As the lobbyists for the Florida Mental Health Counselors Association (FMHCA) it’s important to relay pertinent updates to the Association even when the Florida Legislature is not holding its annual 60-day legislative session. The FMHCA Government Relations Committee (GRC), Board of Directors (Board) and dedicated association members work year-round to ensure that FMCHA is poised to react to Florida’s policy and political landscape on behalf of the mental health counseling industry.
Heading into June, both politics and policy are in-play. The midterm elections are heating up and FMHCA is already engaged in discussions with the state board, Florida Department of Health (DOH) and other industry leaders regarding the topic of license portability – a topic that could result in a bill next year.
Florida is in throws of a turbulent midterm election season. From open seats to races where incumbents preside, a slew of ardent-hearted, money-toting candidates are already trading punches, defending records and spending millions on 30 second media buys in anticipation of the August primary and November general election.
And rightly so. The stakes are high. The Florida Senate is currently made up of 23 Republicans and 17 Democrats. It’s believed that the Democrats may bring the upper-chamber closer to balanced. In addition, Florida’s four cabinet seats are up for grabs and the race for governor will be one of the most watched in the nation. If the “blue wave” persists (Democrats won a massive upset in Florida’s most recent special election. Margaret Good beat Vern Buchanan, son of Congressman Buchanan by a whopping 8 points in a district that Donald Trump carried by more than 4 points; article here) the state is likely to see a subtle shift toward the Democrats.
It’s possible that the “blue wave” will flatten and that the Democrats will make only minor gains, but any movement toward Democratic leadership would be abnormal for Florida’s recent history. The last time a Democrat served as governor of Florida was 1999 and the Senate hasn’t seen a Democratic president since 1993.
These changes could impact how policy is made. The Republicans have remained extremely loyal to their leadership and have accomplished a wealth of their priorities as a result of their cohesion. A closer ratio of Democrat to Republican means extensive negotiating would need to occur in order for legislation to pass. Many of those negotiations would become more bipartisan.
The makeup of the Florida House and Senate has an impact on FMHCA and all Floridians. Contrary to popular belief, state politics has as much, if not more, impact on your daily lives, both personal and professional, than national politics. This Association is the only entity advocating solely for the practice of LMHCs and the people you treat.
One example of that advocacy is FMHCA’s recent involvement in a state board workshop to discuss developing legislation to create a portable licensure system or multistate licensure compact. FMHCA holds a valuable seat at the table where the bill may be written. If FMHCA supports the measure, its lobbyists will advocate for the legislation during the 2019 session which begins in March. If the bill is crafted in such a way that FMHCA cannot support it, we will work to kill the legislation. The concept of portability is relatively new in Florida. The injection of fresh faces into the Florida Legislature and Cabinet may bring forth the opportunity for contemporary ideas.
Being a member of FMHCA is one of the most important roles you can play. The profession and its title exist in statute because your professional predecessors engaged in political races, crafted legislation and advocated for the distinction of LMHC.
Your lobbying team and GRC will continue to update you about the topic of licensure portability as well as the upcoming election. We are proud to lobby on your behalf.
Lobbyist Report, by Corinne Mixon, Rutledge Ecenia, P.A.
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With the backing of local sheriffs, mental health professionals and two mothers who lost their sons to the opioid epidemic, U.S. Rep. Vern Buchanan has introduced a seven-part bill to tackle the opioid epidemic from multiple angles.
"We've come a long way since shutting down pill mills and other things we've done, but there's a lot more we need to do," Buchanan, R-Longboat Key, said Monday at Centerstone, a mental health facility in Bradenton.
The bill, called Opioid Emergency Response Act, is a multifaceted, bipartisan approach that addresses mental health treatment, beefs up screening of packages through the U.S. Postal Service and calls for harsher sentences for convicted dealers.
Centerstone CEO Melissa Larkin-Skinner praised Buchanan's efforts, saying he is at the "forefront of the fight."
She noted that the leading cause of death for people under the age of 50 was of drug overdose, and that 4,215 babies born in Florida were diagnosed with neonatal abstinence syndrome, which is when a newborn withdraws from drugs they are exposed to in the womb.
Buchanan has sponsored a bill within the larger bill called Alternatives to Opioids Prescribing Act, which would incentivize hospital emergency rooms to use high doses of Tylenol or Advil instead of low-dose opioids.
Manatee Memorial Hospital is already using this approach. Kevin DiLallo, CEO of Manatee Healthcare System, said their emergency room has implemented the Alternatives to Opioids method, which focuses on pain management methods that don't rely on opioids. Six months into using the method, the emergency room saw a 30 percent decrease in opioid prescriptions.
"I think this is where you can start," DiLallo said. "Start in the emergency rooms, reduce some of the opioid use and you can reduce some of that on the streets as well."
The other bills within the Opioid Emergency Response Act are:
▪ Opioids and STOP Pain Initiative Act (H.R. 4733), introduced by Rep. Peter Welch, D-Vt., which would direct resources to the National Institutes of Health to research addiction, pain and opioid alternative treatments.
▪ Continue the awarding of grants under the 21st Century Cures Act to increase opportunities for prevention and treatment access.
▪ Mental Health Access Improvement Act (H.R. 3032), introduced by Rep. John Katko, R-NY, would allow new types of providers to join Medicare for senior treatment.
▪ SISTA Act (H.R. 2851), also introduced by Rep. Katko, to facilitate the outlawing of certain synthetic drugs and increase sentences for convicted drug dealers.
▪ STOP Act (S. 372), introduced by Sen. Rob Portman, R-Ohio, would direct the U.S. Postal Service to require more stringent screening of packages to look out for fentanyl and carfentanil.
▪ Veteran Overmedication Prevention Act, introduced by Sen. John McCain of Arizona, that would direct the U.S. Department of Veterans Affairs to study the link between prescription opioids and the high rate of veterans' suicides.
Cindy Bales, of Sarasota, and Ruth Lyerly, of Bradenton, who lost their sons, have been "a guiding light" for Buchanan, he said. When they met eight years ago, they showed him 200 empty prescription bottles, representing the amount of drugs dispensed in the area that day.
"Treatment has been long lacking for many, many years," Lyerly said. "Prevention has come a long way, but treatment has not."
Manatee Sheriff Rick Wells and Sarasota Sheriff Tom Knight also support the approach. Although Manatee County had the highest rate of deaths in Florida related to fentanyl analogs in 2016, deaths have been declining. In the first three months of 2017, the sheriff's office responded to 262 overdoses and 35 deaths, whereas the same time in 2018 they addressed 68 overdoses and eight deaths.
"We have to save our community," Wells said. "My job is to eliminate the source. We have to work together to treat those that are struggling and the congressman has done that today."
BY HANNAH MORSE
April 16, 2018 02:14 PM
Updated April 16, 2018 08:28 PM
Representative Darren Soto, 9th Congressional District has just cosponsored HR 3032. Those who live in the 9th District, please either call or send email to thank him. So now Florida has 3 representatives who have signed on to HR 3032: Rep. Rutherford, Rep. Buchanan, and now Rep. Soto. The challenge is this: Which region/chapter is going to bag the next Representative?
--FMHCA President Louise Sutherland-Hoyt
Gov. Rick Scott on Monday ordered the Florida Department of Children and Families to better coordinate with local law enforcement agencies in all 67 counties to improve substance abuse and mental health services for young people.
The action was taken to help stop someone who may be deemed a threat to carrying out a violent attack similar to the one last month at Marjory Stoneman Douglas High School in Broward County by identifying and helping those in need of counseling.
"My goal is to ensure DCF is integrated in every local department, so we have a person working hand-in-hand with law enforcement and dedicated solely to being a crisis welfare worker focused on repeat cases in each community," said Scott in a statement. "We will continue [to] ensure that all Floridians have the opportunity to get the treatment they need."
Scott's order adds to the provisions already outlined in the Marjory Stoneman Douglas High School Public Safety Act, FL SB7026 (18R), which the governor signed into law March 9. The 105-page bill includes funding for mental health services at schools and to direct mental health counselors to all schools.
The bill became law less than a month after the confessed shooter, 19-year-old Nikolas Cruz, opened fire with an AR-15 on Valentine's Day, killing 17 people, including 14 students, at the Parkland high school. The Associated Press and Miami Herald reported last week that some authorities had wanted to involuntarily commit Cruz.
Committing Cruz for an involuntary examination under the state's Baker Act law would have kept him from purchasing a gun for three days, but would not have been a long-term solution for his behavioral health problems. POLITICO has previously reported that mental health experts say he likely needed to be institutionalized for a year or longer, which would have been costly and difficult in Florida.
Regardless, Cruz's rampage has highlighted the many weaknesses in Florida's fractured mental health system.
Following the worst school shooting in state history, Scott directed three state-run workshops to assess how his administration could better prepare law enforcement, schools and behavioral health experts to prevent future school shootings. Throughout those workshops, sheriffs reiterated their need to get people struggling with mental health issues out of jail and into treatment.
The statewide group representing state health administrators applauded Scott's order.
"We welcome this collaboration with school officials and law enforcement," Natalie Kelly, the executive director of the Florida Association of Managing Entities, told POLITICO. "This way we can ensure that we have effective communication across the big three: school officials, law enforcement and mental health providers."
03/26/2018 06:49 PM EDT
Politico Florida Policy Reporter
Chief Justice Labarga directed the Committee on ADR Rules and Policy (Committee) to review the Parenting Coordinator Discipline Operating Procedures and develop new rules of discipline to be added to Part II, Discipline, of the Rules for Qualified and Court-Appointed Parenting Coordinators. The Committee invites all interested persons to comment on the proposed disciplinary rules for Qualified and Court-Appointed Parenting Coordinators.
Please note that parenting coordinators are qualified and disqualified pursuant to subsections 61.125(4) and (5), Florida Statutes, and In re: Parenting Coordination Application Form and Training Standards, Fla. Admin. Order No. AOSC14-64 (Nov. 14, 2014). The administrative order specifically places the qualification and disqualification of parenting coordinators with the chief judge of each judicial circuit and not with the Parenting Coordination Discipline and Review Board (PCDRB) or the Dispute Resolution Center. Part II of the proposed rules includes a number of references to disqualification by the chief judge and it is important to understand their role in the disciplinary process. [See ADR Resource Handbook]
Please address your comments to:
The Honorable Rodney Smith, Chair,
Committee on ADR Rules and Policy
Supreme Court of Florida
Dispute Resolution Center
Corinne Mixon, Rutledge-Ecenia (FMHCA Lobbyist)
The 2018 Florida Legislative Session (session) came to a dramatic close on Sunday evening (3/11/18). The 60-day window for policy making was one of the most gut-wrenching terms in Florida’s history. The rear impact of Hurricane Irma, which seemed to dominate the Florida’s interim committee weeks in the fall, fell to a distant second place as a matter of importance, as Florida’s legislators and executive cabinet scrambled to respond to the shooting of 17 innocent people at Marjory Stoneman Douglas High School.
Detailed Bill InformationBelow you’ll find a list of bills that may be of interest to you and your practice. If you have specific questions on any legislation, please feel free to contact us.
The timing of the event was surreal in its opportunism, as the Legislature was about half way through its annual policy making process. If the shooting would have occurred 20 days later, Florida’s Legislature would have shepherded-in the 2018-2019 fiscal year with $68 million fewer dollars to address the mental health of students and an A-rating from the National Rifle Association (NRA) to match its “near perfect” prior rating.
In addition, dozens (possibly hundreds) more bills may have passed. Instead, the Florida Legislature had just enough time file public safety legislation, debate it and amend its state budget to accommodate the measure known as SB 7026, An Act Relating to Public Safety. That budget passed on Sunday evening after the Legislature was forced to extend session by two days.
Changes to Florida’s gun laws would not have passed if the shooting hadn’t occurred. However, the Legislature and Governor Rick Scott had been mulling-over the possibility of increasing mental health spending prior to the massacre. Governor Rick Scott’s initial budget recommendation, for instance, recommended an additional $53 million for combatting the opioid crisis and $21.7 million for community mental health, community action teams and child protective investigators. An initial education proposal by the Senate also proposed an additional $40 million to be earmarked for student mental health services.
Funding aside, the Legislature also considered several proposals to enhance services for veterans, seniors and children. The Florida Mental Health Counselors Association (FMHCA) supported many of these measures. In addition, FMCHA crafted and lobbied for the successful adoption of an amendment that strengthens and streamlines the accreditation standards to become licensed in mental health counseling. That language was part of a bigger legislative package that lost steam after the shooting occurred. Ultimately, many bills died in the final days of session once the Legislature turned its attention to gun safety and mental health.
In fact, a record 3,250 bills were filed during the 2018 session; whereas, a record low 200 bills actually passed. That’s about 5-6% compared to the average 10-14% that pass in a typical year.
Worker’s Compensation Reform – Mental Health Reform for First Responders
The passage of SB 376 (Sen. Book) and HB 227 (Rep. Willhite) means that first responders diagnosed with PTSD are eligible for workers’ compensation benefits for the first time ever. Prior to passage of these measures, Florida law did not allow workers comp benefits to be paid to first responders diagnosed with PTSD unless a physical injury had occurred.
After the Pulse Nightclub tragedy occurred, many firefighters and first responders were unable to return to their jobs based on the horror they had experienced. Rather than taking time off to address their (emotional) wounds, as they would have with a physical ailment, many first responders were forced to return to work because they could not afford to take time off without engaging their workers’ compensation policy. Dozens of wives, husbands and children testified about their family members (first responders) committing suicide following the Pulse event and other traumatic experiences which are regularly associated with these difficult careers. Another family member testified about the death of her husband who took his own life after responding to a traffic accident in which he found his brother pinned lifeless under a minivan.
This legislation faced early-opposition from the Florida League of Cities due to the potential of increased cost. However, Sen. Book and Rep. Willhite were able to reinvigorate the policy after the Majority Stoneman Douglas High School shooting.
As a result of these efforts, workers comp benefits are now available to first responders with PTSD arising from murders, suicides, mass casualties or other incidents involving a death.
The Marjory Stoneman Douglas High School Public Safety Act
In 2018 alone, there have been at least 14 school shootings in the US. This legislation passed in direct response to the mass shooting at Marjory Stoneman Douglas in Parkland, FL. FMHCA’s GRC Committee has joined a Joint Advocacy Coalition with ACA, FCA, FAMFT, FSCA, and other mental health organizations to assist with the implementation of several components of this $400 million bill.
The appropriation includes more than $69 million for mental health assistance in schools, and FMHCA is taking an active role in working on the front lines to improve the mental health service needs of our great state. The bill became law immediately following Governor Rick Scott’s approval on March 9. Much of the money appropriated in the legislation will be available to school districts through DOE grants. However, per Section 36 of the bill, the increase of $69 million in mental health student funding associated with the Safe Schools allocation will be available through the Florida Education Finance Program (FEFP). In Section 37 of the bill, $6.7 million is appropriated to youth mental health training.
Opioid Legislation and Funding
The $54 million opioid bill Gov. Rick Scott first unveiled last September to combat Florida's deadly drug epidemic remained consistent with the Governor’s original plan. The bill, which includes the funding component, passed in the final days of the legislative session.
That funding discussion became contentious at the end of session. State House budget chairman Carlos Trujillo accused state Senate President Joe Negron of essentially holding the legislation hostage by requiring Vivitrol get a recurring line-item dollar amount of $5.3 million a year. This medication assisted treatment would have been specifically named in law giving this particular pharmaceutical company a distinct advantage. Ultimately, this provision was stripped from the bill allowing it to pass.
The bill also requires that all prescribers of opioids take a 2-hour course in the safe prescribing of controlled substances. The other two major tenets of the legislation are: limiting prescriptions of opioids to a maximum of three to seven days for the treatment of acute pain, and expanding the use of the Prescription Drug Monitoring Program. That program will receive much-needed technological upgrades as a result of the bill.
Perinatal Mental Health
These bills require that the Department of Health (DOH) offer perinatal mental health care information through the Family Health Line toll-free hotline accessible to general public. Further, the bills revise components included in postpartum evaluation and follow-up care provided by birth centers to include mental health screening and information about postpartum depression.
These bills, HB 937/SB 138 passed and will be implemented in July.
Personal Injury Protection Legislation (PIP) – Motor Vehicle Insurance
Bills that would have overhauled the PIP system of insurance did not pass the legislative process.
This House bill would have repealed the PIP law altogether. In its place, Floridians would be required to purchase more Bodily Injury (BI) coverage.
The Senate version would have provided some medical payments coverage, leaving in place what some were referring to as a “PIP lite” system. The bill also would have allowed for a $5,000 death benefit.
Neither bill passed, but these proposals are expected to return.
Services for Veterans and Their Families
HB 179 by Rep. Burgess and SB 326 by Sen. Young did not pass despite the strong support of many veterans and health care providers. These bills would have helped outsource veteran’s services to local health care providers. Licensed mental health counselors were specifically named in the bill as providers that could oversee (supervise) this care. These bills carried a fiscal impact and ultimately failed; however, we expect they will return.
What is the number of opioid deaths of Medicare recipients in Florida? Pass this along to your congressman as you pitch for support of medicare legislation in Congress.
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Ellsworth “Tony” Williams, President and CEO of Veterans Counseling Veterans and FMHCA Military Service Committee Chair, traveled to Tallahassee Florida to visit State Senator Dana Young's office to voice his concerns and support Senate Bill 326. He was accompanied by members of the Veterans Counseling Veterans team, Felicia and Carol Rasor-Cordero. He pointed out the language of the bill was missing veterans and families suicide postvention counseling services. VCV was also concerned that tying the families eligibility for services to the veterans characterization of discharge would harm the family that needs a service the most.
Overall, Veterans Counseling Veterans supports the passage of Senate Bill 326 and House Bill 179. This bill will provide a coordinated referrals system for veterans and Families who acquired Behavioral Health assistance. While at the capital, Tony participated in the State Veterans Council meeting. The council discusses bills that affect the military residents of Florida
Office: +1 (561) 228-6129
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