Florida Senate - 2020              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. SB 7012
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to mental health; amending s. 14.2019,
    3         F.S.; providing additional duties for the Statewide
    4         Office for Suicide Prevention; establishing the First
    5         Responders Suicide Deterrence Task Force adjunct to
    6         the office; specifying the task force’s purpose;
    7         providing for the composition and the duties of the
    8         task force; requiring the task force to submit reports
    9         to the Governor and the Legislature on an annual
   10         basis; providing for future repeal; amending s.
   11         14.20195, F.S.; providing additional duties for the
   12         Suicide Prevention Coordinating Council; revising the
   13         composition of the council; amending s. 334.044, F.S.;
   14         requiring the Department of Transportation to work
   15         with the office in developing a plan relating to
   16         evidence-based suicide deterrents in certain
   17         locations; amending s. 394.455, F.S.; defining the
   18         term “first episode psychosis program”; amending s.
   19         394.4573, F.S.; revising the requirements for the
   20         annual state behavioral health services assessment;
   21         revising the essential elements of a coordinated
   22         system of care; amending s. 394.463, F.S.; requiring
   23         that certain information be provided to the guardian
   24         or representative of a minor patient released from
   25         involuntary examination; creating s. 456.0342, F.S.;
   26         providing applicability; requiring specified persons
   27         to complete certain suicide prevention education
   28         courses by a specified date; requiring certain boards
   29         to include the hours for such courses in the total
   30         hours of continuing education required for the
   31         profession; amending s. 627.6675, F.S.; conforming a
   32         provision to changes made by the act; transferring,
   33         renumbering, and amending s. 627.668, F.S.; requiring
   34         certain entities issuing, delivering, or issuing for
   35         delivery certain health insurance policies to comply
   36         with specified federal provisions that prohibit the
   37         imposition of less favorable benefit limitations on
   38         mental health and substance use disorder benefits than
   39         on medical and surgical benefits; deleting provisions
   40         relating to optional coverage for mental and nervous
   41         disorders by such entities; revising the standard for
   42         defining substance use disorders; requiring such
   43         entities to submit an annual affidavit attesting to
   44         compliance with federal law; requiring the office to
   45         implement and enforce certain federal laws in a
   46         specified manner; authorizing the Financial Services
   47         Commission to adopt rules; repealing s. 627.669, F.S.,
   48         relating to optional coverage required for substance
   49         abuse impaired persons; amending s. 627.6699, F.S.;
   50         providing applicability; amending s. 641.26, F.S.;
   51         requiring certain entities to submit an annual
   52         affidavit to the Office of Insurance Regulation
   53         attesting to compliance with certain requirements;
   54         authorizing the office to adopt rules; amending s.
   55         641.31, F.S.; requiring that certain health
   56         maintenance contracts comply with certain
   57         requirements; authorizing the commission to adopt
   58         rules; creating s. 786.1516, F.S.; defining the terms
   59         “emergency care” and “suicide emergency”; providing
   60         that persons providing certain emergency care are not
   61         liable for civil damages or penalties under certain
   62         circumstances; amending ss. 1002.33 and 1012.583,
   63         F.S.; requiring charter schools and public schools,
   64         respectively, to incorporate certain training on
   65         suicide prevention in continuing education and
   66         inservice training requirements; providing that such
   67         schools must require all instructional personnel to
   68         participate in the training; requiring such schools to
   69         have a specified minimum number of staff members who
   70         are certified or deemed competent in the use of
   71         suicide screening instruments; requiring such schools
   72         to have a policy for such instruments; requiring such
   73         schools to report certain compliance to the Department
   74         of Education; conforming provisions to changes made by
   75         the act; amending ss. 394.495, 394.496, 394.9085,
   76         409.972, 464.012, and 744.2007, F.S.; conforming
   77         cross-references; requiring the Office of Program
   78         Policy Analysis and Government Accountability to
   79         perform a review of certain programs and efforts
   80         relating to suicide prevention programs in other
   81         states and make certain recommendations; requiring the
   82         office to submit a report to the Legislature by a
   83         specified date; providing effective dates.
   85  Be It Enacted by the Legislature of the State of Florida:
   87         Section 1. Paragraphs (a) and (d) of subsection (2) of
   88  section 14.2019, Florida Statutes, are amended, paragraphs (e)
   89  and (f) are added to that subsection, and subsection (5) is
   90  added to that section, to read:
   91         14.2019 Statewide Office for Suicide Prevention.—
   92         (2) The statewide office shall, within available resources:
   93         (a) Develop a network of community-based programs to
   94  improve suicide prevention initiatives. The network shall
   95  identify and work to eliminate barriers to providing suicide
   96  prevention services to individuals who are at risk of suicide.
   97  The network shall consist of stakeholders advocating suicide
   98  prevention, including, but not limited to, not-for-profit
   99  suicide prevention organizations, faith-based suicide prevention
  100  organizations, law enforcement agencies, first responders to
  101  emergency calls, veterans, servicemembers, suicide prevention
  102  community coalitions, schools and universities, mental health
  103  agencies, substance abuse treatment agencies, health care
  104  providers, and school personnel.
  105         (d) Coordinate education and training curricula in suicide
  106  prevention efforts for law enforcement personnel, first
  107  responders to emergency calls, veterans, servicemembers, health
  108  care providers, school employees, and other persons who may have
  109  contact with persons at risk of suicide.
  110         (e)Act as a clearinghouse for information and resources
  111  related to suicide prevention by:
  112         1. Disseminating and sharing evidence-based best practices
  113  relating to suicide prevention;
  114         2. Collecting and analyzing data on trends in suicide and
  115  suicide attempts annually by county, age, gender, profession,
  116  and other demographics as designated by the statewide office.
  117         (f) Advise the Department of Transportation on the
  118  implementation of evidence-based suicide deterrents in the
  119  design elements and features of infrastructure projects
  120  throughout the state.
  121         (5) The First Responders Suicide Deterrence Task Force, a
  122  task force as defined in s. 20.03(8), is created adjunct to the
  123  Statewide Office for Suicide Prevention.
  124         (a) The purpose of the task force is to make
  125  recommendations on how to reduce the incidence of suicide and
  126  attempted suicide among employed or retired first responders in
  127  this state.
  128         (b) The task force is composed of a representative of the
  129  statewide office and a representative of each of the following
  130  first responder organizations, nominated by the organization and
  131  appointed by the Secretary of Children and Families:
  132         1. The Florida Professional Firefighters.
  133         2. The Florida Police Benevolent Association.
  134         3. The Florida Fraternal Order of Police: State Lodge.
  135         4. The Florida Sheriffs Association.
  136         5. The Florida Police Chiefs Association.
  137         6. The Florida Fire Chiefs’ Association.
  138         (c) The task force shall elect a chair from among its
  139  membership. Except as otherwise provided, the task force shall
  140  operate in a manner consistent with s. 20.052.
  141         (d) The task force shall identify or make recommendations
  142  on developing training programs and materials that would better
  143  enable first responders to cope with personal life stressors and
  144  stress related to their profession and foster an organizational
  145  culture that:
  146         1. Promotes mutual support and solidarity among active and
  147  retired first responders;
  148         2. Trains agency supervisors and managers to identify
  149  suicidal risk among active and retired first responders;
  150         3. Improves the use and awareness of existing resources
  151  among active and retired first responders; and
  152         4. Educates active and retired first responders on suicide
  153  awareness and help-seeking.
  154         (e) The task force shall identify state and federal public
  155  resources, funding and grants, first responder association
  156  resources, and private resources to implement identified
  157  training programs and materials.
  158         (f) The task force shall report on its findings and
  159  recommendations for training programs and materials to deter
  160  suicide among active and retired first responders to the
  161  Governor, the President of the Senate, and the Speaker of the
  162  House of Representatives by each July 1, beginning in 2021, and
  163  through 2023.
  164         (g) This subsection is repealed July 1, 2023.
  165         Section 2. Paragraph (c) of subsection (1) and subsection
  166  (2) of section 14.20195, Florida Statutes, are amended, and
  167  paragraph (d) is added to subsection (1) of that section, to
  168  read:
  169         14.20195 Suicide Prevention Coordinating Council; creation;
  170  membership; duties.—There is created within the Statewide Office
  171  for Suicide Prevention a Suicide Prevention Coordinating
  172  Council. The council shall develop strategies for preventing
  173  suicide.
  174         (1) SCOPE OF ACTIVITY.—The Suicide Prevention Coordinating
  175  Council is a coordinating council as defined in s. 20.03 and
  176  shall:
  177         (c) Make findings and recommendations regarding suicide
  178  prevention programs and activities, including, but not limited
  179  to, the implementation of evidence-based mental health awareness
  180  and assistance training programs and gatekeeper training in
  181  municipalities throughout the state. The council shall prepare
  182  an annual report and present it to the Governor, the President
  183  of the Senate, and the Speaker of the House of Representatives
  184  by January 1, each year. The annual report must describe the
  185  status of existing and planned initiatives identified in the
  186  statewide plan for suicide prevention and any recommendations
  187  arising therefrom.
  188         (d)In conjunction with the Department of Children and
  189  Families, advise members of the public on the locations and
  190  availability of local behavioral health providers.
  191         (2) MEMBERSHIP.—The Suicide Prevention Coordinating Council
  192  shall consist of 32 27 voting members and one nonvoting member.
  193         (a) Eighteen Thirteen members shall be appointed by the
  194  director of the Statewide Office for Suicide Prevention and
  195  shall represent the following organizations:
  196         1. The Florida Association of School Psychologists.
  197         2. The Florida Sheriffs Association.
  198         3. The Suicide Prevention Action Network USA.
  199         4. The Florida Initiative of Suicide Prevention.
  200         5. The Florida Suicide Prevention Coalition.
  201         6. The American Foundation of Suicide Prevention.
  202         7. The Florida School Board Association.
  203         8. The National Council for Suicide Prevention.
  204         9. The state chapter of AARP.
  205         10. The Florida Behavioral Health Association The Florida
  206  Alcohol and Drug Abuse Association.
  207         11. The Florida Council for Community Mental Health.
  208         12. The Florida Counseling Association.
  209         12.13. NAMI Florida.
  210         13.The Florida Medical Association.
  211         14.The Florida Osteopathic Medical Association.
  212         15.The Florida Psychiatric Society.
  213         16.The Florida Psychological Association.
  214         17.Veterans Florida.
  215         18.The Florida Association of Managing Entities.
  216         (b) The following state officials or their designees shall
  217  serve on the coordinating council:
  218         1. The Secretary of Elderly Affairs.
  219         2. The State Surgeon General.
  220         3. The Commissioner of Education.
  221         4. The Secretary of Health Care Administration.
  222         5. The Secretary of Juvenile Justice.
  223         6. The Secretary of Corrections.
  224         7. The executive director of the Department of Law
  225  Enforcement.
  226         8. The executive director of the Department of Veterans’
  227  Affairs.
  228         9. The Secretary of Children and Families.
  229         10. The executive director of the Department of Economic
  230  Opportunity.
  231         (c) The Governor shall appoint four additional members to
  232  the coordinating council. The appointees must have expertise
  233  that is critical to the prevention of suicide or represent an
  234  organization that is not already represented on the coordinating
  235  council.
  236         (d) For the members appointed by the director of the
  237  Statewide Office for Suicide Prevention, seven members shall be
  238  appointed to initial terms of 3 years, and seven members shall
  239  be appointed to initial terms of 4 years. For the members
  240  appointed by the Governor, two members shall be appointed to
  241  initial terms of 4 years, and two members shall be appointed to
  242  initial terms of 3 years. Thereafter, such members shall be
  243  appointed to terms of 4 years. Any vacancy on the coordinating
  244  council shall be filled in the same manner as the original
  245  appointment, and any member who is appointed to fill a vacancy
  246  occurring because of death, resignation, or ineligibility for
  247  membership shall serve only for the unexpired term of the
  248  member’s predecessor. A member is eligible for reappointment.
  249         (e) The director of the Statewide Office for Suicide
  250  Prevention shall be a nonvoting member of the coordinating
  251  council and shall act as chair.
  252         (f) Members of the coordinating council shall serve without
  253  compensation. Any member of the coordinating council who is a
  254  public employee is entitled to reimbursement for per diem and
  255  travel expenses as provided in s. 112.061.
  256         Section 3. Present paragraph (c) of subsection (10) of
  257  section 334.044, Florida Statutes, is redesignated as paragraph
  258  (d), and a new paragraph (c) is added to that subsection, to
  259  read:
  260         334.044 Powers and duties of the department.—The department
  261  shall have the following general powers and duties:
  262         (10)
  263         (c) The department shall work with the Statewide Office for
  264  Suicide Prevention in developing a plan to consider the
  265  implementation of evidence-based suicide deterrents on all new
  266  infrastructure projects.
  267         Section 4. Present subsections (17) through (48) of section
  268  394.455, Florida Statutes, are redesignated as subsections (18)
  269  through (49), respectively, and a new subsection (17) is added
  270  to that section, to read:
  271         394.455 Definitions.—As used in this part, the term:
  272         (17) “First episode psychosis program” means an evidence
  273  based program for individuals between 14 and 30 years of age who
  274  are experiencing early indications of serious mental illness,
  275  especially a first episode of psychotic symptoms. The program
  276  includes, but is not limited to, intensive case management,
  277  individual or group therapy, supported employment, family
  278  education and supports, and appropriate psychotropic medication,
  279  as indicated.
  280         Section 5. Section 394.4573, Florida Statutes, is amended
  281  to read:
  282         394.4573 Coordinated system of care; annual assessment;
  283  essential elements; measures of performance; system improvement
  284  grants; reports.—On or before December 1 of each year, the
  285  department shall submit to the Governor, the President of the
  286  Senate, and the Speaker of the House of Representatives an
  287  assessment of the behavioral health services in this state. The
  288  assessment shall consider, at a minimum, the extent to which
  289  designated receiving systems function as no-wrong-door models,
  290  the availability of treatment and recovery services that use
  291  recovery-oriented and peer-involved approaches, the availability
  292  of less-restrictive services, and the use of evidence-informed
  293  practices. The assessment must also describe the availability of
  294  and access to first episode psychosis programs, and any gaps in
  295  the availability and access of such programs, in all areas of
  296  the state. The department’s assessment shall consider, at a
  297  minimum, the needs assessments conducted by the managing
  298  entities pursuant to s. 394.9082(5). Beginning in 2017, the
  299  department shall compile and include in the report all plans
  300  submitted by managing entities pursuant to s. 394.9082(8) and
  301  the department’s evaluation of each plan.
  302         (1) As used in this section:
  303         (a) “Care coordination” means the implementation of
  304  deliberate and planned organizational relationships and service
  305  procedures that improve the effectiveness and efficiency of the
  306  behavioral health system by engaging in purposeful interactions
  307  with individuals who are not yet effectively connected with
  308  services to ensure service linkage. Examples of care
  309  coordination activities include development of referral
  310  agreements, shared protocols, and information exchange
  311  procedures. The purpose of care coordination is to enhance the
  312  delivery of treatment services and recovery supports and to
  313  improve outcomes among priority populations.
  314         (b) “Case management” means those direct services provided
  315  to a client in order to assess his or her needs, plan or arrange
  316  services, coordinate service providers, link the service system
  317  to a client, monitor service delivery, and evaluate patient
  318  outcomes to ensure the client is receiving the appropriate
  319  services.
  320         (c) “Coordinated system of care” means the full array of
  321  behavioral and related services in a region or community offered
  322  by all service providers, whether participating under contract
  323  with the managing entity or by another method of community
  324  partnership or mutual agreement.
  325         (d) “No-wrong-door model” means a model for the delivery of
  326  acute care services to persons who have mental health or
  327  substance use disorders, or both, which optimizes access to
  328  care, regardless of the entry point to the behavioral health
  329  care system.
  330         (2) The essential elements of a coordinated system of care
  331  include:
  332         (a) Community interventions, such as prevention, primary
  333  care for behavioral health needs, therapeutic and supportive
  334  services, crisis response services, and diversion programs.
  335         (b) A designated receiving system that consists of one or
  336  more facilities serving a defined geographic area and
  337  responsible for assessment and evaluation, both voluntary and
  338  involuntary, and treatment or triage of patients who have a
  339  mental health or substance use disorder, or co-occurring
  340  disorders.
  341         1. A county or several counties shall plan the designated
  342  receiving system using a process that includes the managing
  343  entity and is open to participation by individuals with
  344  behavioral health needs and their families, service providers,
  345  law enforcement agencies, and other parties. The county or
  346  counties, in collaboration with the managing entity, shall
  347  document the designated receiving system through written
  348  memoranda of agreement or other binding arrangements. The county
  349  or counties and the managing entity shall complete the plan and
  350  implement the designated receiving system by July 1, 2017, and
  351  the county or counties and the managing entity shall review and
  352  update, as necessary, the designated receiving system at least
  353  once every 3 years.
  354         2. To the extent permitted by available resources, the
  355  designated receiving system shall function as a no-wrong-door
  356  model. The designated receiving system may be organized in any
  357  manner which functions as a no-wrong-door model that responds to
  358  individual needs and integrates services among various
  359  providers. Such models include, but are not limited to:
  360         a. A central receiving system that consists of a designated
  361  central receiving facility that serves as a single entry point
  362  for persons with mental health or substance use disorders, or
  363  co-occurring disorders. The central receiving facility shall be
  364  capable of assessment, evaluation, and triage or treatment or
  365  stabilization of persons with mental health or substance use
  366  disorders, or co-occurring disorders.
  367         b. A coordinated receiving system that consists of multiple
  368  entry points that are linked by shared data systems, formal
  369  referral agreements, and cooperative arrangements for care
  370  coordination and case management. Each entry point shall be a
  371  designated receiving facility and shall, within existing
  372  resources, provide or arrange for necessary services following
  373  an initial assessment and evaluation.
  374         c. A tiered receiving system that consists of multiple
  375  entry points, some of which offer only specialized or limited
  376  services. Each service provider shall be classified according to
  377  its capabilities as either a designated receiving facility or
  378  another type of service provider, such as a triage center, a
  379  licensed detoxification facility, or an access center. All
  380  participating service providers shall, within existing
  381  resources, be linked by methods to share data, formal referral
  382  agreements, and cooperative arrangements for care coordination
  383  and case management.
  385  An accurate inventory of the participating service providers
  386  which specifies the capabilities and limitations of each
  387  provider and its ability to accept patients under the designated
  388  receiving system agreements and the transportation plan
  389  developed pursuant to this section shall be maintained and made
  390  available at all times to all first responders in the service
  391  area.
  392         (c) Transportation in accordance with a plan developed
  393  under s. 394.462.
  394         (d) Crisis services, including mobile response teams,
  395  crisis stabilization units, addiction receiving facilities, and
  396  detoxification facilities.
  397         (e) Case management. Each case manager or person directly
  398  supervising a case manager who provides Medicaid-funded targeted
  399  case management services shall hold a valid certification from a
  400  department-approved credentialing entity as defined in s.
  401  397.311(10) by July 1, 2017, and, thereafter, within 6 months
  402  after hire.
  403         (f) Care coordination that involves coordination with other
  404  local systems and entities, public and private, which are
  405  involved with the individual, such as primary care, child
  406  welfare, behavioral health care, and criminal and juvenile
  407  justice organizations.
  408         (g) Outpatient services.
  409         (h) Residential services.
  410         (i) Hospital inpatient care.
  411         (j) Aftercare and other postdischarge services.
  412         (k) Medication-assisted treatment and medication
  413  management.
  414         (l) Recovery support, including, but not limited to,
  415  support for competitive employment, educational attainment,
  416  independent living skills development, family support and
  417  education, wellness management and self-care, and assistance in
  418  obtaining housing that meets the individual’s needs. Such
  419  housing may include mental health residential treatment
  420  facilities, limited mental health assisted living facilities,
  421  adult family care homes, and supportive housing. Housing
  422  provided using state funds must provide a safe and decent
  423  environment free from abuse and neglect.
  424         (m) Care plans shall assign specific responsibility for
  425  initial and ongoing evaluation of the supervision and support
  426  needs of the individual and the identification of housing that
  427  meets such needs. For purposes of this paragraph, the term
  428  “supervision” means oversight of and assistance with compliance
  429  with the clinical aspects of an individual’s care plan.
  430         (n)First episode psychosis programs.
  431         (3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific
  432  appropriation by the Legislature, the department may award
  433  system improvement grants to managing entities based on a
  434  detailed plan to enhance services in accordance with the no
  435  wrong-door model as defined in subsection (1) and to address
  436  specific needs identified in the assessment prepared by the
  437  department pursuant to this section. Such a grant must be
  438  awarded through a performance-based contract that links payments
  439  to the documented and measurable achievement of system
  440  improvements.
  441         Section 6. Subsection (3) of section 394.463, Florida
  442  Statutes, is amended to read:
  443         394.463 Involuntary examination.—
  444         (3) NOTICE OF RELEASE.—Notice of the release shall be given
  445  to the patient’s guardian or representative, to any person who
  446  executed a certificate admitting the patient to the receiving
  447  facility, and to any court which ordered the patient’s
  448  evaluation. If the patient is a minor, information regarding the
  449  availability of a local mobile response service, suicide
  450  prevention resources, social supports, and local self-help
  451  groups must also be provided to the patient’s guardian or
  452  representative along with the notice of the release.
  453         Section 7. Section 456.0342, Florida Statutes, is created
  454  to read:
  455         456.0342 Required instruction on suicide prevention.—The
  456  requirements of this section apply to each person licensed or
  457  certified under chapter 458, chapter 459, or part I of chapter
  458  464.
  459         (1) By January 1, 2022, each licensed or certified
  460  practitioner shall complete a board-approved 2-hour continuing
  461  education course on suicide prevention. The course must address
  462  suicide risk assessment, treatment, and management.
  463         (2)Each licensing board that requires a licensee or
  464  certificate holder to complete a course pursuant to this section
  465  must include the hours required for completion in the total
  466  hours of continuing education required by law for such
  467  profession.
  468         Section 8. Effective January 1, 2021, paragraph (b) of
  469  subsection (8) of section 627.6675, Florida Statutes, is amended
  470  to read:
  471         627.6675 Conversion on termination of eligibility.—Subject
  472  to all of the provisions of this section, a group policy
  473  delivered or issued for delivery in this state by an insurer or
  474  nonprofit health care services plan that provides, on an
  475  expense-incurred basis, hospital, surgical, or major medical
  476  expense insurance, or any combination of these coverages, shall
  477  provide that an employee or member whose insurance under the
  478  group policy has been terminated for any reason, including
  479  discontinuance of the group policy in its entirety or with
  480  respect to an insured class, and who has been continuously
  481  insured under the group policy, and under any group policy
  482  providing similar benefits that the terminated group policy
  483  replaced, for at least 3 months immediately prior to
  484  termination, shall be entitled to have issued to him or her by
  485  the insurer a policy or certificate of health insurance,
  486  referred to in this section as a “converted policy.” A group
  487  insurer may meet the requirements of this section by contracting
  488  with another insurer, authorized in this state, to issue an
  489  individual converted policy, which policy has been approved by
  490  the office under s. 627.410. An employee or member shall not be
  491  entitled to a converted policy if termination of his or her
  492  insurance under the group policy occurred because he or she
  493  failed to pay any required contribution, or because any
  494  discontinued group coverage was replaced by similar group
  495  coverage within 31 days after discontinuance.
  496         (8) BENEFITS OFFERED.—
  497         (b) An insurer shall offer the benefits specified in s.
  498  627.4193 s. 627.668 and the benefits specified in s. 627.669 if
  499  those benefits were provided in the group plan.
  500         Section 9. Effective January 1, 2021, section 627.668,
  501  Florida Statutes, is transferred, renumbered as section
  502  627.4193, Florida Statutes, and amended to read:
  503         627.4193 627.668Requirements for mental health and
  504  substance use disorder benefits; reporting requirements Optional
  505  coverage for mental and nervous disorders required; exception.—
  506         (1) Every insurer issuing, delivering, or issuing for
  507  delivery comprehensive major medical individual or, health
  508  maintenance organization, and nonprofit hospital and medical
  509  service plan corporation transacting group health insurance
  510  policies or providing prepaid health care in this state must
  511  comply with the federal Paul Wellstone and Pete Domenici Mental
  512  Health Parity and Addiction Equity Act of 2008 (MHPAEA) and any
  513  regulations relating to MHPAEA, including, but not limited to,
  514  45 C.F.R. s. 146.136, 45 C.F.R. s. 147.160, and 45 C.F.R. s.
  515  156.115(a)(3); and must provide shall make available to the
  516  policyholder as part of the application, for an appropriate
  517  additional premium under a group hospital and medical expense
  518  incurred insurance policy, under a group prepaid health care
  519  contract, and under a group hospital and medical service plan
  520  contract, the benefits or level of benefits specified in
  521  subsection (2) for the medically necessary care and treatment of
  522  mental and nervous disorders, including substance use disorders,
  523  as described defined in the Diagnostic and Statistical Manual of
  524  Mental Disorders, Fifth Edition, published by standard
  525  nomenclature of the American Psychiatric Association, subject to
  526  the right of the applicant for a group policy or contract to
  527  select any alternative benefits or level of benefits as may be
  528  offered by the insurer, health maintenance organization, or
  529  service plan corporation provided that, if alternate inpatient,
  530  outpatient, or partial hospitalization benefits are selected,
  531  such benefits shall not be less than the level of benefits
  532  required under paragraph (2)(a), paragraph (2)(b), or paragraph
  533  (2)(c), respectively.
  534         (2) Under individual or group policies described in
  535  subsection (1) or contracts, inpatient hospital benefits,
  536  partial hospitalization benefits, and outpatient benefits
  537  consisting of durational limits, dollar amounts, deductibles,
  538  and coinsurance factors may not be provided in a manner that is
  539  more restrictive than medical and surgical benefits, and limits
  540  on the scope or duration of treatments which are not expressed
  541  numerically, also known as nonquantitative treatment
  542  limitations, must be provided in a manner that is comparable and
  543  may not be applied more stringently than limits on medical and
  544  surgical benefits, in accordance with 45 C.F.R. s.
  545  146.136(c)(2), (3), and (4) shall not be less favorable than for
  546  physical illness generally, except that:
  547         (a) Inpatient benefits may be limited to not less than 30
  548  days per benefit year as defined in the policy or contract. If
  549  inpatient hospital benefits are provided beyond 30 days per
  550  benefit year, the durational limits, dollar amounts, and
  551  coinsurance factors thereto need not be the same as applicable
  552  to physical illness generally.
  553         (b) Outpatient benefits may be limited to $1,000 for
  554  consultations with a licensed physician, a psychologist licensed
  555  pursuant to chapter 490, a mental health counselor licensed
  556  pursuant to chapter 491, a marriage and family therapist
  557  licensed pursuant to chapter 491, and a clinical social worker
  558  licensed pursuant to chapter 491. If benefits are provided
  559  beyond the $1,000 per benefit year, the durational limits,
  560  dollar amounts, and coinsurance factors thereof need not be the
  561  same as applicable to physical illness generally.
  562         (c) Partial hospitalization benefits shall be provided
  563  under the direction of a licensed physician. For purposes of
  564  this part, the term “partial hospitalization services” is
  565  defined as those services offered by a program that is
  566  accredited by an accrediting organization whose standards
  567  incorporate comparable regulations required by this state.
  568  Alcohol rehabilitation programs accredited by an accrediting
  569  organization whose standards incorporate comparable regulations
  570  required by this state or approved by the state and licensed
  571  drug abuse rehabilitation programs shall also be qualified
  572  providers under this section. In a given benefit year, if
  573  partial hospitalization services or a combination of inpatient
  574  and partial hospitalization are used, the total benefits paid
  575  for all such services may not exceed the cost of 30 days after
  576  inpatient hospitalization for psychiatric services, including
  577  physician fees, which prevail in the community in which the
  578  partial hospitalization services are rendered. If partial
  579  hospitalization services benefits are provided beyond the limits
  580  set forth in this paragraph, the durational limits, dollar
  581  amounts, and coinsurance factors thereof need not be the same as
  582  those applicable to physical illness generally.
  583         (3) Insurers must maintain strict confidentiality regarding
  584  psychiatric and psychotherapeutic records submitted to an
  585  insurer for the purpose of reviewing a claim for benefits
  586  payable under this section. These records submitted to an
  587  insurer are subject to the limitations of s. 456.057, relating
  588  to the furnishing of patient records.
  589         (4)Every insurer shall submit an annual affidavit
  590  attesting to compliance with the applicable provisions of the
  591  MHPAEA.
  592         (5)The office shall implement and enforce applicable
  593  provisions of MHPAEA and federal guidance or regulations
  594  relating to MHPAEA, including, but not limited to, 45 C.F.R. s.
  595  146.136, 45 C.F.R. s. 147.160, and 45 C.F.R. s. 156.115(a)(3),
  596  and this section.
  597         (6)The Financial Services Commission may adopt rules to
  598  implement this section.
  599         Section 10. Subsection (4) is added to section 627.669,
  600  Florida Statutes, to read:
  601         627.669 Optional coverage required for substance abuse
  602  impaired persons; exception.—
  603         (4) This section is repealed January 1, 2021.
  604         Section 11. Effective January 1, 2021, present subsection
  605  (17) of section 627.6699, Florida Statutes, is redesignated as
  606  subsection (18), and a new subsection (17) is added to that
  607  section, to read:
  608         627.6699 Employee Health Care Access Act.—
  610  benefit plan that provides coverage to employees of a small
  611  employer is subject to s. 627.4193.
  612         Section 12. Effective January 1, 2021, subsection (9) is
  613  added to section 641.26, Florida Statutes, to read:
  614         641.26 Annual and quarterly reports.—
  615         (9) Every health maintenance organization issuing,
  616  delivering, or issuing for delivery contracts providing
  617  comprehensive major medical coverage shall annually submit an
  618  affidavit to the office attesting to compliance with the
  619  requirements of s. 627.4193. The office may adopt rules to
  620  implement this subsection.
  621         Section 13. Effective January 1, 2021, subsection (48) is
  622  added to section 641.31, Florida Statutes, to read:
  623         641.31 Health maintenance contracts.—
  624         (48) All health maintenance contracts that provide
  625  comprehensive medical coverage must comply with the coverage
  626  provisions of s. 627.4193. The commission may adopt rules to
  627  implement this subsection.
  628         Section 14. Section 786.1516, Florida Statutes, is created
  629  to read:
  630         786.1516 Immunity for providing assistance in a suicide
  631  emergency.—
  632         (1) As used in this section, the term:
  633         (a) “Emergency care” means assistance or advice offered to
  634  avoid, mitigate, or attempt to mitigate the effects of a suicide
  635  emergency.
  636         (b) “Suicide emergency” means an occurrence that reasonably
  637  indicates an individual is at risk of dying or attempting to die
  638  by suicide.
  639         (2) A person who provides emergency care at or near the
  640  scene of a suicide emergency, gratuitously and in good faith, is
  641  not liable for any civil damages or penalties as a result of any
  642  act or omission by the person providing the emergency care
  643  unless the person is grossly negligent or caused the suicide
  644  emergency.
  645         Section 15. Present subsection (28) of section 1002.33,
  646  Florida Statutes, is redesignated as subsection (29), and a new
  647  subsection (28) is added to that section, to read:
  648         1002.33 Charter schools.—
  651         (a) By October 1, 2020, every charter school must:
  652         1. Incorporate 2 hours of training offered pursuant to s.
  653  1012.583. The training must be included in the existing
  654  continuing education or inservice training requirements for
  655  instructional personnel and may not add to the total hours
  656  currently required by the department. Every charter school must
  657  require all instructional personnel to participate.
  658         2. Have at least two school-based staff members certified
  659  or otherwise deemed competent in the use of a suicide screening
  660  instrument approved under s. 1012.583(1) and have a policy to
  661  use such suicide risk screening instrument to evaluate a
  662  student’s suicide risk before requesting the initiation of, or
  663  initiating, an involuntary examination due to concerns about
  664  that student’s suicide risk.
  665         (b) Every charter school must report its compliance with
  666  this subsection to the department.
  667         Section 16. Subsections (2) and (3) of section 1012.583,
  668  Florida Statutes, are amended to read:
  669         1012.583 Continuing education and inservice training for
  670  youth suicide awareness and prevention.—
  671         (2) By October 1, 2020, every public school must A school
  672  shall be considered a “Suicide Prevention Certified School” if
  673  it:
  674         (a) Incorporate Incorporates 2 hours of training offered
  675  pursuant to this section. The training must be included in the
  676  existing continuing education or inservice training requirements
  677  for instructional personnel and may not add to the total hours
  678  currently required by the department. Every public school A
  679  school that chooses to participate in the training must require
  680  all instructional personnel to participate.
  681         (b) Have Has at least two school-based staff members
  682  certified or otherwise deemed competent in the use of a suicide
  683  screening instrument approved under subsection (1) and have has
  684  a policy to use such suicide risk screening instrument to
  685  evaluate a student’s suicide risk before requesting the
  686  initiation of, or initiating, an involuntary examination due to
  687  concerns about that student’s suicide risk.
  688         (3) Every public school A school that meets the criteria in
  689  subsection (2) must report its compliance with this section to
  690  the department. The department shall keep an updated record of
  691  all Suicide Prevention Certified Schools and shall post the list
  692  of these schools on the department’s website. Each school shall
  693  also post on its own website whether it is a Suicide Prevention
  694  Certified School, and each school district shall post on its
  695  district website a list of the Suicide Prevention Certified
  696  Schools in that district.
  697         Section 17. Paragraphs (a) and (c) of subsection (3) of
  698  section 394.495, Florida Statutes, are amended to read:
  699         394.495 Child and adolescent mental health system of care;
  700  programs and services.—
  701         (3) Assessments must be performed by:
  702         (a) A professional as defined in s. 394.455(5), (7), (33)
  703  (32), (36) (35), or (37) (36);
  704         (c) A person who is under the direct supervision of a
  705  qualified professional as defined in s. 394.455(5), (7), (33)
  706  (32), (36) (35), or (37) (36) or a professional licensed under
  707  chapter 491.
  708         Section 18. Subsection (5) of section 394.496, Florida
  709  Statutes, is amended to read:
  710         394.496 Service planning.—
  711         (5) A professional as defined in s. 394.455(5), (7), (33)
  712  (32), (36) (35), or (37) (36) or a professional licensed under
  713  chapter 491 must be included among those persons developing the
  714  services plan.
  715         Section 19. Subsection (6) of section 394.9085, Florida
  716  Statutes, is amended to read:
  717         394.9085 Behavioral provider liability.—
  718         (6) For purposes of this section, the terms “detoxification
  719  services,” “addictions receiving facility,” and “receiving
  720  facility” have the same meanings as those provided in ss.
  721  397.311(26)(a)4., 397.311(26)(a)1., and 394.455(40) 394.455(39),
  722  respectively.
  723         Section 20. Paragraph (b) of subsection (1) of section
  724  409.972, Florida Statutes, is amended to read:
  725         409.972 Mandatory and voluntary enrollment.—
  726         (1) The following Medicaid-eligible persons are exempt from
  727  mandatory managed care enrollment required by s. 409.965, and
  728  may voluntarily choose to participate in the managed medical
  729  assistance program:
  730         (b) Medicaid recipients residing in residential commitment
  731  facilities operated through the Department of Juvenile Justice
  732  or a treatment facility as defined in s. 394.455(47).
  733         Section 21. Paragraph (e) of subsection (4) of section
  734  464.012, Florida Statutes, is amended to read:
  735         464.012 Licensure of advanced practice registered nurses;
  736  fees; controlled substance prescribing.—
  737         (4) In addition to the general functions specified in
  738  subsection (3), an advanced practice registered nurse may
  739  perform the following acts within his or her specialty:
  740         (e) A psychiatric nurse, who meets the requirements in s.
  741  394.455(36) s. 394.455(35), within the framework of an
  742  established protocol with a psychiatrist, may prescribe
  743  psychotropic controlled substances for the treatment of mental
  744  disorders.
  745         Section 22. Subsection (7) of section 744.2007, Florida
  746  Statutes, is amended to read:
  747         744.2007 Powers and duties.—
  748         (7) A public guardian may not commit a ward to a treatment
  749  facility, as defined in s. 394.455(47), without an involuntary
  750  placement proceeding as provided by law.
  751         Section 23. The Office of Program Policy Analysis and
  752  Government Accountability shall perform a review of suicide
  753  prevention programs and efforts made by other states and make
  754  recommendations on their applicability to this state. The office
  755  shall submit a report containing the findings and
  756  recommendations to the President of the Senate and the Speaker
  757  of the House of Representatives by January 1, 2021.
  758         Section 24. Except as otherwise expressly provided in this
  759  act, this act shall take effect July 1, 2020.