Preheat oven according to tater tot package directions (usually 425°F).
Heat large (11-3/4" minimum) oven-safe skillet over medium-high heat.
Add sausage and cauliflower, breaking meat into small pieces. Cook until no pink remains, about 5-7 minutes.
Reduce heat to medium, sprinkle flour over meat. Cook 1 minute, stirring constantly.
Slowly add milk while whisking continuously to prevent lumps.
Season with salt and pepper. Simmer 3-4 minutes until slightly thickened.
Remove from heat, arrange tots in circular pattern on top.
Bake according to tot package time until golden brown.
Let rest 5 minutes before serving.
Garnish with green onions if desired.