Florida 2025 2025 Regular Session

Florida Senate Bill S1240 Analysis / Analysis

Filed 03/18/2025

                    The Florida Senate 
BILL ANALYSIS AND FISCAL IMPACT STATEMENT 
(This document is based on the provisions contained in the legislation as of the latest date listed below.) 
Prepared By: The Professional Staff of the Committee on Children, Families, and Elder Affairs  
 
BILL: SB 1240 
INTRODUCER:  Senator Calatayud 
SUBJECT:  Substance Abuse and Mental Health Care 
DATE: March 18, 2025 
 
 ANALYST STAFF DIRECTOR  REFERENCE  	ACTION 
1. Kennedy Tuszynski CF Pre-meeting 
2.     AHS   
3.     RC  
 
I. Summary: 
SB 1240 integrates the 988 Suicide and Crisis Lifeline Call Center into the state mental health 
crisis response network. The bill requires the Florida Department of Children and Families 
(DCF) to authorize, regulate, and oversee 988 call centers.  
 
The bill removes the “needs assessment” requirement for licensure of medication-assisted 
treatment (MAT) programs for opioid addiction. 
 
The bill establishes enhanced training standards for mental health professionals conducting 
forensic evaluations, emphasizing competency restoration, evidence-based practices, and 
placement alternatives to ensure consistent and effective forensic evaluations. The bill requires 
court-appointed mental health experts performing forensic evaluations to complete DCF-
approved forensic training and ongoing education. The bill also requires mental health 
professionals to assess the availability of community-based treatment before recommending 
involuntary hospitalization.  
 
The bill does not have a fiscal impact on state government or the private sector. See Section V. 
Fiscal Impact Statement. 
 
The bill takes effect July 1, 2025. 
II. Present Situation: 
The present situation for each issue is described below in Section III, Effect of Proposed 
Changes. 
REVISED:   BILL: SB 1240   	Page 2 
 
III. Effect of Proposed Changes: 
SB 1240 makes changes to Florida’s mental health and substance abuse care systems of care by 
integrating crisis services, expanding treatment accessibility, and strengthening provider 
oversight. The bill improves response times for mental health emergencies, streamlines 
treatment, and enhances training for behavioral health professionals. 
 
Background 
Mental Health and Mental Illness 
Mental health is a state of well-being in which the individual realizes his or her own abilities, can 
cope with the normal stresses of life, can work productively and fruitfully, and is able to 
contribute to his or her community.
1
 The primary indicators used to evaluate an individual’s 
mental health are:
2
 
• Emotional well-being- Perceived life satisfaction, happiness, cheerfulness, peacefulness; 
• Psychological well-being- Self-acceptance, personal growth including openness to new  
• experiences, optimism, hopefulness, purpose in life, control of one’s environment, 
spirituality,  
• Self-direction, and positive relationships; and  
• Social well-being- Social acceptance, beliefs in the potential of people and society as a 
whole,  
• Personal self-worth and usefulness to society, sense of community. 
 
Mental illness is collectively all diagnosable mental disorders or health conditions that are 
characterized by alterations in thinking, mood, or behavior (or some combination thereof) 
associated with distress or impaired functioning.
3
 Thus, mental health refers to an individual’s 
mental state of well-being whereas mental illness signifies an alteration of that well-being. 
Mental illness affects millions of people in the United States each year. Nearly one in five adults 
lives with a mental illness.
4
 During childhood and adolescence, almost half of children will 
experience a mental disorder, though the proportion experiencing severe impairment during 
childhood and adolescence is lower, at about 22%.
5
 
 
Florida Mental Health and Substance Abuse Services Acts 
The Department of Children and Families (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.
6
 The DCF is charged with 
providing a coordinated system of care, to serves as a “no-wrong-door model” that provides a 
 
1
 World Health Organization, Mental Health: Concepts in Mental Health, available at: https://www.who.int/news-room/fact-
sheets/detail/mental-health-strengthening-our-response (last visited 3/7/25). 
2
 Centers for Disease Control and Prevention, Mental Health Basics, available at: http://medbox.iiab.me/modules/en-
cdc/www.cdc.gov/mentalhealth/basics.htm (last visited 3/7/25).  
3
 Id. 
4
 National Institute of Mental Health (NIHM), Mental Illness, available at: https://www.nimh.nih.gov/health/statistics/mental-
illness (last visited 3/7/25). 
5
 Id. 
6
 See generally, Part I, Ch. 394, F.S., and Ch. 397, F.S.  BILL: SB 1240   	Page 3 
 
fully array of behavioral health services from front end crisis intervention through long-term 
recovery services, including a range of prevention, acute interventions (e.g. crisis stabilization), 
residential treatment, transitional housing, outpatient treatment, and recovery support services.
7
 
 
988 Suicide and Crisis Lifeline 
Present Situation 
The 988 Suicide & Crisis Lifeline is the United States’ three-digit telephone number for mental 
health crises, providing connection to free and confidential emotional support 24/7.
8
 Launched 
nationally on July 16, 2022, 988 was established by federal law as an easy-to-remember 
alternative to the 10-digit National Suicide Prevention Lifeline.
9
 By dialing 988 (or texting 988, 
or using the web chat), callers in distress are routed to one of over 200 local crisis centers 
nationwide, where trained crisis counselors provide immediate counseling, support, and referrals 
to resources.
10
 By May 2024, nearly two years post-launch, the Lifeline had fielded 10.8 million 
total interactions, comprising roughly 6.4 million calls, 1.6 million chats, and 1.6 million texts.
11
  
 
Florida has also experienced growth in the 988 program. Since launching in July 2022, the 988 
Lifeline has connected 95,672 individuals to mental health or related services and offered 
telephone-based support to 398,939 people across Florida.
12
 The Florida 988 program is funded 
through a federal discretionary grant that will end in September of 2026; the DCF intends to 
become one of the first states to fully fund and operate their in-state 988 network without the 
need for federal discretionary grant funding.
13
 The 988 network ensures individuals have 
immediate access to trained professionals through a centralized helpline which ultimately 
reduces dependence on 911 and law enforcement for mental health emergencies. 
 
Effect of Proposed Changes 
Section 1 of the bill amends s. 394.4573, F.S., to add the 988 Suicide and Crisis Lifeline Call 
Center as a statutorily required part of the state’s crisis response as part of the coordinated 
system of care. This change places duty of regulation and assessment of the 988 Suicide Crisis 
Lifeline with the DCF. 
 
 
7
 See s. 394.4573, F.S. 
8
 988 Suicide & Crisis Lifeline, The Lifeline and 988, available at: https://988lifeline.org/current-events/the-lifeline-and-
988/#:~:text=On%20July%2016%2C%202022%2C%20the,Vibrant (last visited 3/7/25).  
9
 KFF, One Year After the Launch of 988, the National Suicide and Crisis Hotline Has Received Nearly 5 Million Combined 
Calls, Texts, and Chats, Available at: https://www.kff.org/mental-health/press-release/one-year-after-the-launch-of-988-the-
national-suicide-and-crisis-hotline-has-received-nearly-5-million-combined-calls-texts-and-
chats/#:~:text=Overall%2C%20the%20988%20line%20steers,mental%20health%20crisis%20to%20recall (last visited 
3/7/25). 
10
 988 Suicide & Crisis Lifeline, The Lifeline and 988, available at: https://988lifeline.org/current-events/the-lifeline-and-
988/#:~:text=On%20July%2016%2C%202022%2C%20the,Vibrant (last visited 3/7/25). 
11
 KFF, 988 Suicide & Crisis Lifeline: Two Years After Launch, available at: https://www.kff.org/mental-health/issue-
brief/988-suicide-crisis-lifeline-two-years-after-
launch/#:~:text=Since%20launch%20in%20July%202022%2C,third%20of%20total%20contacts%2C%20accounting (last 
visited 3/7/25).  
12
 Florida Department of Children and Families, 2025 Agency Analysis, p. 2 (on file with the Children, Families, and Elder 
Affairs Committee). 
13
 Id.   BILL: SB 1240   	Page 4 
 
Section 2 amends s. 394.67, F.S., to define “988 suicide and crisis lifeline call center” to mean a 
call center that meets national accreditation and recognized by the DCF to receive 988 calls, 
texts, or other forms of communication. The bill also adds the 988 suicide and crisis lifeline call 
center to the definition of “crisis services.” These changes integrate the role of 988 centers into 
the state’s behavioral health system, specifically as a crisis response service. 
 
Section 3 creates s. 394.9088, F.S., to require the DCF to authorize and provide oversight to the 
988 network crisis call centers. The bill prohibits 988 services to be provided by non-authorized 
call centers. The bill allows the DCF to ensure compliance with state and federal crisis response 
standards, improving service quality, and establishing a framework for coordination between 988 
and 911 emergency services. 
 
Medication-Assisted Treatment (MAT) Needs Assessment 
Present Situation 
Medication-Assisted Treatment (MAT) for opioid use disorders is a service that uses methadone 
or other medication as authorized by state and federal law, in combination with medical, 
rehabilitative, supportive, and counseling services in the treatment of individuals who are 
dependent on opioid drugs.
14
 This integrated approach aims to provide a whole-patient treatment 
strategy.
15
 Medications commonly used in MAT include methadone, buprenorphine, and 
naltrexone, which work by reducing cravings, alleviating withdrawal symptoms, and blocking 
the euphoric effects of substances.
16
 
 
Current law requires the DCF to determine the need for new MAT providers in the state.
17
 This 
requirement does not allow opioid treatment programs (OTPs) or methadone clinics to open 
freely at will; instead, new clinics can only be established if the DCF finds there is an unmet 
need in a region for additional services.
18
 This needs-based licensure process serves as a state-
level control on the number and location of MAT clinics.  
 
Florida currently has 72 operational MAT clinics, collectively assisting nearly 22,000 clients 
statewide.
19
 However, under the current federal methodology, three needs assessments have been 
conducted since FY 2018/2019, and none have identified a statewide need for additional 
facilities. The Department lacks the flexibility to grant licenses outside of the annual need 
determination process, even in urgent situations such as the closure of the only clinic in a given 
area.
20
 
 
14
 Section 397.311,7 
15
 Florida Department of Health – Palm Beach County, Medication Assisted Treatment (MAT), 
https://palmbeach.floridahealth.gov/programs-and-services/OD2A/_documents/Fact-Sheet-Medication-Assisted-
Treatment.pdf (last visited March 17, 2025) 
16
 Substance Abuse and Mental Health Services Administration, Find Substance Use Disorder Treatment, available at 
https://www.samhsa.gov/substance-use/treatment/find-treatment (last visited March 17, 2025); Addiction Group, What is 
Medication-Assisted Treatment (MAT), available at https://www.addictiongroup.org/treatment/therapies/mat/ (last visited 
March 17, 2025) 
17
 Section 397.427, F.S. 
18
 Id.  
19
 Florida Department of Children and Families, 2025 Agency Analysis, pg.2 (on file with the Children, Families, and Elder 
Affairs Committee). 
20
 Id.   BILL: SB 1240   	Page 5 
 
 
The federal algorithm presents additional challenges in addressing the needs of jail-based and 
rural populations. Current law does not exempt agencies that serve specific, limited groups, such 
as jails, prisons, and federally qualified health centers.
21
 Providing these facilities with the 
flexibility to offer services as needed would improve access to care for those specialized 
populations. 
 
Effect of Proposed Changes 
Section 4 of the bill deletes s. 397.427(2) and amends s. 397.427(4), F.S., removing the 
requirement that the DCF must determine the need for establishing MAT programs. Removing 
the requirement for new providers to demonstrate community need fosters the expansion of 
MAT services, increasing access to treatment, especially within rural communities. 
 
Forensic Evaluators 
Present Situation 
Chapter 916, F.S., establishes the Forensic Client Services Act detailing the framework for 
addressing mental health issues within the state’s criminal justice system, specifically requiring 
the DCF to establish, locate, and maintain facilities and programs for the treatment or training of 
defendants who have been charged with a felony and who have been found to be incompetent to 
proceed in the legal system due to mental illness.
22
 The law guides how courts appoint mental 
health experts, assess a defendant’s competency to stand trial, and manage individuals found not 
guilty by reason of insanity.  
 
Mental health evaluations ensure that defendants with mental health conditions receive proper 
assessment and treatment. Courts appoint licensed psychiatrists, psychologists, or physicians to 
determine a defendant’s competency, sanity, or need for involuntary treatment.
23
 These 
professionals have specific forensic training and a one-time class from the DCF. These 
evaluations, conducted in jails, forensic centers, or medical facilities, help courts decide whether 
a defendant can stand trial or requires hospitalization. If deemed incompetent, individuals may 
be committed to a DCF facility for treatment until they can participate in legal proceedings or, if 
their behavior is non-threatening, may be released under supervision.
24
  
 
Defendants found not guilty by reason of insanity may be involuntarily committed if they pose a 
danger to themselves or others.
25
 Placement in a State Mental Health Treatment Facility 
(SMHTF) ensures access to necessary treatment while maintaining public safety. Regular 
evaluations determine whether continued hospitalization is required or if a supervised release 
plan is appropriate. Mental health professionals conduct these assessments, provide expert 
testimony, and oversee treatment, helping courts balance the needs of individuals with mental 
illness against legal and public safety concerns.
26
 
 
21
 Id.  
22
 Chapter 916, F.S. 
23
 Section s. 916.11, F.S.  
24
 Section 916.12, F.S. 
25
 Section 916.15, F.S.  
26
 Id.   BILL: SB 1240   	Page 6 
 
 
Florida faces growing challenges with increasing referrals to the SMHTFs from courts and 
forensic hospital beds occupancy rates are above 97%. These challenges delay care and leave 
individuals in jail awaiting inpatient services. With 462 people on the waitlist and 333 waiting 
more than 15 days, the backlog continues to strain the system.
27
 However, many of these 
individuals could be restored to competency through less restrictive alternatives, reducing the 
need for full hospitalization in an SMHTF. Court decisions on commitment orders are heavily 
influenced by evaluators’ findings and recommendations, which help determine the most 
appropriate treatment setting.
28
 
 
In 2023, changes to Chapter 916, F.S., introduced a requirement for expert evaluators and courts 
to assess alternative treatment options before committing a defendant to a SMHTF. Evaluators 
are expected to provide a comprehensive report on available alternatives, including a thorough 
justification if those options are deemed inadequate.
29
 Evaluators must consider a list of 
minimum alternative treatment options before ordering a defendant to be placed in a treatment 
facility. Experts must also report on the appropriateness of the following community-based 
options for treating and supporting the recovery of a patient:
30
 
• Mental health services; 
• Treatment services; 
• Rehabilitative services; 
• Support services; and 
• Case management services as those terms are defined in s. 394.67(16), F.S., which may be 
provided by or within: 
o Multidisciplinary community treatment teams; 
o Community treatment teams, such as Florida Assertive Community Treatment (FACT)   
teams; 
o Conditional release programs; 
o Outpatient services or intensive outpatient treatment programs; and 
o Supportive employment and supportive housing opportunities.
31
 
 
However, the implementation of this requirement has not been consistent statewide. Without a 
legal requirement for forensic evaluators to participate in ongoing training, evaluators lack 
critical updates on new or revised statutes, alternative placements, and least restrictive options.
32
 
 
Effect of Proposed Changes 
Section 5 amends s. 916.111, F.S., to update training requirements for mental health 
professionals conducting forensic evaluations, to require training on statutes and rules related to 
competency restoration, evidence-based practices, and least restrictive treatment alternatives and 
 
27
 Florida Department of Children and Families, 2025 Agency Analysis, p. 3 (on file with the Children, Families, and Elder 
Affairs Committee). 
28
 Id. 
29
 Id.  
30
 Section 916.12, F.S. 
31
 Section 394.67, F.S. 
32
 Id.  BILL: SB 1240   	Page 7 
 
placements. This change will require provided trainings to be more accurate, aligned with current 
law, and produce more standardized evaluations in legal proceedings. 
 
Section 6 amends s. 916.115, F.S., to require court-appointed mental health experts to complete 
both an initial and ongoing DCF-approved forensic training. The bill requires those experts 
performing juvenile evaluations to complete annual juvenile forensic competency evaluation 
training. The bill also requires all current expert evaluators to complete the newly created DCF-
provided continuing education for experts by July 1, 2026 to remain an active evaluator.  
 
These changes are intended to increase the training for expert forensic evaluators to increase the 
consistency of evaluations and ultimately improve judicial decision-making in criminal cases 
involving defendants with mental illness. 
 
Section 7 amends s. 916.12, F.S., to require mental health evaluators to assess whether less 
restrictive treatment alternatives are available in the community and acceptable. The bill requires 
this assessment to involve current resources and information, to include the ongoing DCF-
approved training required under the bill’s language. This change is intended to ensure 
individuals receive care in the least restrictive setting possible, reducing unnecessary 
institutionalization. 
 
Section 8 and Section 9 are conforming cross-reference changes.  
 
Section 10 of the bill provides an effective date of July 1, 2025.  
IV. Constitutional Issues: 
A. Municipality/County Mandates Restrictions: 
None. 
B. Public Records/Open Meetings Issues: 
None. 
C. Trust Funds Restrictions: 
None. 
D. State Tax or Fee Increases: 
None. 
E. Other Constitutional Issues: 
None identified.  BILL: SB 1240   	Page 8 
 
V. Fiscal Impact Statement: 
A. Tax/Fee Issues: 
None. 
B. Private Sector Impact: 
None. 
C. Government Sector Impact: 
None. 
VI. Technical Deficiencies: 
None. 
VII. Related Issues: 
None. 
VIII. Statutes Affected: 
This bill amends the following sections of the Florida Statutes: 394.4573, 394.67, 397.427, 
916.111, 916.115, 916.12, 394.674, and 394.74. 
 
This bill creates s. 394.9088 of the Florida Statutes. 
IX. Additional Information: 
A. Committee Substitute – Statement of Changes: 
(Summarizing differences between the Committee Substitute and the prior version of the bill.) 
None. 
B. Amendments: 
None. 
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.