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: CS/SB 1240
INTRODUCER: Children, Families, and Elder Affairs Committee and Senator Calatayud
SUBJECT: Substance Abuse and Mental Health Care
DATE: March 20, 2025
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Kennedy Tuszynski CF Fav/CS
2. AHS
3. RC
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
CS/SB 1240 integrates the 988 Suicide and Crisis Lifeline Call Center into the state mental
health crisis response network and requires the Florida Department of Children and Families 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.
REVISED: BILL: CS/SB 1240 Page 2
II. Present Situation:
The present situation for each issue is described below in Section III, Effect of Proposed
Changes.
III. Effect of Proposed Changes:
CS/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
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. BILL: CS/SB 1240 Page 3
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
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 is available
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.
6
See generally, Part I, Ch. 394, F.S., and Ch. 397, F.S.
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: CS/SB 1240 Page 4
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.
Section 6 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 7 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.
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. BILL: CS/SB 1240 Page 5
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
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 8 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
19
Florida Department of Children and Families, 2025 Agency Analysis, pg.2 (on file with the Children, Families, and Elder
Affairs Committee).
20
Id.
21
Id.
22
Chapter 916, F.S.
23
Section s. 916.11, F.S.
24
Section 916.12, F.S. BILL: CS/SB 1240 Page 6
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
Florida faces growing challenges with increasing referrals to the SMHTFs from courts and
forensic hospital bed occupancy rates 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 a 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
25
Section 916.15, F.S.
26
Id.
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. BILL: CS/SB 1240 Page 7
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 10 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
placements. This change will require provided trainings to be more accurate, aligned with current
law, and produce more standardized evaluations in legal proceedings.
Section 11 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 improve the
consistency of evaluations and ultimately the judicial decision-making in criminal cases
involving defendants with mental illness.
Section 12 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.
Conforming Language and Cross-Reference Changes to Align with 2024 Legislation
Present Situation
A number of significant bills were introduced and passed during the 2024 legislative session.
CS/SB 7016 was the flagship of the 2024 “Live Healthy” initiative. The bill revised preexisting
health care programs, created new programs, revised licensure and regulatory requirements for
health care practitioners and facilities, created new provisions within programs relating to health
care practitioner education, amended the state Medicaid program, and appropriated both general
revenue and trust fund dollars for the purpose of growing Florida’s health care workforce and
increasing access to health care services.
CS/CS/HB 7021 made substantive changes to both Florida’s Baker and Marchman Acts by
combining processes for courts to order individuals to involuntary outpatient services and
involuntary inpatient placement in the Baker Act. This bill streamlined the process for obtaining
involuntary services, and provided more flexibility for courts to meet individuals’ treatment
32
Id. BILL: CS/SB 1240 Page 8
needs. The bill also integrated existing provisions for court-ordered involuntary assessments and
stabilization in the Marchman Act into a new consolidated involuntary treatment process.
Effect of the Bill
CS/SB 1240 makes multiple changes to make conforming language changes; clarify and refine
provisions; and further align statute with the changes in the 2024 legislation.
Sections 2, 3, 4, and 5 amends multiple sections of ch. 394, F.S., to make conforming language
and cross-reference changes to align current statute with the substantive changes of HB 7021
(2024) and SB 7016 (2024). Specifically, the sections amend current statute to:
• Clarify that a guardian advocate is to be discharged when a patient is discharged from an
order for involuntary outpatient services, involuntary inpatient placement, or when the
patient is transferred from involuntary to voluntary status.
• Require a qualified mental health professional to review a voluntary patient discharge request
within 12 hours.
• Clarify that a clinical psychologist must have three years of clinical training in the practice of
clinical psychology.
• Require that petitioners prepare a services plan for patients prior to submitting an order for
involuntary outpatient placement services.
• Define the responsibilities of administrative law judges and courts regarding involuntary
inpatient placement and involuntary outpatient services.
Sections 13 and 14 make conforming cross-reference changes.
Section 15 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: CS/SB 1240 Page 9
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 Substantial Changes:
(Summarizing differences between the Committee Substitute and the prior version of the bill.)
CS by Children, Families, and Elder Affairs on March 19, 2025:
The CS makes the following changes:
• Clarifies that a guardian advocate is to be discharged of responsibility when a patient
enters involuntary outpatient services.
• Requires that a clinical psychologist have three years of clinical training in the
practice of clinical psychology.
• Allows the court to order involuntary outpatient placement based on expanded
criteria.
• Mandates that petitioners prepare service plans for patients prior to submitting an
order for involuntary outpatient placement services.
• Defines the responsibilities of administrative law judges and courts regarding
involuntary inpatient placement and involuntary outpatient services. BILL: CS/SB 1240 Page 10
B. Amendments:
None.
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.