ENROLLED
       2023 Legislature                                   CS for SB 914
       
       
       
       
       
       
                                                              2023914er
    1  
    2         An act relating to suicide prevention; amending s.
    3         111.09, F.S.; defining the term “affiliated first
    4         responder organization”; revising the definition of
    5         the term “first responder peer”; amending s. 112.1815,
    6         F.S.; authorizing certain diagnoses to be made through
    7         telehealth; amending s. 394.9086, F.S.; renaming the
    8         Commission on Mental Health and Substance Abuse as the
    9         Commission on Mental Health and Substance Use
   10         Disorder; revising the purposes of the commission to
   11         include an assessment of the state’s suicide
   12         prevention infrastructure; revising the membership and
   13         duties of the commission; requiring the commission to
   14         submit annual interim reports to the Governor and
   15         Legislature for a specified timeframe; revising the
   16         date by which the commission must submit its final
   17         report; extending the repeal date of the commission;
   18         providing an effective date.
   19          
   20  Be It Enacted by the Legislature of the State of Florida:
   21  
   22         Section 1. Subsection (1) of section 111.09, Florida
   23  Statutes, is amended to read:
   24         111.09 Peer support for first responders.—
   25         (1) For purposes of this section, the term:
   26         (a) “Affiliated first responder organization” includes, but
   27  is not limited to, any of the following organizations:
   28         1. Regularly organized volunteer firefighting departments
   29  or associations.
   30         2. Regularly organized volunteer ambulance services.
   31         3. Combination fire departments, as that term is defined in
   32  s. 633.135(1).
   33         (b) “First responder” has the same meaning as provided in
   34  s. 112.1815 and includes 911 public safety telecommunicators as
   35  defined in s. 401.465.
   36         (c)(b) “First responder peer” means a person who:
   37         1. Is not a health care practitioner as defined in s.
   38  456.001.
   39         2. Has experience working as or with a first responder,
   40  including active, volunteer, and retired first responders,
   41  regarding any physical or emotional conditions or issues
   42  associated with the first responder’s employment.
   43         3. Has been designated by the first responder’s employing
   44  agency or affiliated first responder organization to provide
   45  peer support as provided in this section and has received
   46  training for this purpose.
   47         (d)(c) “Peer support” means the provision of physical,
   48  moral, or emotional support to a first responder by a first
   49  responder peer for the purpose of addressing physical or
   50  emotional conditions or other issues associated with being a
   51  first responder.
   52         (e)(d) “Peer support communication” means electronic, oral,
   53  or written communication, made with a mutual expectation of
   54  confidentiality while a first responder peer is providing peer
   55  support in his or her official capacity.
   56         Section 2. Paragraph (a) of subsection (5) of section
   57  112.1815, Florida Statutes, is amended to read:
   58         112.1815 Firefighters, paramedics, emergency medical
   59  technicians, and law enforcement officers; special provisions
   60  for employment-related accidents and injuries.—
   61         (5)(a) For the purposes of this section and chapter 440,
   62  and notwithstanding sub-subparagraph (2)(a)3. and ss. 440.093
   63  and 440.151(2), posttraumatic stress disorder, as described in
   64  the Diagnostic and Statistical Manual of Mental Disorders, Fifth
   65  Edition, published by the American Psychiatric Association,
   66  suffered by a first responder is a compensable occupational
   67  disease within the meaning of subsection (4) and s. 440.151 if:
   68         1. The posttraumatic stress disorder resulted from the
   69  first responder acting within the course of his or her
   70  employment as provided in s. 440.091; and
   71         2. The first responder is examined and subsequently
   72  diagnosed with such disorder by a licensed psychiatrist, in
   73  person or through telehealth as that term is defined in s.
   74  456.47, who is an authorized treating physician as provided in
   75  chapter 440 due to one of the following events:
   76         a. Seeing for oneself a deceased minor;
   77         b. Directly witnessing the death of a minor;
   78         c. Directly witnessing an injury to a minor who
   79  subsequently died before or upon arrival at a hospital emergency
   80  department;
   81         d. Participating in the physical treatment of an injured
   82  minor who subsequently died before or upon arrival at a hospital
   83  emergency department;
   84         e. Manually transporting an injured minor who subsequently
   85  died before or upon arrival at a hospital emergency department;
   86         f. Seeing for oneself a decedent whose death involved
   87  grievous bodily harm of a nature that shocks the conscience;
   88         g. Directly witnessing a death, including suicide, that
   89  involved grievous bodily harm of a nature that shocks the
   90  conscience;
   91         h. Directly witnessing a homicide regardless of whether the
   92  homicide was criminal or excusable, including murder, mass
   93  killing as defined in 28 U.S.C. s. 530C, manslaughter, self
   94  defense, misadventure, and negligence;
   95         i. Directly witnessing an injury, including an attempted
   96  suicide, to a person who subsequently died before or upon
   97  arrival at a hospital emergency department if the person was
   98  injured by grievous bodily harm of a nature that shocks the
   99  conscience;
  100         j. Participating in the physical treatment of an injury,
  101  including an attempted suicide, to a person who subsequently
  102  died before or upon arrival at a hospital emergency department
  103  if the person was injured by grievous bodily harm of a nature
  104  that shocks the conscience; or
  105         k. Manually transporting a person who was injured,
  106  including by attempted suicide, and subsequently died before or
  107  upon arrival at a hospital emergency department if the person
  108  was injured by grievous bodily harm of a nature that shocks the
  109  conscience.
  110         Section 3. Subsections (1), (2), and (3), paragraph (a) of
  111  subsection (4), and subsections (5) and (6) of section 394.9086,
  112  Florida Statutes, are amended to read:
  113         394.9086 Commission on Mental Health and Substance Use
  114  Disorder Abuse.—
  115         (1) CREATION.—The Commission on Mental Health and Substance
  116  Use Disorder Abuse, a commission as defined in s. 20.03(10), is
  117  created adjunct to the department. The department shall provide
  118  administrative and staff support services relating to the
  119  functions of the commission.
  120         (2) PURPOSES.—The purposes of the commission are to examine
  121  the current methods of providing mental health and substance use
  122  disorder abuse services in the state and to improve the
  123  effectiveness of current practices, procedures, programs, and
  124  initiatives in providing such services; identify any barriers or
  125  deficiencies in the delivery of such services; assess the
  126  adequacy of the current infrastructure of Florida’s 988 Suicide
  127  and Crisis Lifeline system and other components of the state’s
  128  crisis response services; and recommend changes to existing
  129  laws, rules, and policies necessary to implement the
  130  commission’s recommendations.
  131         (3) MEMBERSHIP; TERM LIMITS; MEETINGS.—
  132         (a) The commission shall be composed of 20 19 members as
  133  follows:
  134         1. A member of the Senate, appointed by the President of
  135  the Senate.
  136         2. A member of the House of Representatives, appointed by
  137  the Speaker of the House of Representatives.
  138         3. The Secretary of Children and Families or his or her
  139  designee.
  140         4. The Secretary of the Agency for Health Care
  141  Administration or his or her designee.
  142         5. A person living with a mental health disorder, appointed
  143  by the President of the Senate.
  144         6. A family member of a consumer of publicly funded mental
  145  health services, appointed by the President of the Senate.
  146         7. A representative of the Louis de la Parte Florida Mental
  147  Health Institute within the University of South Florida,
  148  appointed by the President of the Senate.
  149         8. A representative of a county school district, appointed
  150  by the President of the Senate.
  151         9. A representative of mental health courts, appointed by
  152  the Governor.
  153         10. A representative of a treatment facility, as defined in
  154  s. 394.455, appointed by the Speaker of the House of
  155  Representatives.
  156         11. A representative of a managing entity, as defined in s.
  157  394.9082(2), appointed by the Speaker of the House of
  158  Representatives.
  159         12. A representative of a community substance use disorder
  160  abuse provider, appointed by the Speaker of the House of
  161  Representatives.
  162         13. A psychiatrist licensed under chapter 458 or chapter
  163  459 practicing within the mental health delivery system,
  164  appointed by the Speaker of the House of Representatives.
  165         14. A psychologist licensed under chapter 490 practicing
  166  within the mental health delivery system, appointed by the
  167  Governor.
  168         15. A mental health professional licensed under chapter
  169  491, appointed by the Governor.
  170         16. An emergency room physician, appointed by the Governor.
  171         17. A representative from the field of law enforcement,
  172  appointed by the Governor.
  173         18. A representative from the criminal justice system,
  174  appointed by the Governor.
  175         19. A representative of a child welfare agency involved in
  176  the delivery of behavioral health services, appointed by the
  177  Governor.
  178         20.A representative of the statewide Florida 211 Network
  179  as described in s. 408.918, appointed by the Governor.
  180         (4) DUTIES.—
  181         (a) The duties of the Commission on Mental Health and
  182  Substance Use Disorder abuse include the following:
  183         1. Conducting a review and evaluation of the management and
  184  functioning of the existing publicly supported mental health and
  185  substance use disorder abuse systems and services in the
  186  department, the Agency for Health Care Administration, and all
  187  other departments which administer mental health and substance
  188  use disorder abuse services. Such review shall include, at a
  189  minimum, a review of current goals and objectives, current
  190  planning, services strategies, coordination management,
  191  purchasing, contracting, financing, local government funding
  192  responsibility, and accountability mechanisms.
  193         2. Considering the unique needs of persons who are dually
  194  diagnosed.
  195         3. Addressing access to, financing of, and scope of
  196  responsibility in the delivery of emergency behavioral health
  197  care services.
  198         4. Addressing the quality and effectiveness of current
  199  mental health and substance use disorder abuse services delivery
  200  systems, and professional staffing and clinical structure of
  201  services, roles, and responsibilities of public and private
  202  providers, such as community mental health centers; community
  203  substance use disorder abuse agencies; hospitals, including
  204  emergency services departments; law enforcement agencies; and
  205  the judicial system.
  206         5. Addressing priority population groups for publicly
  207  funded mental health and substance use disorder abuse services,
  208  identifying the comprehensive mental health and substance use
  209  disorder abuse services delivery systems, mental health and
  210  substance use disorder abuse needs assessment and planning
  211  activities, and local government funding responsibilities for
  212  mental health and substance use disorder abuse services.
  213         6. Reviewing the implementation of chapter 2020-107, Laws
  214  of Florida.
  215         7. Identifying any gaps in the provision of mental health
  216  and substance use disorder services.
  217         8. Providing recommendations on how behavioral health
  218  managing entities may fulfill their purpose of promoting service
  219  continuity and work with community stakeholders throughout this
  220  state in furtherance of supporting the 988 Suicide and Crisis
  221  Lifeline system and other crisis response services.
  222         9.Conducting an overview of the current infrastructure of
  223  the 988 Suicide and Crisis Lifeline system.
  224         10.Analyzing the current capacity of crisis response
  225  services available throughout this state, including services
  226  provided by mobile response teams and centralized receiving
  227  facilities. The analysis must include information on the
  228  geographic area and the total population served by each mobile
  229  response team along with the average response time to each call
  230  made to a mobile response team; the number of calls that a
  231  mobile response team was unable to respond to due to staff
  232  limitations, travel distance, or other factors; and the veteran
  233  status and age groups of individuals served by mobile response
  234  teams.
  235         11. Evaluating and making recommendations to improve
  236  linkages between the 988 Suicide and Crisis Lifeline
  237  infrastructure and crisis response services within this state.
  238         12. Identifying available mental health block grant funds
  239  that can be used to support the 988 Suicide and Crisis Lifeline
  240  and crisis response infrastructure within this state, including
  241  any available funding through opioid settlements or through the
  242  American Rescue Plan Act of 2021, Pub. L. No. 117-2; the
  243  Coronavirus Aid, Relief, and Economic Security (CARES) Act, Pub.
  244  L. No. 116-136; or other federal legislation.
  245         13. In consultation with the Agency for Health Care
  246  Administration, identifying sources of funding available through
  247  the Medicaid program specifically for crisis response services,
  248  including funding that may be available by seeking approval of a
  249  Section 1115 waiver submitted to the Centers for Medicare and
  250  Medicaid Services.
  251         14.9. Making recommendations regarding the mission and
  252  objectives of state-supported mental health and substance use
  253  disorder abuse services and the planning, management, staffing,
  254  financing, contracting, coordination, and accountability
  255  mechanisms which will best foster the recommended mission and
  256  objectives.
  257         15.10. Evaluating and making recommendations regarding the
  258  establishment of a permanent, agency-level entity to manage
  259  mental health, substance use disorder abuse, and related
  260  services statewide. At a minimum, the evaluation must consider
  261  and describe the:
  262         a. Specific duties and organizational structure proposed
  263  for the entity;
  264         b. Resource needs of the entity and possible sources of
  265  funding;
  266         c. Estimated impact on access to and quality of services;
  267         d. Impact on individuals with behavioral health needs and
  268  their families, both those currently served through the affected
  269  systems providing behavioral health services and those in need
  270  of services; and
  271         e. Relation to, integration with, and impact on providers,
  272  managing entities, communities, state agencies, and systems
  273  which provide mental health and substance use disorder abuse
  274  services in this state. Such recommendations must ensure that
  275  the ability of such other agencies and systems to carry out
  276  their missions and responsibilities is not impaired.
  277         16. Evaluating and making recommendations regarding skills
  278  based training that teaches participants about mental health and
  279  substance use disorder issues, including, but not limited to,
  280  Mental Health First Aid models.
  281         (5) REPORTS.—Beginning By January 1, 2023, and annually
  282  thereafter through January 1, 2025, the commission shall submit
  283  an interim report to the President of the Senate, the Speaker of
  284  the House of Representatives, and the Governor containing its
  285  findings and recommendations on how to best provide and
  286  facilitate mental health and substance use disorder abuse
  287  services in the state. The commission shall submit its final
  288  report to the President of the Senate, the Speaker of the House
  289  of Representatives, and the Governor by September 1, 2026 2023.
  290         (6) REPEAL.—This section is repealed September 1, 2026
  291  2023, unless saved from repeal through reenactment by the
  292  Legislature.
  293         Section 4. This act shall take effect July 1, 2023.