1004.44(1), F.S.
29
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); 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.
30
S. 1004.44(3), F.S.
31
See S. 1004.44(4), F.S.
32
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%22colI d%
22:%22Location%22,%22sort%22:%22asc%22%7D (last visited Mar. 15, 2023).
33
Id.
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State
Total Mental
Health HPSA
Designations
Population
Within HPSAs
Percent of
Need Met
Psychiatrists
Needed to Remove
HPSA Designation
Florida 228 10,207,269 21.8% 587
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.
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.
34
Graduate Medical Education
Graduate medical education (GME) refers to the training residents complete after medical school
graduation to develop clinical and professional skills required to practice medicine. During this
education, residents train in a specialty (e.g., general surgery, pediatrics, or internal medicine).
35
All
medical school graduates must complete a period of GME, or residency training, to be licensed to
practice medicine in the United States. GME comprises the second phase, after medical school, of the
34
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).
35
Office of Program Policy Analysis and Government Accountability, Florida’s Graduate Medical Education System (Report No. 14-08),
available at https://oppaga.fl.gov/Documents/Reports/14-08.pdf (last visited Feb. 12, 2024).
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formal education that prepares doctors for medical practice. During residency, doctors learn skills and
techniques specific to their chosen specialty under the supervision of attending physicians and serve as
part of a care team.
36
GME programs include residencies and fellowships. First year GME students fill categorical or
preliminary resident positions. Categorical residents begin a multi-year program with a sponsoring
institution during their first year of GME training. During their first year, preliminary residents receive
prerequisite training. After receiving prerequisite training, preliminary residents transfer to categorical
resident programs. After completing a residency program, physicians may also pursue advanced GME
training by completing a fellowship in a subspecialty program, such as cardiology or vascular surgery.
37
GME Accreditation
The Accreditation Council for Graduate Medical Education (ACGME) accredits allopathic GME
programs, and the American Osteopathic Association (AOA) accredits osteopathic GME programs. The
ACGME is a private, 501(c)(3), not-for-profit organization that accredits GME (physician residency and
fellowship) and certain medically related post-doctoral fellowship programs and the institutions that
sponsor them in the United States.
38
ACGME accreditation is overseen by a Review Committee made
up of volunteer specialty experts from the field that set accreditation standards and provide peer
evaluation of Sponsoring Institutions and specialty and subspecialty residency and fellowship
programs. In academic year 2022-2023, there were approximately 886 ACGME-accredited institutions
sponsoring approximately 13,000 residency and fellowship programs in 182 specialties and
subspecialties.
39
The AOA is the primary certifying body for osteopathic physicians and the accrediting agency for all
osteopathic medical schools. The AOA represent more than 186,000 osteopathic physicians and
medical students across the United States. The AOA accredits Osteopathic Postdoctoral Training
Institutions, which train residents in community-based settings.
40
With osteopathic residency programs,
a college of osteopathic medicine serves as the academic sponsor and has an agreement with a base
institution.
Residents in these programs train at base institutions, which are most often hospitals. The base
institution maintains administrative and financial responsibility.
41
Florida Medicaid GME
Medicaid is the health care safety net for low-income Floridians, administered by AHCA under Title XIX
of the federal Social Security Act and Ch. 409, F.S. The Medicaid program is a medical assistance
program funded jointly between the state and federal governments. The program provides health care
coverage for over 4.8 million low-income families and individuals, the elderly, and individuals with
disabilities in Florida, including 3.4 million recipients who receive their services through a managed
care plan.
42
36
Association of American Medical Colleges, State-by-State Graduate Medical Education Data, available at
https://www.aamc.org/advocacy-policy/state-state-graduate-medical-education-data (last visited Feb. 12, 2024).
37
Id.
38
Accreditation Council for Graduate Medical Education, ACGME Frequently Asked Questions (FAQs), available at
https://www.acgme.org/about/acgme-frequently-asked-questions (last visited Feb. 12, 2024).
39
Accreditation Council for Graduate Medical Education, Overview, https://www.acgme.org/about/overview/ (last visited Feb. 12, 2024).
40
American Osteopathic Association, About Us, available at https://osteopathic.org/about/ (last visited Feb. 12, 2024).
41
Agency for Health Care Administration, Florida KidCare, Florida KidCare Enrollment Report, March 2023 (on file with the Senate
Appropriations Committee on Health and Human Services).
42
Agency for Health Care Administration, Comprehensive Medicaid Managed Care Enrollment Reports (December 31, 2023) available
at https://ahca.myflorida.com/medicaid/medicaid-finance-and-analytics/medicaid-data-analytics/medicaid-monthly-enrollment-report
(last visited January 31, 2024).
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The Florida Medicaid program also uses state and federal Medicaid funds to support GME. The Florida
Medicaid GME program provides funding to qualified participating hospitals involved in providing
resources for the education and training of physicians in specialties which are in a statewide supply-
and-demand deficit. Florida Medicaid GME currently consists of eight programs, the newest of which is
the Slots for Doctors Program.
43
Slots for Doctors Program
The Slots for Doctors Program exists specifically to alleviate the physician workforce shortage in
Florida. The Florida Legislature created the Slots for Doctors Program through Chapter 2023-243, Laws
of Fla.,
44
as a specific means to increase the supply of highly trained physicians by creating new
resident positions to increase access to care and improve health outcomes for Medicaid recipients.
45
To this end, AHCA must annually allocate $100,000 to hospitals and FQHCs for each newly created
resident position that is first filled on or after June 1, 2023, and filled thereafter. However, each newly
created resident position must first be accredited by the ACGME or the Osteopathic Postdoctoral
Training Institution in an initial or established accredited training program which is in a physician
specialty or subspecialty in a statewide supply-and-demand deficit. The General Appropriations Act
identifies which physician specialties and subspecialties are in a statewide supply-and-demand deficit.
46
In FY 2023-24, AHCA distributed $25.5 million (of the $30 million appropriated) to 31 Medicaid
participating hospitals and FQHCs in Florida through the Slots for Doctors Program to fund 255 new
residency slots.
47
Training, Education, and Clinicals in Health (TEACH) Funding Program
The TEACH Funding Program is created in SB 7016 (2024). The program is created to provide a high-
quality educational experience with “qualified facilities,” defined as federally qualified health centers,
community mental health centers, rural health clinics, and certified community behavioral health clinics.
The program does this by providing specific funding to offset the administrative costs and loss of
revenue associated with training residents and students to become licensed health care practitioners.
The program is intended to be used to support the state Medicaid program and underserved
populations by expanding the available health care workforce. The qualified facilities under TEACH that
operate residency programs may not be reimbursed more than $100,000 per fiscal year.
SB 7016 (2024) appropriates $25 million in recurring General Revenue to AHCA for the TEACH
Funding Program.
Behavioral Health Teaching Hospitals
43
The eight programs are the Statewide Medicaid Residency Program; the Startup Bonus Program; Teaching Hospitals with Highly
Specialized Tertiary Care; Full Time Equivalents in Primary Care in Specific Medicaid Regions; Funding for Residency, Fellow, or Intern
Positions to Address the Deficit in Mental and Behavioral Health Facilities; the Citrus Health Network for Psychiatry Residency Slots in
Federally Qualified Health Centers; Primary Care in Regions 1 and 2; and the Slots for Doctors Program. Florida Agency for Health
Care Administration, Florida Medicaid: Graduate Medical Education Overview (Presentation the Florida Senate Health Policy
Committee), (Nov. 14, 2023)
https://ahca.myflorida.com/content/download/23696/file/Graduate%20Medical%20Education%20Program%20Overview%20Final_.pdf
(last visited Feb. 12, 2024).
44
Ch. 23-243, Laws of Fla.; see also Florida House of Representatives, Staff Final Bill Analysis of 2023 Senate Bill 2510 (Jun. 19,
2023).
45
s. 409.909(6), F.S.
46
Id.
47
SB 2500 (2023), General Appropriations Act, Specific Appropriation 202; Bureau of Medicaid Program Finance, SFY 2023-24
Graduate Medical Education Slots for Docs Program Distribution, Agency for Healthcare Administration (Dec. 5, 2023)
https://ahca.myflorida.com/content/download/23699/file/SFY%2023-24%20GME%20S4D%20Model.pdf (last visited Feb. 10, 2024).
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To increase the overall supply of behavioral health professionals, some states may choose to act
through partnerships with educational institutions and residency programs.
48
These partnerships can
encourage students and early career professionals to practice in rural and underserved communities.
49
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.
50
McLean Hospital (Massachusetts) Model
A member of Mass General Brigham, McLean Hospital is an international mental health facility for
psychiatric treatment, education, and research.
51
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.
52
The U.S. News & World Report currently
ranks McLean Hospital as the country’s best hospital for psychiatry.
53
McLean Hospital, in partnership with Harvard Medical School, provides clinical supervision of the
following persons through residencies,
54
fellowships,
55
and other educational training programs
56
:
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.
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
48
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).
49
Id.
50
Commonwealth of Massachusetts Session Law 2023-28, Line Item 4000-0054,
https://malegislature.gov/Laws/SessionLaws/Acts/2023/Chapter28 (last visited Jan. 7, 2024).
51
Mass General Brigham, International Patient Care: About McLean Hospital, https://www.massgeneralbrigham.org/en/patient-
care/international/about/mclean (last visited Dec. 17, 2023).
52
Id.
53
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).
54
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.
55
McLean Hospital, Psychiatry Fellowships, https://www.mcleanhospital.org/training/psychiatry-fellowships (last visited Dec. 17, 2023).
56
McLean Hospital, Mental Health Clinical Pastoral Education Program, https://www.mcleanhospital.org/training/cpe (last visited Dec.
21, 2023).
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Legislature and the University of Washington School of Medicine partnered to pass House Bill 1593,
57
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.
58
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
59
serving both inpatient and outpatient needs, consultation
rooms to provide state-wide telepsychiatry consultation, and graduate medical education workspaces.
60
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.
61
In 2023, Florida appropriated $10,000,000 in nonrecurring General Revenue to establish Tampa
General Behavioral Health Hospital,
62
which is to be a new 96-bed inpatient behavioral health hospital
at TGH with the capacity to expand to 120 beds.
63
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.
64
University of Florida Health and the University of Florida
The University of Florida Health (UF Health) is an academic health center with main campuses in
Gainesville and Jacksonville and satellite sites in Jupiter, Leesburg, and The Villages. UF Health
encompasses two major teaching hospital systems, UF Health Shands in Gainesville and UF Health
Jacksonville. UF Health Shands in Gainesville is home to the UF Health Psychiatric Hospital. Overall,
UF Health fills over 1,500 slots for residencies and fellowships.
65
Both Gainesville and Jacksonville campuses of UF Health maintain psychiatry residency programs. UF
Health in Gainesville currently fills 43 psychiatry residency slots, and UF Health Jacksonville current fills
57
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).
58
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).
59
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).
60
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).
61
About Tampa General Hospital, Tampa General Hospital, https://www.tgh.org/about-tgh (last visited Dec. 21, 2023).
62
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).
63
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).
64
Id.
65
The University of Florida Health, UF Health Overview, (Oct. 10, 2022) https://ufhealth.org/assets/media/fact-sheets/2022-134782-UF-
Health-Overview-Fact-Sheet.pdf (last visited Feb. 13, 2024).
STORAGE NAME: h1617z.DOCX PAGE: 13
DATE: 3/22/2024
17 psychiatry residency slots.
66
In addition, the UF Health offers subspecialty psychiatry fellowships in
the areas of addiction medicine, child and adolescent psychiatry, community psychiatry (Jacksonville),
geriatric psychiatry, and neuromodulation.
67
Jackson Memorial Hospital and the University of Miami
Jackson Memorial Hospital, the centerpiece of the Jackson Health System in Miami, is an accredited,
non-profit, tertiary care hospital and the major teaching facility for the University of Miami Leonard M.
Miller School of Medicine. The primary training facility for the School of Medicine’s Department of
Psychiatry is Jackson Behavioral Health Hospital.
68
The Jackson Behavioral Health Hospital is
sponsored by Thriving Mind South Florida, the region’s Managing Entity, and DCF.
69
Jackson
Behavioral Health partners with Thriving Mind South Florida to develop discharge plans for patients,
arrange follow-up services, and coordinate care for high-utilizers of the emergency department.
70
The Jackson Health System’s 4-year psychiatry residency program trains 14-16 residents per class in
the areas of molecular neurobiology, genetics, brain imaging, epidemiology, pharmacogenomics,
psychopharmacology, and psychotherapy.
71
Jackson Health System currently fills 51 psychiatry and
behavioral sciences residents.
72
In addition, the Jackson Health System offers subspecialty psychiatry
fellowships in the areas of addiction psychiatry, child and adolescent psychiatry, consultation-liaison
psychiatry, forensic psychiatry, and geriatric psychiatry.
73
The Executive Office of Reimaging Education and Career Help
Section 14.36, F.S. authorizes the Governor's Office of Reimagining Education and Career Help to
facilitate coordination among the departments of Economic Opportunity and Education, and
CareerSource Florida, Inc., to develop and expand apprenticeship, pre-apprenticeship, and other work-
based learning models and streamline efforts to recruit and onboard new apprentices, pre-apprentices,
students, and employers. The office must also to develop criteria and display public information that will
assist the public in making informed decisions when deciding to access the local workforce board or
one-stop career center.
74
Effect of the Bill
Behavioral Health Teaching Hospitals
The bill creates the behavioral health teaching hospital program within AHCA for Florida-based
hospitals to establish a nationally acclaimed behavioral health system of care and to fund both
behavioral health GME and hospital workforce projects. The goal of the program is to increase the size
66
The University of Florida Health, UF Psychiatry Residency: Current Residents, https://psychiatry.ufl.edu/training/residency/current-
residents-2/ (last visited Feb. 13, 2024); The University of Florida Health, UF Jacksonville Psychiatry Residency: Current Residents,
https://psychiatry.med.jax.ufl.edu/psychiatry-residency/residents/ (last visited Feb. 13, 2024).
67
The University of Florida College of Medicine, Department of Psychiatry: Fellowship Programs,
https://psychiatry.ufl.edu/training/fellowships/ (last visited Feb. 13, 2024).
68
The University of Miami Leonard M. Miller School of Medicine, Teaching Hospitals: Psychiatry & Behavioral Sciences,
https://med.miami.edu/departments/psychiatry/education/graduate-medical-education/teaching-hospitals (last visited Feb. 13, 2024).
69
Jackson Health System, Jackson Behavioral Health Hospital, https://jacksonhealth.org/locations/jackson-behavioral-health-hospital/
(last visited Feb. 13, 2024).
70
Jackson Health System, Behavioral Health and Psychiatry, https://jacksonhealth.org/services/mental-behavioral-health/ (last visited
Feb. 13, 2024).
71
Jackson Health System, Graduate Medical Education: Psychiatry Residency, https://graduate.jacksonhealth.org/program/psychiatry/
(last visited Feb. 13, 2024).
72
The University of Miami Leonard M. Miller School of Medicine, Current Residents: Psychiatry & Behavioral Sciences,
https://med.miami.edu/departments/psychiatry/education/graduate-medical-education/current-residents (last visited Feb. 13, 2024).
73
Jackson Health System, Graduate Medical Education: Programs, https://graduate.jacksonhealth.org/programs/ (last visited Feb. 13,
2024).
74
s. 14.35, F.S.; Office of Program Policy Analysis and Government Accountability, Executive Office of the Governor: Updates,
https://oppaga.fl.gov/ProgramSummary/ProgramDetail?programNumber=6105 (last visited Feb. 23, 2024)
STORAGE NAME: h1617z.DOCX PAGE: 14
DATE: 3/22/2024
and quality of the state’s behavioral health workforce and to close the supply-and-demand gap in the
state’s behavioral health care sector.
Designation Criteria
Within 30 days after the act becomes law, AHCA must designate the following four hospitals as
behavioral health teaching hospitals:
Tampa General Hospital, in affiliation with USF.
UF Health Shands Hospital, in affiliation with the University of Florida.
UF Health Jacksonville, in affiliation with the University of Florida.
Jackson Memorial Hospital, in affiliation with the University of Miami.
Within 90 days after receiving the behavioral health teaching hospital designation, each of these four
hospitals, and all future behavioral teaching hospitals, must meet the following standards established
by the bill.
Operate as a teaching hospital, as defined in s. 408.07, F.S.;
75
Offer a psychiatric residency program accredited through the Residency Review Committee of
the Accreditation Council of Graduate Medical Education;
Offer, or have filed an application for approval to establish, an accredited postdoctoral clinical
psychology fellowship program;
Provide behavioral health services;
Establish and maintain an affiliation with a Florida-based university with one of the accredited
Florida-based medical schools listed
76
under s. 458.3145(1)(i)1.-6., 8., or 10., to create and
maintain integrated workforce development programs for students of the university’s colleges
and schools of medicine, nursing, psychology, social work, and public health related to the
entire continuum of behavioral health;
Develop a plan to create and maintain integrated workforce development programs with the
affiliated university’s colleges or schools and to supervise clinical care provided by students
participating in those programs.
Beginning on July 1, 2025, the bill authorizes any Florida-licensed hospital desiring designation as a
behavioral health teaching hospital to apply with AHCA. Ahead of Fiscal Year (FY) 2025-2026, a first
time applicant for the designation must submit a letter of intent to AHCA on or before January 1, 2025.
Ahead of FY 2026-27, a first time applicant for the designation must submit a letter of intent to AHCA
on or before January 1, 2026. These letters of intent will help AHCA develop a preliminary financial plan
for allocating available grant funds during a fiscal year.
The same rights and obligations created under the behavioral health teaching hospital program for the
first four statutorily designated behavioral health teaching hospitals also apply to all future designated
behavioral health teaching hospitals. Except for the University of Florida’s affiliation with UF Health
Shands and UF Health Jacksonville, a university may only affiliate with one behavioral health teaching
hospital.
The two differences between the first four designated hospitals and all future designated hospitals are
that the bill exempts the first four hospitals from the application process and affords the first four
75
“A ‘Teaching hospital’ means any Florida hospital officially affiliated with an accredited Florida medical school which exhibits activity
in the area of graduate medical education as reflected by at least seven different graduate medical education programs accredited by
the Accreditation Council for Graduate Medical Education or the Council on Postdoctoral Training of the American Osteopathic
Association and the presence of 100 or more full-time equivalent resident physicians. The Director of the Agency for Health Care
Administration shall be responsible for determining which hospitals meet this definition.” s. 408.07(46), F.S.
76
The eligible medical schools are those at the University of Florida, University of Miami, University of South Florida, Florida State
University, Florida International University, University of Central Florida, Florida Atlantic University, and Nova Southeastern University.
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hospitals a one-year head start in the behavioral health teaching hospital program, which is significant
for appropriations purposes.
Maintaining the Designation
Once AHCA approves a hospital’s application and designates it as a behavioral health teaching
hospital, the bill requires the hospital to maintain the designation by performing three tasks.
First, within 90 days after designation, the hospital must establish two agreements. The bill requires the
hospital to develop and maintain a consultation agreement with the Florida Center for Behavioral Health
Workforce (Center) within the Louis de la Parte Florida Mental Health Institute at USF. The bill requires
the consultation agreement to establish best practices related to integrated workforce development
programs for the behavioral health professions, a term which the bill defines. Then, the hospital must
enter into an agreement with DCF to provide state treatment facility beds, as DCF finds necessary.
Second, designated behavioral health teaching hospitals must also collaborate with DCF and the
regional managing entities to identify gaps in the regional continuum of behavioral health care that are
appropriate for the hospital to address, either independently or in collaboration with other organizations
providing behavioral health services. The collaboration must focus on gaps that facilitate the
implementation of the hospital’s integrated workforce development plan.
Third, each designated behavioral health teaching hospital must also provide data related to the
hospital’s integrated workforce development programs and the services provided and determined by
ACHA, DCF, or the Executive Office of Reimaging Education and Career Help.
The bill establishes a two-year term for the behavioral health teaching hospital designation. If a Florida-
licensed hospital elects to renew the designation, the bill requires the hospital to apply for renewal to
AHCA at least 90 days prior to the two-year expiration date of the designation. The bill subjects the
renewal process to the time periods and tolling provisions of the Florida Administrative Procedure Act to
prevent a hospital from losing a designation at no fault of its own.
The bill authorizes AHCA to deny, revoke, or suspend a hospital’s designation as a behavioral health
teaching hospital if the hospital fails to comply with the statutory requirements to keep the designation.
In this way, AHCA can build the credibility of, and preserve the integrity of, the behavioral health
teaching hospital program.
Incentives
Slots for Doctors Program
Once AHCA designates a Florida-licensed hospital as a behavioral health teaching hospital, the bill
requires AHCA to award funding, subject to legislative appropriation, to the behavioral health teaching
hospital for up to 10 newly created resident positions through the Slots for Doctors Program at
$150,000 per slot. For FY 2024-25, the bill appropriates $6 million in recurring funds for the first four
designated behavioral health teaching hospitals to establish these residencies.
Effective July 1, 2025, the bill adds designated behavioral health teaching hospitals to the entities
permanently eligible for GME funding in the Slots for Doctors Program in s. 409.909(6), F.S.
Training, Education, and Clinicals in Health (TEACH) Funding Program
Once AHCA designates a Florida-licensed hospital as a behavioral health teaching hospital, the bill
also requires AHCA to award TEACH funding, subject to legislative appropriation, to the behavioral
health teaching hospital to offset a portion of the costs of maintaining integrated workforce development
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programs. For FY 2024-25, the bill appropriates $2 million in recurring funds for this purpose at the first
four designated behavioral health teaching hospitals.
Grant Program
The bill establishes a competitive grant program, subject to legislative appropriation, exclusively for the
benefit of designated behavioral health teaching hospitals. The bill requires AHCA to hold an annual
open application period to receive special project requests from the designated behavioral health
teaching hospitals. The bill authorizes grant funding to be used for operations, expenses, and fixed
capital outlay projects (e.g., facility building, renovations, and upgrades). The bill requires each grant
applicant to include a detailed spending plan with its application.
The bill requires AHCA, in consultation with DCF, to evaluate, rank, and recommend the applications
for grant funding based on the quality of the hospital’s plan to create and maintain integrated workforce
development programs with the affiliated university’s colleges or schools and to supervise clinical care
provided by students participating in those programs and the hospital’s implementation of that plan.
Once AHCA evaluates, ranks, and recommends the applications for grant funding, the bill requires
AHCA to submit the evaluation and grant award recommendations to the President of the Senate and
the Speaker of the House of Representatives within 90 days after the close of the open application
period.
To issue the grant awards, AHCA must submit budget amendments for legislative approval.
77
The bill
authorizes AHCA to submit budget amendments relating to capital improvement projects under the
grant program only within 90 days after the close of the open application period. The bill authorizes a
maximum carry forward period of 8 years for unspent, appropriated general revenue funds for which a
contract exists to spend grant funds or for which a commitment exists to spend grant funds by end of
the state fiscal year (June 30) in which the Legislature appropriated the grant funds.
78, 79
For FY 2024-25, the bill appropriates $300 million in nonrecurring funds for the grant program, for use
in $100 million increments over the next three fiscal years. Since AHCA cannot designate future
behavioral health teaching hospitals during FY 2024-25, the four statutorily designated behavioral
health teaching hospitals will have exclusive access to the first $100 million increment.
Reporting
The bill requires each designated behavioral health teaching hospital to annually report to AHCA and
DCF the current status of the designated behavioral health teaching hospital program. The bill requires
the annual report, due by each December 1, to address at a minimum the following quantitative and
qualitative information.
The number of psychiatric residents.
The number of postdoctoral clinical psychology fellows.
The status and details of the consultation agreement with the Center.
The implementation status of the hospital’s plan to:
o Create and maintain integrated workforce development programs with the affiliated
university’s colleges or schools; and
o Supervise clinical care provided by students participating in those programs.
77
The bill exempts AHCA from current statutory limitations on the use of budget amendments in ss. 216.177, 216.181, and 216.292,
F.S., to accomplish the bill’s purpose.
78
The bill exempts AHCA from current statutory limitations relating to unspent balances of appropriated funds in s. 216.301, F.S., to
accomplish the bill’s purpose.
79
The bill incorporates by express reference s. 216.351, F.S., to accomplish the bill’s purpose.
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The activities, agreements, and accomplishments of the collaboration with DCF and the regional
managing entities to identify and address gaps in the regional continuum of behavioral health
care.
The number of bed days and patients served at the hospital as DCF state treatment facility
beds.
The bill authorizes AHCA to adopt rules necessary to implement all the facets of the designated
behavioral health teaching hospital program.
Mental Health Safety Net Services
The Louis de la Parte Florida Mental Health Institute at the University of South Florida
The bill creates the Florida Center for Behavioral Health Workforce (Center) within the Louis de la Parte
Florida Mental Health Institute at USF. The bill establishes the Center to support an adequate, highly
skilled, resilient, and innovative workforce that meets the current and future human resources needs of
the state’s behavioral health system in order to provide high-quality care, services, and supports to
Floridians with, or at risk of developing, behavioral health conditions. To this end, the bill authorizes the
Center to perform original research, policy analysis, and evaluation and to develop and share best
practices.
For FY 2024-25, the bill appropriates $5 million in recurring funds to operate the Center.
Goals of the Center
The bill creates three primary goals for the Center. The first goal relates to researching the state’s
current behavioral health workforce and future needs. The second goal relates to expanding the
number of clinicians, professionals, and other workers involved in the behavioral health workforce. The
third goal relates to enhancing the skill level and innovativeness of the workforce.
To advance these goals, the bill requires the Center to perform at least three duties.
Duties
First, the Center must describe and analyze the current workforce and project possible future workforce
demand, especially in critical roles, and develop strategies for addressing any gaps. As a means to this
end, the bill authorizes the Center to produce a statistically valid biennial analysis of the supply and
demand of the behavioral health workforce.
Second, the Center must work to expand pathways to behavioral health professions through enhanced
educational opportunities and improved faculty development and retention. In furtherance of this duty,
the bill authorizes the Center to:
Identify best practices in the academic preparation and continuing education of behavioral
health professionals.
Facilitate and coordinating the development of academic-practice partnerships that support
behavioral health faculty employment and advancement.
Develop and implement innovative projects to support the recruitment, development, and
retention of behavioral health educators, faculty, and clinical preceptors.
Develop distance learning infrastructure for behavioral health education and the evidence-based
use of technology, simulation, and distance learning techniques.
Third, the Center must promote the behavioral health professions. To this end, the bill authorizes the
Center to conduct original research on the factors affecting recruitment, retention, and advancement of
the behavioral health workforce, such as by designing and implementing a longitudinal study of the
STORAGE NAME: h1617z.DOCX PAGE: 18
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state's behavioral health workforce. In addition, the Center may develop and implement innovative
projects to support the recruitment, development, and retention of behavioral health workers.
The bill authorizes the Center to host conventions to assist the Center in fulfilling its purpose and
accomplishing its goals. Concerning presenters and attendees, the bill advises the Center to convene
at least:
Behavioral health clinicians, professionals, and workers.
Employers of behavioral health clinicians, professionals, and workers.
Non-behavioral health care providers.
Individuals experiencing behavioral health conditions, and their families.
Leaders of business and industry.
Policymakers.
Educators.
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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.
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,
and the report submitted in 2025 must include an initial statewide strategic plan for meeting the goals of
the Center. The bill requires the Center to update its initial statewide strategic plan for each subsequent
annual report.
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 as
soon as practicable.
Inpatient Services Capacity Study
The bill requires DCF to contract with a vendor to study the state’s supply-and-demand relationship
concerning involuntary inpatient services and to offer recommendations for enhancing the availability
for inpatient treatment services and for providing alternatives to such services. At a minimum, the bill
requires the study to accomplish the following:
Describe, by facility and by program type:
o The current number and allocation of beds for inpatient treatment between forensic and
civil placements.
o The number of individuals admitted and discharged annually.
o The lengths of stay.
Describe, by department region:
o The current number and allocation of beds in receiving, treatment, and state treatment
facilities and residential treatment centers for children and adolescents for inpatient
treatment between forensic and civil placements.
o The number of individuals admitted and discharged annually.
o The types and frequencies of diagnoses.
o The lengths of stay.
o The current and projected future demand for civil and forensic inpatient placements at
receiving, treatment, and state treatment facilities and residential treatment centers for
children and adolescents.
o Any gaps in the current and projected future availability of inpatient placements
compared to current and projected future service demand.
o The number of inpatient beds needed by facility type and placement type to meet current
and projected future demand.
Describe, by agency region:
o The number of individuals admitted and discharged annually.
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o The types and frequencies of diagnoses.
o The lengths of stay for Medicaid statewide inpatient psychiatric program services.
o The current and projected future demand for services.
o Any gaps in the current and projected future availability of services compared to current
and projected future service demand.
o The number of inpatient beds needed by facility type and placement type to meet current
and projected future demand.
Specify policy recommendations for:
o Ensuring sufficient bed capacity for inpatient treatment at treatment facilities, state
treatment facilities, and receiving facilities.
o Ensuring sufficient bed capacity at residential treatment centers for children and
adolescents.
o Enhancing preventative services to mitigate involuntary inpatient placements.
In addition, the study must include the gap analysis recommended by the Commission on Mental
Health and Substance Use Disorder in the annual interim report dated January 1, 2024.
The bill was approved by the Governor on March 21, 2024, ch. 2024-12, L.O.F., and will become
effective on July 1, 2024; except for provisions related to the DCF study which are effective upon the
act becoming law, and amendments to s. 409.909, F.S., related to the Slots for Doctors Program which
are effective July 1, 2025.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
For FY 2024-25, the bill appropriates:
$300 million in nonrecurring funds for the grant program, for use in $100 million increments
over the next three fiscal years;
$6 million in recurring funds for residencies through the Slots for Doctors Program at
$150,000 per each newly created residency position, for the first four designated behavioral
health teaching hospitals;
$2 million in recurring funds for workforce development programs through the TEACH
Funding Program, for the first four designated behavioral health teaching hospitals; and
$5 million in recurring funds to operate the Center.
AHCA will need to dedicate staff to organize, implement, and regulate the new behavioral health
teaching hospital program. Without an appropriation set apart for these purposes in the bill, AHCA
will have to absorb the cost of establishing this program with existing resources.
DCF must contract for the comprehensive, systematic study of the behavioral health supply-and-
demand relationship in Florida. DCF can absorb the cost of the study within existing contracted
services funds.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
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None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
As AHCA designates Florida-based hospitals as behavioral health teaching hospitals, each designated
hospital will receive financial awards and access grant funding to develop the behavioral health
professions in Florida.
D. FISCAL COMMENTS:
None.