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 Appropriations Committee on Health and Human Services
BILL: CS/SB 1240
INTRODUCER: Children, Families, and Elder Affairs Committee and Senator Calatayud
SUBJECT: Substance Abuse and Mental Health Care
DATE: April 14, 2025
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Kennedy Tuszynski CF Fav/CS
2. Sneed McKnight AHS Pre-meeting
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 Department of Children and Families (DCF) to
authorize, regulate, and oversee Florida’s 988 Lifeline program.
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 has no fiscal impact on state expenditures. 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:
The bill makes changes to Florida’s mental health and substance abuse coordinated system 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 percent.
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 serve as a “no-wrong-door model” that provides a
comprehensive 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 and Crisis Lifeline is the national three-digit telephone number available for
mental health crises, providing a 24/7 connection to free and confidential emotional support.
8
Launched 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 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 988 Lifeline had fielded 10.8
million interactions nationwide, comprising roughly 6.4 million calls, 1.6 million chats, and 1.6
million texts.
11
The federal government established the 988 Suicide and Crisis Lifeline with the intention of
turning over its oversight and funding responsibilities to the states in 2026.
Since July 2022, the in-state 988 Lifeline program known as the Florida 988 Lifeline (988
Lifeline) has connected 95,672 individuals to mental health or related services and offered
telephone-based support to 398,939 people across the state.
12
The 988 Lifeline network ensures
individuals have immediate access to trained professionals through a centralized helpline which
ultimately reduces dependence on 911 calls 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
Department of Children and Families, 2025 Agency Analysis, p. 2 (on file with the Children, Families, and Elder Affairs
Committee). BILL: CS/SB 1240 Page 4
Effect of Proposed Changes
Section 1 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 behavioral health coordinated
system of care. This change places the duties 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 is recognized by the DCF to receive 988
calls, texts, or other forms of communication. The bill adds the 988 Suicide and Crisis Lifeline
Call Center to the definition of “mental health 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 from being 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.
13
This integrated approach aims to provide a whole-patient treatment
strategy.
14
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.
15
Current law requires the DCF to determine the need for new MAT providers in the state.
16
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.
17
This needs-based licensure process serves as a state-
level control on the number and location of MAT clinics.
13
Section 397.311,7
14
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)
15
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)
16
Section 397.427, F.S.
17
Id. BILL: CS/SB 1240 Page 5
Florida currently has 72 operational MAT clinics, collectively assisting nearly 22,000 clients
statewide.
18
However, under the current federal methodology, three needs assessments have been
conducted since Fiscal Year 2018-2019, and none have identified a statewide need for additional
facilities. The DCF lacks the flexibility to grant licenses outside of the annual needs-based
determination process, even in urgent situations such as the closure of the only clinic in a given
area.
19
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.
20
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 deletes s. 397.427(2) and amends s. 397.427(4), F.S., to remove the requirement that
the DCF conduct Methadone MAT Needs Assessments annually. The proposed change will
deregulate the process, allowing any interested provider to apply for an MAT maintenance
license without the need for a certificate of need. This change will expedite the process to open a
facility or operate a mobile MAT unit as they will not have to await an award of a certificate of
need. This change will increase access to treatment, particularly in smaller, less populous
counties. Additionally, removing the certificate of need requirement will provide greater
flexibility for mobile MAT clinics, enabling providers to expand beyond their brick-and-mortar
locations to better serve communities. The overall intended effect of repealing this requirement is
a significant decrease in overdose deaths due to opioid use
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.
21
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.
22
These
professionals have specific forensic training and a one-time class from the DCF. These
18
Department of Children and Families, 2025 Agency Analysis, pg.2 (on file with the Children, Families, and Elder Affairs
Committee).
19
Id.
20
Id.
21
Chapter 916, F.S.
22
Section s. 916.11, F.S. BILL: CS/SB 1240 Page 6
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.
23
Defendants found not guilty by reason of insanity may be involuntarily committed if they pose a
danger to themselves or others.
24
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.
25
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.
26
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.
27
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.
28
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:
29
• 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;
23
Section 916.12, F.S.
24
Section 916.15, F.S.
25
Id.
26
Department of Children and Families, 2025 Agency Analysis, p. 3 (on file with the Children, Families, and Elder Affairs
Committee).
27
Id.
28
Id.
29
Section 916.12, F.S. BILL: CS/SB 1240 Page 7
o Outpatient services or intensive outpatient treatment programs; and
o Supportive employment and supportive housing opportunities.
30
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.
31
Effect of Proposed Changes
Section 10 amends s. 916.111, F.S., to update training requirements for mental health
professionals conducting forensic evaluations. The bill requires training on statutes and rules
related to competency restoration, evidence-based practices, and least restrictive treatment
alternatives and placements. This change will require 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 and 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 increased training requirements for expert forensic evaluators is intended 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 the use of current resources and information, and include the ongoing
DCF-approved training. This change is intended to ensure individuals receive care in the least
restrictive setting possible to eliminate the need for unnecessary institutionalization.
Conforming Language and Cross-Reference Changes to Align with 2024 Legislation
Present Situation
A number of 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
30
Section 394.67, F.S.
31
Id. BILL: CS/SB 1240 Page 8
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
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
The bill makes multiple conforming language changes to clarify and refine provisions and
further align current law 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 law with the substantive changes of HB 7021 (2024)
and SB 7016 (2024). Specifically, the bill amends current law 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.
The bill takes effect 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. BILL: CS/SB 1240 Page 9
E. Other Constitutional Issues:
None identified.
V. Fiscal Impact Statement:
A. Tax/Fee Issues:
None.
B. Private Sector Impact:
None.
C. Government Sector Impact:
The bill has no fiscal impact on state expenditures.
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 a clinical psychologist to 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. BILL: CS/SB 1240 Page 10
• Defines the responsibilities of administrative law judges and courts regarding
involuntary inpatient placement and involuntary outpatient services.
B. Amendments:
None.
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.