Florida
Splitting the Year: Psychiatric Care for Florida’s Seasonal Residents
By Dr. Stacey Forbes, DNP, APRN, PMHNP-BC
Key Takeaways
- Clinicians are licensed by state, and care must be delivered where the patient is located — which is why splitting the year breaks continuity.
- The clinical cost is real: each restart means a new history, a new prescriber’s judgement, and frequently a medication change that was not clinically necessary.
- Florida appointment availability tightens exactly when the seasonal population arrives, which is the worst possible timing.
- One practice licensed in the state where you spend most of your time, plus a clear plan for the months you are elsewhere, beats two half-relationships.
A large number of Floridians are only Floridians for part of the year. For psychiatric care that creates a specific and under-discussed problem: because a clinician can only treat a patient who is physically located in a state where the clinician holds a licence, the person who moves twice a year tends to end up with two prescribers, two versions of their history, and a treatment plan that resets every time they pack the car.
Why care restarts every time you move
Licensure follows the patient, not the clinician. A psychiatric clinician licensed in Florida can see you when you are in Florida; when you are physically in another state, that clinician generally cannot. It is a rule about where you are sitting at the time of the appointment, not about where you pay taxes or keep a mailing address, and it surprises people every year.
What the restart actually costs
The cost is not administrative, it is clinical. A new prescriber takes the history again, usually in less time than the original evaluation took, and inherits a medication regimen without the reasoning behind it. Reasonable clinicians facing an unfamiliar regimen frequently make a change — not because the regimen was wrong, but because they cannot see why it was chosen. Two of those a year, for several years, produces a medication history that looks like a long list of failures when it is really a long list of interruptions.
What actually works
The most workable arrangement is usually one primary psychiatric relationship, held with a clinician licensed in the state where you spend the larger share of the year, plus an explicit plan for the months you are elsewhere. That plan is a conversation worth having before you leave rather than after: how prescriptions will be handled, how long a supply you need, what happens if something changes while you are away, and at what point you should seek local care instead of waiting.
- Decide which state holds the primary relationship, and say so out loud
- Agree the plan for the away months before you leave, not after
- Keep one current medication list rather than two partial ones
- Ask what would count as a reason to seek local care rather than waiting
Timing, and why season makes it worse
Florida psychiatric availability is tightest between roughly December and April, which is precisely when the seasonal population is present and wanting appointments. Arriving in January and starting the search then is the hardest version of this. Establishing care during the quieter months, even if the first appointments are by video before you arrive, avoids competing with everyone else for the same narrow window.
Where telehealth helps and where it does not
Telehealth removes distance from the equation, so a patient in Naples and a patient in Tallahassee can see the same clinician. What it does not remove is the state line: a video visit is still care delivered where the patient sits. That means telehealth solves the "my clinician is three hours away" problem completely and the "I am in Michigan until May" problem not at all — which is why the away-months plan matters.
Common Questions
Can my Florida clinician see me by video when I am up north?
Generally no. Care has to be delivered in a state where the clinician is licensed, and that is determined by where you are physically located at the time of the appointment — not by where you usually live.
Should I have two psychiatrists?
Usually it works better to have one primary relationship, in the state where you spend most of the year, with an agreed plan for the months you are away. Two parallel prescribers frequently means two incomplete pictures.
When should I establish care if I arrive in December?
Earlier than December. Availability tightens as the seasonal population arrives, so establishing the relationship in the quieter months — even remotely, once you are in the state — avoids the worst of the crunch.
What do I do about prescriptions while I am away?
Agree it before you leave: how long a supply you need, how refills will be handled, and what should prompt you to seek local care rather than wait. It is a five-minute conversation that prevents most of the problems.
Sources & Further Reading
Care in Florida
Dr. Stacey Forbes, DNP, PMHNP-BC, provides integrative telehealth psychiatry to patients throughout Florida. See psychiatric care across Florida, or book a consultation →
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Dr. Stacey Forbes, DNP, APRN, PMHNP-BC
Board-certified Psychiatric-Mental Health Nurse Practitioner and founder of Willow & Stone Integrative Mental Health. Nearly two decades of clinical experience; integrative, root-cause psychiatry via telehealth. Licensed in Texas, New Mexico, Florida, Alaska, Arizona & Colorado.
About Dr. Forbes →