Congratulations to Asha Terminello on her appointment as Chief Executive Officer of the Agency for Community Treatment Services, Inc (ACTS) in Tampa, effective June 2019.
Asha has been with the ACTS for more than 27 years and has extensive experience with behavioral health, juvenile justice and criminal justice systems of care. She served as the Chief Operating Officer for more than 11 years where she was responsible for a wide array of clinical treatment and community-based services in Hillsborough, Pinellas and Polk counties. Her experience in the field has enhanced community relationships, and has helped ACTS build strong alliances with law enforcement, the courts, Department of Juvenile Justice, Department of Children and Families, Child Welfare, Veteran’s Administration and Central Florida Behavioral Health Network. She was instrumental in the implementation of the first Juvenile Assessment Center in Hillsborough County and assisted on the implementation of several JACs in Florida. She currently serves as a board member for Florida’s Behavioral Health Association, Florida Juvenile Justice Association, Hillsborough Anti-Drug Alliance, Hillsborough County Behavioral Health Task Force and the Health Care Advisory Board’s Management Subcommittee. She earned her Bachelor’s Degree in Psychology from the University of South Florida and a Master’s Degree in Mental Health Counseling from Nova Southeastern University.
The Department of Children and Families recently released the second Notice of Change/Withdrawl to the proposed rewrite of Rule 65D -30. The Notice of Change modifies some of the initial proposed rewrite as well as in the first Notice of Change. Here is the history of rule promulgation on this rule. The most recent release is a much smaller document than the previous two, indicating that the Department is beginning to “close out” some of the proposed items. To date, a Public Workshop has not been scheduled. Meanwhile, the Department adopted the final rule regarding Methadone Maintenance, along with the Fiscal Year 2018-19 Methadone Needs Assessment. However, if you have any questions, comments, or concerns, please feel free to contact Jill Gran (firstname.lastname@example.org) or Sally Cunningham (email@example.com). Here are two documents prepared by the association. The first document is a spreadsheet that outlines each change, and when the change was made, along with comments made by members of the association. The second document summarizes the second Notice of Change.
How would you describe your job to someone who is not in your line of work?
Although many people experience behavioral health issues among family or friends, it is foreign territory to discuss it. Besides the usual CEO duties of leading, finding more funding and communicating to staff and community, helping people understand and discuss behavioral health so it isn’t unfamiliar territory is a key role. So many don’t know how to put issues into words or into perspective. I spend hours on the phone with community contacts and family members helping them understand the need and methodology for treatment, access and levels of care including Marchman Act options.
How did you get started in your profession?
I am a Psychiatric Nurse Practitioner so education prepared me for a role in Behavioral Health.
What are the biggest challenges in your role?
Equality in healthcare is such an uphill battle. I have hope that one day, politicians and healthcare plan leaders will understand the impact behavioral health has on all illnesses and will welcome parity for this field of healthcare.
What is the most rewarding part of your job?
I have the incredible experience of working with a smart and talented Board of Trustees and a quality staff that is beyond reproach. They make my job so much easier! My biggest reward is running into family members and people in the community that have received or need our help. Being the answer to someone’s prayers is a very special place to be!
What is your hope for the future of health care in Florida?
My hope is that Behavioral health will eventually take its place in hospital care and community care as a key to treatment of all diseases and parity becomes a reality. Rehab for orthopedics is paid for in a rehab center for months by insurance after a hip surgery, but rehab after detox is a denied service. Usually the detox isn’t paid for either. This just has to change!
What are your favorite hobbies?
The mountains with my husband and spending time with my grandchildren are tops on my list. I enjoy duplicate bridge with friends.
When another healthcare organization, or another member, thinks of Circles of Care what do you want them to visualize?
We are a large, financially sound provider of mental health and substance abuse services in Brevard County, Florida. We have 10 locations in Brevard County to serve the needs of the mentally ill and substance abusers. All of us on the management team are involved in community organizations or statewide committees. This allows us to network with other professionals and have community allies.
How has growth affected Circles of Care over the years?
Circles of Care was founded in 1963 with 6 employees. While we have a 40-million dollar budget, real growth did not start until the 1980s when we opened a 52 bed licensed psychiatric hospital. In the 1990s we opened our first commercial pharmacy and we now have three pharmacies. We also developed and expanded residential facilities for the mentally ill which now totals 98 beds. In the 2000s we built a 50 bed Baker Act Receiving Facility, the largest in the state and got licensed for 50 beds. We now have a total of 102 adult psychiatric beds. This Baker Act unit was awarded the Architect & Contractor ACE award for the most innovative building in Central and South Florida in 2011 under 25 million dollars. We have three major Outpatient Clinics located throughout the county. Our central county Outpatient Clinic was built in 2017 and named after the former President & CEO James B. Whitaker.
What else should we know about Circles of Care?
• Circles of Care is JCAHO Accredited • We have 600 employees • Sally’s House is our long-term residential recovery home program for substance abusing women and their children. We acquired this program through a merger. • Circles has both Inpatient and Outpatient Medically Assisted Treatment programs • Circles has a 16 bed children’s crisis unit • Circles has a 30 bed detox/residential program • Circles was one of the founding members of the old FCCMH and we are honored to have four of our staff receive Fellow Status: James B. Whitaker, former President & CEO, Linda Brannon, VP of Human Resources, Stephen Lord VP Information Systems and myself David L. Feldman, President and CEO.
What is the most common challenge you find when speaking with executives at other community-based behavioral healthcare organizations?
Circles, like many centers, has many challenges-primarily the limited funding we receive from the State, particularly for our Safety Net Programs. In addition, we face new competition from a private for profit psychiatric hospital. Managed Care companies have become even more restrictive, learning new ways to deny /reduce payment for services. We will attempt to meet these challenges to continue to be the provider of choice in Brevard County and even thrive in this new healthcare environment. Thank you taking the time to read this and learning about Circles of Care, Inc.
In the Tampa Bay area, one in six people suffers from depression. One in twelve has a substance abuse disorder. And there is only one mental health professional for every 700 people in Florida. These are some of the statistics given Thursday to highlight the region’s need for more mental health coverage.
Leaders from organizations around the region gathered in Tampa to discuss a new initiative to address the mental health crisis. They announced that they’re forming a nonprofit called The West Central Florida Mental Wellness Coalition. While BayCare is the company leading the coalition, CEO Tommy Inzina said it will take a community effort for it to succeed. “We’re not in the school systems every day, we’re not dealing with everything law enforcement has to deal with, there’s a lot the business community can do,” said Inzina. “So we had this idea of creating a community coalition.”
Pasco County Sheriff Chris Nocco said police officers deal with the mental health crisis first-hand every single day. “Last year we handled 19,283 mental health calls. Approximately 11% of our calls for service are mental health related. We weren’t built for this. But we have to adapt because this is the environment,” he said.
The sheriff went on to say that deputies responded to over 2,000 suicide calls last year. He said one night he was dispatched to a suicidal person’s house and when he got there, the person just wanted someone to talk to.
Mental health is an issue in schools as well, according to Hillsborough County Assistant Superintendent Trayce Brown. “It is nothing for us to think about taking our students to the nurse for a physical ailment, but often times we don’t do the same thing for mental wellness,” she said. Brown said it’s important that schools feel equipped to get students the help they need, and that’s why the school district is joining the coalition.
Barbara Daire, CEO of mental healthcare provider Suncoast Center, Inc. said the coalition is a dream come true for her. “It’s just so wonderful to have everyone really look at this very important issue because we have a lot of unhappiness and a lot of unsettled people in our community,” Daire said. “This has been a lifelong dream of mine. I see that this group is going to be able to raise awareness and break the stigma in a big way across four counties (Hillsborough, Pinellas, Pasco, and Polk). “We could potentially be the model for the rest of the country.”
The West Central Florida Mental Wellness Coalition has three primary goals. They want to start a public awareness campaign to get people educated on the scope of the mental health issue, they want to increase urgent care access for behavioral health, and they want to provide resources for patients seeking mental health help.
The coalition has already raised a little over $5 million toward their goal of $7.5 million that they need to cover operating costs for the first five years.
BayCare is matching any donations given to the coalition. So far, companies like Advent Health, Florida Blue, and Tampa General Hospital have donated. Inzina said that the board for the nonprofit will be representative of all stakeholders. He said he hopes hospital systems, mental health providers, local businesses, law enforcement, and schools will be included. “This is not a BayCare initiative, it’s only going to be as successful as the support we can get.”
In late June, Governor Ron DeSantis signed the FY2019-20 “Bold Vision for a Brighter Future” budget, nearly seven weeks after the Legislature adjourned “sine die.” During his press conference DeSantis said, “it’s a fiscally responsible budget. I think we put taxpayers first.”
The General Appropriations Act (SB 2500) went into effect on July 1, 2019 with roughly $131.3 million in line-item vetoes. This compares to $64.1 million vetoed in FY2018-19 by his predecessor. Among the $131.3 million special- project vetoes, $14.182 million were for local initiatives for substance abuse, mental health, and housing, including cost of living increases at contracted state hospitals ($4.14 million); affordable housing project in Jacksonville ($8 million); and CESC homeless housing ($1 million).
In his press release, the Governor highlights that the budget, “includes more than $123 million in total funding to fight the opioid epidemic and $106 million to provide funding for services to children and families who depend on Florida’s child welfare system. Furthermore, the budget provides more than $70 million to serve individuals on the Agency for Persons with Disabilities home and community-based waiver program.”
As passed the FY2019-20 budget totaled $91.1 billion. After the Governor’s line item vetoes the total dropped to $90.9 billion, but still up approximately $2.2 billion from last year’s budget.
The passage of the Telehealth bill does not actually require health plans to cover services delivered via telehealth. With an effective date of January 1, 2020, the bill creates a new Section 627.42396, F.S., which reads, “A contract between a health insurer issuing major medical comprehensive coverage through an individual or group policy and a telehealth provider, as defined in s. 456.47, must be voluntary between the insurer and the provider and must establish mutually acceptable payment rates or payment methodologies for services provided through telehealth.” Subsection (45) also was added to Section 641.31, F.S., which mirrors this language for health maintenance organizations.
The language only clarifies that contracts signed by insurers with telehealth providers be “voluntary” with mutually acceptable rates or payment methodologies and requires the telehealth provider to initial any contract provision that would cause telehealth reimbursement to be different than reimbursement for the same services provided in person. Unfortunately health plan reimbursement continues to be a stumbling block for telehealth providers and patients as Florida remains among the minority of states without telehealth insurance coverage. What does this mean for Medicaid? We are working with the Agency to encourage that current coverage stays “as is.”