VICTORIES from 2022 FLORIDA LEGISLATIVE SESSION

Governor DeSantis signed the largest increase in behavioral health spending in decades. The increase includes:

• More than $126M in RECURRING funding for Children’s Community Action (CAT)Teams, Family Intensive Treatment (FIT) Teams, Florida Assertive Community Teams (FACT), and mobile response teams. 
• An additional one-time appropriation of $108,711,638 from the CARES Act for mental health and substance use disorder services for individuals, families and communities that have “demonstrated success in improving treatment outcomes or supporting recovery.”

1. Record Increase in Behavioral Health Funding
2. Peer Specialist Bill
3. Baker Act Improvement Bills
4. Medication for Schizophrenia Bill
5. Drug Overdose Prevention Bill
6. Mental Health Services in Public Schools Bills
7. Medicaid Managed Care Oversight Bill
8. Commission on Mental Health and Substance Abuse Bill

• Recognizes the role of the peer specialist as "an essential element of a coordinated system of care” and says they should be paid a living wage.
• Relaxes some screening requirements that have prevented peers with a criminal background from being certified as Recovery Peer Specialists.
• Assigns coordination of peer specialist training to the Managing Entities which may contract those services.
• Extends from 90 to 180 days the period during which a peer can work while a request for exemption from a background check disqualification is pending.

• Law enforcement officers must use the least restrictive manner possible in transporting individuals for Baker or Marchman Acts, especially minors. 

• Requires receiving facilities to contact the person’s guardian, guardian advocate, health care surrogate, attorney or representative or other emergency contact through electronic databases identified by police within 24 hours of the person’s arrival.

• Discharge planning must include follow-up behavioral health appointments, information on how to obtain prescribed medications, information pertaining to available living arrangements, and recovery support opportunities.

• Allows prescribers to bypass the “fail first” step-therapy requirement for Medicaid patients for medications for schizophrenia if prior authorization was previously granted for the prescribed drug and the medication was dispensed to the patient during the previous 12 months. 

• Allows (but does not require) first responders to use Narcan without liability issues and allows pharmacies to carry Narcan.

• Allows (but does not require) first responders to use Narcan without liability issues and allows pharmacies to carry Narcan.  
• Mental Health Coordinators in all school districts
• Charter school data on involuntary examinations of students
• 15-day requirement to initiate school-based mental health services for students 
• Information for parents on other behavioral health services in their communities
• Safe-school officers who are sworn law enforcement officers must complete mental health CIT training.
• Other safe-school officers must receive training on incident response and de-escalation.
• 80% of all school personnel must have youth mental health first aid training. 

Medicaid Managed Care companies are now required to provide more data on the populations they are serving and post the data on their websites.

Allows the Commission on MHSA to meet in person. Extends deadline for interim report from September 2022 to January 1, 2023. The final report is due September 1, 2023.

We are pleased to see these essential behavioral health services funded:

• FIT = Family Intensive Treatment Teams treat parents with behavioral health conditions who come into contact with the child welfare system
• CAT = Community Action Treatment Teams provide intense behavioral health care to youth 
• MRT = Mobile Response Teams provide on-site crisis assessment and linkage to services
• FACT = Florida Assertive Community Treatment Teams provide evidence-based intensive treatment, rehabilitation, and support services for adults with serious mental illness (Note that FACT may be funded through the Medicaid Match Trust Fund and we are watching to see how that will work)
• CRF = Centralized Receiving Facilities assess and link patients to care and resources and provide a quick drop-off location for law enforcement

SB1488/HB1447 – Commission on Mental Health and Substance Use by Senator Darryl Rouson and Representative Christine Hunschofsky.

The language from this bill was inserted into SB96, a Child Welfare bill by Rules and Children, Families, and Elder Affairs; and Senators Book and Brodeur.

This bill, an outgrowth of the Marjorie Stoneman Douglas Commission, creates a commission on mental health and substance use disorders and requires DCF to provide administrative support. It requires the commission to submit an annual report to the Legislature and Governor. The Commission, which includes a family member of someone with a behavioral health condition and a peer who is receiving publicly-funded mental health services, will have the power to call in various agencies to provide assistance in a timely manner.

We feel that this bill sends a bold statement that we must improve Florida’s fragmented behavioral health system. People and families experiencing mental health conditions and/or crises must be able to get quality affordable care as quickly as possible.

View the appointed members of the Commission by clicking on the link below.

CS/SB590 School Safety by Appropriations and Senator Gayle Harrell

NOTE: Senator Harrell’s original bill was folded into a larger School Safety Bill. 

A large section of this bill represents an attempt to reduce the increasing number of students being involuntarily transported by law enforcement from schools and school-related activities to Baker Act receiving facilities, sometimes without their parents being notified before the student is removed. 

Details of the bill:

• Requires public district and charter schools to make a reasonable attempt to notify parents or guardians of a minor student before the student is removed from school, school transportation, or a school-sponsored activity for an involuntary mental health examination. 
• Provides that a school principal or designee may delay notification if they believe it is necessary to avoid jeopardizing the health and safety of the student. 
• Requires the school to document the method and number of attempts made to contact the parent, guardian, or emergency contact.
• Requires the Department of Children and Families to maintain data for each public school, the number of involuntary examinations initiated by the school, and the number of children for whom an examination is initiated.
• Requires that each school district adopt a policy that requires the district superintendent to annually report to the Department of Children and Families the number of involuntary examinations initiated by the school, and the number of children for whom an examination is initiated.
• Requires that all school safety officers undergo crisis intervention training. 
• The bill also requires schools to contact a health care practitioner capable of initiating a Baker Act in person (may contact a Mobile Response Team) or via telehealth prior to a Baker Act being initiated. 
• As part of the Mental Health Assistance Allocation to districts and  charter schools must include in their mental health plans procedures to assist a behavioral health provider, school resource officer or school safety officer to verbally de-escalate a student’s crisis situation, including strategies for de-escalating crisis situations for students with developmental disabilities.
• School districts must have policies that require that, in a student crisis situation, schools or law enforcement personnel must make a reasonable attempt to contact a mental health professional who may initiate an involuntary examination unless the child poses an imminent danger to themselves or others, before initiating an involuntary examination. This contact may be in person or by using telehealth.
• The mental health professional referred to above may be available to the district either by contracts or interagency agreements with the managing entity, local community behavioral health providers, or the local mobile response team, or be a school district employee.
• Requires schools to include behavioral health call/text lines on the back of student identification cards and mandates the collection of data by school districts and the Department of Children and Families relating to the number and frequency of involuntary examinations of minors initiated by schools.
• The bill also includes other requirements of schools related to school safety, such as notifying parents of unlawful acts and significant emergencies occurring at a school, parents’ access to school safety and discipline incidents, treatment of students who commit criminal offenses and petty acts of misconduct, and special accommodations for exceptional students when participating in emergency drills.

HB231 – Services for Veterans and Their Families by Representative Ardian Zika.

The bill requires the Department of Veterans’ Affairs to establish the Florida Veterans’ Care Coordination Program to provide behavioral health care referral and care coordination services for veterans and their families. The bill requires Florida 211 Network participants to collect program implementation data and to submit such data to the department. 

 CS/HB701– Increasing Access to Mental Health Care/Behavioral Health Care Services Coverage and Access by Representative Cyndi Stevenson.
Starting October 1, 2021, this bill creates a more reliable system for the state to collect and report on consumer complaints about denials of service, affordability, and lack of coverage for behavioral health care by private health insurers and HMOs.  (This bill does not address complaints about behavioral health coverage by Medicaid or Medicaid Managed Care companies.)
Here are details of the bill:

• The Department of Financial Services (DFS) will widely promote the toll-free number and hyperlink that allows consumers to report complaints about private health insurers and HMOs. That number and link are: 1-877-693-5236 (1-877-MY-FL-CFO) M-F 8am-5pm, and https://apps.fldfs.com/ESERVICE/Newrequest.aspx.

NOTE: This is important because last year DFS received only a handful of complaints because consumers were not aware that this hotline even existed.

• In January of each year, DFS will submit a report to the Governor, Senate President, and Speaker of the House on the number of, nature of, and disposition of complaints by consumers. The report will include recommendations by DFS on how to ensure access to and affordability of behavioral health services to insureds and subscribers. This report will become public record.
• DFS will make available on its website a description of the behavioral health care benefits required by law for individual and group policies.
• Health insurers and HMOs must also make available on their websites and by direct notice the state and federal requirements for coverage of behavioral health services and the toll-free number and website link for making a complaint. 

We hope that this new system will result in insurance companies being held accountable if they don’t provide equitable access to behavioral health treatment.
Now What? It is important that all of us advertise and use the toll-free number and/or web link. Call to report complaints if you were prevented from accessing behavioral health care through your plan: 1-877-693-5236 (1-877-MY-FL-CFO) M-F 8am-5pmhttps://apps.fldfs.com/ESERVICE/Newrequest.aspx.
If your inability to access behavioral health care is not resolved, you may also contact your elected officials. Let’s end discrimination against behavioral health patients so we all get the care we need to move to recovery rather than relapse. Find your legislators here.  

 On October 23rd, 2020, we saw a great victory for veterans’ mental health care. President Trump signed a landmark bipartisan bill, S.785,The Commander John Scott Hannon Veterans Mental Health Care Improvement Act.

S.785 is named to celebrate the legacy of NAMI Montana member and retired Navy SEAL Commander John Scott Hannon, who served for 23 years and fought a courageous battle with post-traumatic stress, traumatic brain injury and bipolar disorder. 

When veterans transition out of service into civilian life, they can experience many challenges. And tragically, 17 veterans die by suicide each day. Our nation must do better for those who serve our country. This legislation will: 

• Provide wrap-around suicide prevention services through veteran-serving community organizations. 
• Increase accountability of mental health and suicide prevention programs at the Department of Veterans Affairs (VA).
• Help rural veterans by expanding VA telehealth care.
• Boost research, including creating a Precision Medicine for Veterans Initiative to identify biomarkers for mental health conditions.

This bill will help transitioning and former service members access better care—care they deserve and need—and advance research into mental health conditions.

CDR Hannon embodied the strength of veterans with mental health conditions, and this bill represents his passion and efforts to improve access to veterans’ mental health care.

We did it! Because of actions you took, S. 2661, the National Suicide Hotline Designation Act, has been signed into law by President Trump. This bill makes 9-8-8 a nationwide three-digit dialing code for mental health crises and suicide prevention.

The Federal Communications Commission (FCC) approved 9-8-8 with a goal to have it available by July 2022.* S. 2661 will make 9-8-8 fully operational and provide resources to meet the demand for mental health services. When a person is in a mental health crisis, they can be connected to mental health support instead of ending up in the back of a police car. This law will help make that possible. 

This victory is because of the power of your voice and that of tens of thousands of other mental health advocates calling for a better way to help people with mental health conditions and their loved ones during a mental health crisis.

Thank you for your advocacy! 

 *9-8-8 is not yet operational, but help is available now if you or somebody you know is having thoughts of suicide or is in crisis. Text “NAMI” to 741741 or call the Suicide Prevention Lifeline at 1-800-273-8255.