America’s mental health system is stretched to its limits. Rising rates of depression, anxiety, and suicidal ideation make it clear that we are in the midst of a crisis — one that is devastating communities and straining an already overburdened healthcare system.

As a physician, I have seen the heartbreaking consequences of our state’s mental health crisis. Patients wait months for an appointment, are forced to seek emergency care when their conditions spiral, further overloading ER departments, or — far too often — simply go without the help they need.

Floridians in particular face an uphill battle when trying to access mental health care. According to Mental Health America, Florida ranks 11th in prevalence of mental illness but 40th in access to care, leaving 58% of those struggling with a mental health condition untreated. Nearly a quarter of adults experiencing anxiety or depression report needing therapy but are unable to access it.

The demand for mental health services has never been higher, yet the number of available providers remains far too low. Florida needs more hands on deck, and the solution is right in front of us.

Psychiatric Mental Health Nurse Practitioners (PMHNPs) are highly trained specialists in mental and behavioral health, with advanced degrees and clinical expertise. They are more than ready to provide safe, high-quality care to Floridians struggling with mental illness. Yet, due to restrictions in Florida’s Nurse Practice Act, they are barred from practicing independently.

Even more odd is that Florida already allows ‘primary care’ nurse practitioners to practice independently — including the ability to provide mental health treatment. In other words, psychiatric nurses who are specifically trained in mental health are blocked from delivering the very care they are most qualified to provide.

This does not make sense. We have skilled professionals ready to step up, but arbitrary restrictions are keeping them on the sidelines.

Some providers see expanded practice authority for PMHNPs as a replacement for doctors. I see it as a lifeline for patients. According to the Kaiser Family Foundation’s analysis of the U.S. Department of Health & Human Services data, the state needs more than 500 new providers to meet existing needs. In other words, the health system severely lacks the clinical personnel to serve its sole purpose — caring for people.

Granting full practice authority to psychiatric nurses isn’t just good for patients. It’s also fiscally responsible. Studies show that when APRNs are allowed to practice to the full extent of their training, health care costs decrease, and access improves. Florida could save millions of dollars annually by reducing unnecessary ER visits and treatment delays.

The Florida Legislature has already made mental health a priority, approving a historic $2.5 billion investment in expanding services. But money alone won’t fix this crisis if we don’t have enough providers to deliver care. The fastest, most effective way to increase access is to let Psychiatric Mental Health Nurse Practitioners do what they have been trained to do.

That’s why I’m encouraged to see lawmakers acting through HB 883 and SB 758, legislation that grants full practice authority to psychiatric nurse practitioners.

This legislation represents a critical step toward closing Florida’s mental health access gap, and I commend Sen. Corey Simon and Rep. Jason Shoaf for their leadership in sponsoring this much-needed policy. Now that the Florida House has passed HB 883 with supermajority support, I urge our state’s leaders to send this language to the Governor’s desk as we near the end of Session.

Twenty-seven states have already embraced this common-sense reform and our service members and veterans across the country have been treated by autonomous PMHNPs through the military and VA health systems for years. It’s time for Florida to do the same. Patients can’t afford to wait. Let’s unlock the full potential of our mental health workforce and ensure that everyone who needs care can get it.

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Dr. Alicia Sanchez is a licensed physician in Florida.

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Despite critics from several counties speaking out, the House Budget Committee advanced its tax package to dissolve tourist development councils (TDC) and lower property taxes while allowing counties to tap into hotel tax money for general uses.

In the Sunshine State, where millions visit the theme parks and beaches, counties levy a hotel tax known as the tourist development tax (TDT). Currently, at least 40% of TDT revenues must be spent on tourism ads — something the House tax bill calls to eliminate.

“I stand before you opposing any impact on the tourist development tax. This is not a tax cut, but a job killer,” said Paul Beirnes, the Vice President of the Amelia Island Convention & Visitors Bureau. “Tourism on Amelia Island itself accounts for 36% of the jobs in Nassau County. Without marketing that we do so well, Florida will lose visitors. Florida will certainly lose jobs, and Florida will lose tax revenue as a result.”

Beirnes said the county also spends $1 million annually in TDT on beach renourishments to draw tourists.

Under the House tax package (HB 7033), starting in 2026, a credit against county ad valorem taxes would get applied to property tax bills equal to the previous year’s TDT revenue, minus any revenue required for debt service for projects funded by the TDT or remaining contracts.

“Our counties are not asking for indiscriminate flexibility as it relates to how we can spend TDTs. Nor are we wanting to shut down all the TDCs,” said Jeff Scala, deputy director of the Florida Association of Counties.

“We’re not sure what, how the impact of the mechanism to account for the property tax offsets will work. I think there’s a lot of questions about how to allocate those credits and make sure that it is a fair process.”

Republican Rep. Wyman Duggan, who introduced the bill in the budget committee, told critics that the proposal “is the beginning of a process. … The cake is not baked, so there’s a long way to go.”

“Ultimately, this approach with the tourist development taxes is something that we can do right now. We can do it potentially on an interim basis,” Duggan said. “Doesn’t have to be permanent necessarily. Could be the start of a way to do some interim relief.”

The proposed TDT changes come as the state is considering putting a permanent property tax cut on the ballot.

In Central Florida, home of Disney World, officials also are concerned about the potential changes to TDT funding.

“We are closely monitoring legislative proposals related to the TDT and how they might impact already approved projects, including the KIA Center and Camping World Stadium. These are projects that went through an extensive public process and were ultimately approved by both the City Council and the County Commission,” said city of Orlando spokeswoman Ashley Papagni.

“These projects are vital to maintaining Orlando’s position as a premier destination for entertainment and tourism, and they deliver substantial economic benefits to local businesses. We remain hopeful that the final legislation will preserve the tools local governments rely on to support these important investments.”

Rep. Anna Eskamani, an Orlando Democrat, has been a proponent for Orange County having more flexibility to pay for public transportation or affordable housing with the TDT revenue. However, she said the House proposal wouldn’t mean extra money for Orlando’s needs since TDT revenues would go toward bond payments or property tax reduction. 

“It is not the TDT reform I am looking for — I want local flexibility and control,” Eskamani said. “Hopefully, through legislative negotiations, we’ll be able to strike a balance.”

House Budget Committee Chair Lawrence McClure told lawmakers the Senate and House are moving forward in budget talks.

“Just stay tuned,” he said at the start of the meeting. “We feel like we’re going to get to a place here pretty quickly, we will be in conference.”

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A proposal to block further development on Florida state park land is heading to the floor of the Senate after the Fiscal Policy Committee signed off on the measure.

The bill (SB 80) is the result of a massive move against additions, such as golf courses, hotels and pickleball courts, on state park land. Those proposals prompted widespread protests by residents last Summer when the Gov. Ron DeSantis administration pitched increasing development on protected park land.

The plans were scrapped after the rising intensity of protests across the state.

Sen. Gayle Harrell, a Stuart Republican, sponsored the bill, called “The State Preservation Act.” It would require “public hearings for all updated conservation and nonconservation land management plans; requiring the Division of Recreation and Parks of the Department of Environmental Protection to comply with specified provisions when granting certain privileges, leases, concessions, and permits.”

Harrell said the sizable protests to the plans from DeSantis last year proved that there’s no leeway when it comes to protecting some 175 state parks.

“We had many demonstrations across the state when there was an endeavor to really commercialize our state parks,” Harrell said. She added her measure is designed to honor those protests and “to make sure it doesn’t happen again.”

Sen. Joe Gruters, a Sarasota Republican, did propose a substitute for an amendment to the measure that would open up reviews of any plans to add development to parks. That proposed amendment wasn’t filed until Monday and suggested that some new amenities could be added. But it would have to be proven that they don’t “cause substantial harm” to the parks or the environment within those facilities.

Gruters said he didn’t want the amendment to augment developments such as hotels and golf courses, but there may be some need for additional amenities at some parks in the future. He said his main concern was for rehabilitation, upgrades and maintenance on existing facilities. He added his amendment still required a “high hurdle” before anything could be added to state parks.

The proposed amendment fell flat and drew sharp criticism.

Travis Moore of the Friends of the Everglades said the amendment is not what those who were opposed to state park development would even entertain.

“I don’t think the public (last) Summer was interested in setting a high hurdle,” Moore said. “I think there’s clarity from the outpouring that we saw (last) Summer that golf courses not be allowed. The ‘substantial harm’ is subjective. The subjectivity is a concern.”

Committee members agreed and rejected the Gruters proposed amendment.

The Senate bill is identical to a House measure (HB 209) by Rep. John Snyder, a Stuart Republican, that was approved on the floor of that chamber earlier this month.

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