Newsletter April 1, 2019
Message From the President
By Melanie Brown-Woofter, OBHA President
Welcome to the April Edition of Florida’s One Behavioral Health Association (OBHA) Newsletter. We continue to move forward integrating our associations. More than 20 of our members represented the Florida Delegation at the recent National Council for Behavioral Health Conference (NatCon19) in Nashville.
The National Council Awards of Excellence annually recognize individuals and organizations working to strengthen behavioral health care, enhance access to care, and support our communities with visionary leadership. This year, One Behavioral Health Association Member and IMPOWER CEO and President, Anna Baznik accepted the National Council Awards of Excellence for Technology. OBHA Executive Staff Member Mark Fontaine accepted a Visionary Leadership Award for his work with FADAA.
We applaud the excellent work of our members and staff. The National Council’s recogniton helps to showcase the work that has been done, and continues to be done on a daily basis by our members and dedicated staff.
We are now in week five of Florida’s Legislative session and continue to monitor the issues of importance to OBHA membership. One of the highlights of this edition of our newsletter is the rebroadcast of the Governor’s Listening session on mental health issues.
As always, we welcome your feedback on this newsletter and all our communications. Contact Melanie here.
ICYMI – In Case You Missed It
Governor DeSantis Mental Health Listening Session
OBHA Staff; Reprinted from OBHA Legislative Update
Spearheaded by First Lady Casey DeSantis, Governor Ron DeSantis held an hour-long “listening” session on Thursday, March 28 on mental-health issues with an emphasis on suicide prevention in response to the recent tragic deaths by suicide of two Parkland students. Several agency heads participated in the listening session (DCF, DJJ, Veteran’s Affairs, AHCA, DOH, FDLE, Education, and Elder Affairs) as well as Lt. Governor Nunez, Senator Book, Senator Rouson and Representative Rodrigues. All acknowledged the ongoing difficulties surrounding mental health and suicide. They cited statistics about national life expectancy dropping due to suicides and opioid use and how mental health is a bigger problem than may be widely understood. The Governor urged state agencies to work together to tackle the problem. He said Florida has increased funding for mental-health services, but the “challenge” is to make sure those services are delivered effectively. Ongoing efforts to address the opioid epidemic are being debated in the Legislature. The Senate Children Families and Elder Affairs committee is scheduled to hear a presentation regarding suicide prevention this month. Dr. Maggie Labarta, Meridian, and a Parkland parent have been asked to speak to the committee.
Governor DeSantis Press Release: https://www.flgov.com/2019/03/28/governor-ron-desantis-and-first-lady-casey-desantis-hold-mental-health-listening-session/
Read an article on the listening session here (Melanie quoted): https://thecapitolist.com/gov-desantis-and-first-lady-hold-listening-session-on-mental-health-and-suicide-prevention/.
Archive to the listening session (1 hour): https://thefloridachannel.org/videos/3-28-19-listening-session-on-mental-health/
Smoking Medical Marijuana is Now Legal: What Employers Need to Know
Florida Legislative News; OBHA Staff
Governor Ron DeSantis signed SB 182 on March 18. The bill eliminated the ban on smoking medical marijuana in Florida. The change in law may not directly impact the way your organization provides services. However, it could have an impact on you as an employer – particularly if you operate a drug-free or smoke-free campus or facility.
The bill called for elimination of the ban on smoking medical marijuana to go into effect immediately upon becoming law – so smoking medical marijuana became legal on March 18, 2019.
Before amended by SB 182, Florida law did not include the use of medical marijuana in a qualified patient’s place of employment in the definition of “medical use” of the drug – except when permitted by his or her employer. The new law goes further to state “the smoking of marijuana in an enclosed indoor workplace” is not considered “medical use” of the drug.
Under the law, employers are authorized to establish, continue, or enforce a drug-free workplace program or policy and employers are not required to accommodate the medical use of marijuana in any workplace or for any employee working while under the influence of marijuana. Finally, the law clarifies the provisions related to medical marijuana do not create a cause of action against an employer for wrongful discharge or discrimination.
The changes to state law appear fairly straightforward, with appropriate protections for employers who want to enforce drug-free and smoke-free policies.
However, while medical marijuana is legal in Florida, it is still considered an illegal drug under federal law. This can create confusion if an employee requests a reasonable accommodation under the federal Americans with Disabilities Act (ADA) to use medical marijuana while at work to treat a medical condition. The ADA allows employers to prohibit current illegal use of drugs and alcohol in the workplace and to require employees report for duty without engaging in the unlawful use of drugs.
Additionally, federal courts have ruled the ADA does not require a medical marijuana accommodation. Litigation as to the applicability of the ADA in states where medical marijuana is legal have produced verdicts in favor of both employers and employees. Until state and federal laws on the legality of medical marijuana are reconciled, employers should examine their workplace policies carefully and ensure they are consistently and equitably applied.
Mental Health, Suicide Risk, and Suicide Prevention
National Institute of Mental Health, Journal of Abnormal Psychology, and Florida Department of Health; OBHA Staff
Here’s a staggering statistic: suicide counts were higher than homicides in 62 of Florida’s 67 counties in 2016. Ninety-three percent of the state experienced more suicides than homicides. Look at the numbers for your county here. The number of Florida suicides is more than double the number of homicides and unfortunately that same trend is seen nationwide. Suicides remain twice as common as homicides in the United States.
When looking at the number of suicides two questions prevail: why and what can be done? There are no easy answers, but researchers are studying and trying to answer both those questions.
Social Media may be partly to blame. Teens and young adults using Social Media are experiencing more depression than ten years ago.
A study published on March 14, 2019 in the Journal of Abnormal Psychology finds the percentage of U.S. teens and young adults reporting mental distress, depression and suicidal thoughts and actions has risen significantly over the past decade. While these problems also increased among adults 26 and older, the increase was not nearly as large as among younger people.
Another study is looking at a possible venue for intervention and prevention of suicides: an NIH study shows many preteens screen positive for suicide risk during ER visits.
A research team found nearly one-third of youth ages 10 to 12 years screened positive for suicide risk in emergency department settings. As part of a larger study on youth suicide risk screening in emergency departments, researchers at the National Institute of Mental Health (NIMH), part of the National Institutes of Health, and collaborators sought to explore how frequently preteen youth ages 10 to 12 screened positive for suicide risk. Notably, 7 percent of the preteens who screened positive for suicide risk were seeking help for physical – not psychiatric – concerns.
Friendly Reminder: Please Complete the Core Services Survey!
Request from One Behavioral Health Association
If you haven’t completed the Core Services Survey – it’s not too late. Please Go To This Link to answer 8 quick questions. Your participation will help One Behavioral Health Association gather information to educate the Legislature about the urgent need for additional funding and resources to ensure the legislative intent of chapter 394.66, F.S. to “promote and improve the mental health of the citizens of the state by making substance abuse and mental health treatment and support services available to those persons who are most in need and least able to pay, through a community-based system of care” is realized.
Member Spotlight: Ivan Cosimi, SMA
OBHA Staff, SMA Behavioral Healthcare
How would you describe your job to a child?
I work for a company that saves lives by helping people with either mental health issues or an addiction to drugs or alcohol.
How did you start out in the profession?
I began my career in the behavioral health industry in 1993 as a Billing Department Manager at Marion-Citrus Mental Health Center (Now, The Centers) in Ocala. I moved to Stewart Marchman Center (Now, SMA Healthcare) in 1998 as CFO.
Like many in our field, my family has struggled with addiction and mental health. As a result, I feel closely connected to our mission at SMA.
What are the biggest challenges in your role?
Having been in the industry for 25 years, I find the biggest challenge is trying to serve a population suffering from behavioral health issues that is growing rapidly. Over those many years, the funding for the provision of services to this population has not kept pace with the need. In addition, the requirements for the funding have become more complex. With limited funding for services, trying to square our company’s mission with the growing needs of our community is the biggest challenge that consumes much of the work that I do as an administrator.
What is the most rewarding part of your job?
The most rewarding part of my job is that I get to work with an incredible team of professionals that are all committed to our mission of providing the best possible behavioral health services to the communities we serve. The team has in many ways become family to me. We get to celebrate our successes and comfort each other when we have setbacks. Of course the best times are when we can celebrate those who are in recovery from their illness and leading productive and healthy lives.
What are your favorite hobbies?
I love being in the outdoors, especially when I am cycling! I mostly enjoy road biking and mountain biking. I also love music. I enjoy all kinds of music and I am always in search of something new to enjoy.
Organizational Member Showcase: Better Way of Miami
OBHA Staff, Better Way of Miami
When another healthcare organization, or another member, thinks of Better Way of Miami what do you want them to visualize?
A dedicated, competent and caring staff who deliver excellent behavioral health services.
How has growth affected Better Way of Miami since its launch in 1983 in terms of staff and patient services?
Better Way began in 1983 in a little rented house with a small group of men who wanted to stay clean and sober. There was no paid staff. Today, Better Way services over 300 clients annually, offers permanent supportive housing at three different locations, and is regarded as one of the best Behavioral Health providers in South Florida. We provide evidence-based Substance Abuse and Mental Health services with a staff of Masters level therapists; supervised by licensed clinicians. We provide primary care, vocational and educational services to our clients with an integrated approach with our community partners.
Are there any recent new programs or new innovative services that you would like to highlight?
With new funding opportunities that arose due to the opiate crisis, Better Way was able to secure a new program that provides Substance Abuse treatment along with Medication Assisted Therapy. Better Way is now providing in-home outpatient services to tenants in many of housing programs in Miami-Dade County. We were chosen to pilot a new clinical intervention through Miami Dade Drug Court called “Helping Men Recover” in our Outpatient modality of care. A program that is designed to treat the effects of trauma, specifically for men.
What is the most common challenge you find when speaking with executives at other community-based behavioral health care organizations?
The incredibly fast pace of change in the healthcare world and the challenges of getting ahead of the curve. This requires nimble, experienced and knowledgeable leadership and staff who are not able to be compensated sufficiently; causing a gap that impedes progress. Funding for adequate resources to meet client needs and staffing are persistent issues.
How does your organization define successful outcomes?
We, as most Providers, have several different specific outcome measures which define “success” for our funders. Essentially, this is measured by the consumer’s progress as they move through our system of care; assuring that he/she is clean and sober and has addressed mental health issues through counseling and medication. We prioritize ongoing services such as placement in permanent housing and stable employment as data has shown these have led to better outcomes for our population. We strongly support membership in 12 Step programs to help ensure long-term sobriety.
Are there any awards or recognitions received by BWOM that you would like to share with readers?
Better Way was recently recognized by the Miami Dade County Homeless Trust for sponsoring the Homeless Memorial and its long-time advocacy for the homeless. Many of our staff has received accolades in their field for providing excellent service to the community.
Can you please leave us with a last statement about BWOM: What is most important to remember?
Better Way has been emerging as a contemporary agency offering excellent services by a talented staff. Underneath the growth and clinical sophistication is a staff oriented toward helping those who are the hardest to serve in our community so that they may live usefully whole and productive lives.
Grant and Funding Opportunities
Opioid Implementation Grant
From Health Resources Services Administration; OBHA staff
The Health Resources and Services Administration (HRSA) released an implementation grant (HRSA-19-082) for prevention, treatment, and recovery in federally-designated rural communities. The Florida Alcohol and Drug Abuse Association (FADAA) partnered with several community providers last summer to establish a consortium to develop an opioid action plan in Madison, Taylor, Dixie, Hardee, and Monroe Counties.
This particular funding opportunity implements the plan. One important factor to note is this is not limited to planning grant awardees. Any provider may apply. Here are the focus areas:
- Prevention: Reducing the occurrence and associated risk of OUD among new and at-risk users (including polysubstance users), as well as fatal opioid-related overdoses, and promoting infectious disease detection through activities such as community and provider education, harm reduction strategies, and referral to treatment and recovery support services
- Treatment: Implementing or expanding access to evidence-based practices, including medication-assisted treatment (MAT) with psychosocial intervention, and eliminating or reducing treatment costs for uninsured and underinsured patients
- Recovery: Implementing or expanding access to recovery and treatment options that help people battling OUD (including those with polysubstance disorders) start and stay in recovery, including ensuring access to support services such as, but not limited to, transportation, housing, peer recovery, case management, employment assistance, and child care
HRSA anticipates spending approximately $75,000,000 to fund approximately 75 awards (up to $1-million each). The period of performance is September 1, 2019 through August 31, 2022. Recipients will receive the full amount of the award in the first year of the three-year period of performance. You may apply for a ceiling amount of up to $1-million total cost to cover three years (includes both direct and indirect, facilities and administrative costs).
While applicants do not have to be physically based in rural communities, they must serve rural communities at the highest risk for SUD. They must also form a Consortium among a minimum of four partners to implement the grant. The due date is May 6, 2019.
HRSA has scheduled the following technical assistance Webinar:
Day and Date: Wednesday, March 27, 2019
Time: 11:30 -1 p.m. ET
Call-In Number: 1-888-566-7680
Participant Code: 5808487
Weblink: https://hrsaseminar.adobeconnect.com/rcorp-implementation/ Playback Number: 1-800-839-4845 Passcode: 4321
Additional assistance and information on the HRSA grant may be found by viewing this pre-recorded webinar entitled, National Health Service Corps (NHSC): How Your Site Can Become Approved for NHSC Substance Use Disorder (SUD) Expansion
You may also download the pre-recorded webinar as a PDF here.
Healthline and NAMI Stronger Scholarship Program
The Healthline and NAMI Scholarship Program is dedicated to the advancement of mental health, either through research, raising awareness, community building, or combatting stigma. The program will award four students with a $5,000 scholarship each. The awarded scholarships will include:
- Two scholarships awarded to undergraduate recipients making an impact on mental health
- Two scholarships awarded to graduate recipients making an impact on mental health
The Healthline and NAMI Stronger Scholarship Program is administered by International Scholarship and Tuition Services, Inc. (ISTS).
Learn more about the Scholarship Here. Applications are due by May 1.
DCF Issuance of New Methadone Licenses
DCF; OBHA Staff
In the February 2019 newsletter, One Behavioral Health Association reported the Department of Children and Families (DCF) had received 123 applications for methadone medication-assisted treatment licenses by the February 4 deadline, under the emergency suspension of the requirement for a determination of need.
On March 13, DCF informed the 123 applicants that pursuant to a settlement agreement reached with plaintiffs in a lawsuit challenging the legality of the emergency suspension, the Department would NOT be issuing any new licenses. Application fees will be refunded to organizations that submitted applications before the deadline. DCF will be publishing revisions to the current rule for methadone licenses (65D-30.014) soon – in advance of a public hearing on the proposed changes to the rule currently scheduled for April 5, 2019.
DCF Clarification on Serving Individuals from Out of State in Outpatient Detox
DCF; OBHA Staff
On March 13, the Department of Children and Families (DCF) issued a policy clarification regarding Outpatient Detox and Day or Night with Community Housing services. In the clarification memo, DCF reported that some outpatient detox providers are serving individuals from out of state who do not have family support, as required in Section 65D-30.006(3), FAC. Additionally, DCF has become aware of instances where individuals are receiving treatment services (assistance with medications) while living in day or night treatment with community housing program, in violation of 65D-30.008(1), FAC.
In response to these violations, DCF is requiring all outpatient detox providers to eliminate the practice of admitting individuals from out of state who do not have local family support to monitor their compliance. Additionally, day or night community housing providers may not accept individuals who are receiving detox services. (Read Memo Here)
CMS Updates on Efforts to Address Opioid Epidemic
Centers for Medicare and Medicaid Services
The Medicare Administrative Contractors (MACs) under the Centers for Medicare and Medicaid Services (CMS) recently mailed letters to all Medicare fee-for-service providers to outline federal agency efforts to reduce opioid misuse by Medicare enrollees, including:
- Providing guidance on co-prescribing Naloxone
- Implementing new Medicare Part D opioid policies
- Promoting a range of safe and effective pain treatments
Also released by CMS in February was an expanded version of the Opioid Prescribing Mapping Tool, which includes current data to effectively address the opioid epidemic across the country. The goal is to better inform local prevention and treatment efforts, particularly in rural communities hard hit by the opioid crisis.
New to this tool is data on opioid prescribing through Medicaid, along with the capability to make geographic comparisons of Medicare Part D opioid prescribing rates over time for urban and rural communities.
The full text of the press release can be found here: CMS Press Release (issued February 22).
Webinars and Workshops
Presented by DCF and the Florida Alcohol and Drug Abuse Association
Webinar: Evidence-Based Outreach and Engagement Strategies
The webinar will specifically focus on evidence-based best practices, current and successful models and additional tips and techniques to expand on current outreach strategies for those involved in the criminal justice system, persons without shelter, youth, family and gender specific populations. Participants will be equipped with knowledge, models, tools and an action plan.
|When:||Wednesday, April 3, 2019|
10:00 AM – 12:00 PM
|Presenter:||Tonya Wheeler, CPFS, CACIII|
Webinar: Using Community Outreach Strategies to Increase Engagement
In this webinar, attendees will be invited to consider the ways that community outreach can enhance their program by improving upon intake, retention, and follow-up.
|When:||Friday, April 12, 2019|
10:00 AM – 12:00 PM
Webinar: Multiple Pathways for Recovery
This webinar will explore the various pathways of recovery, why it is important to identify and honor them, and how to ensure that they are available in the community.
|When:||Tuesday, April 23, 2019|
10:00 AM – 12:00 PM
|Presenter:||Tom Hill, Vice President, Addiction and Recovery for the National Council for Behavioral Health|
Events and Meetings
Event Dates: May 9-10, 2019
Florida Mall Hotel and Conference Center 1500 Sand Lake Road, Orlando, FL 32809
The forum brings together chief professionals in the Human Resources, Financial, and Information Technology fields in the Behavioral Health sector. The two day forum features stand-alone presentations for each group, as well as combined presentations. Last year’s event had over 130
participants with the CFOs, CIOs and HR Directors from 30 different behavioral health organizations throughout the state of Florida.
OBHA May Board Meeting
Event Dates: May 21-23, 2019
Embassy Suites by Hilton Oceanfront Resort | St. Augustine Beach
300 A1A Beach Boulevard, St Augustine, Florida, 32080 | 1-904-461-9004
Group Code: OBH
Rate: $149 (Inclusive of parking)
Chuck Ingoglia – the next president and CEO for National Council for Behavioral Health – will be the featured speaker of the May board meeting. He will succeed Linda Rosenberg, the current president and CEO on June 1, 2019.
Ingoglia has served as the National Council’s senior vice president of policy and practice improvement since 2005. His work has centered on issues such as parity, health care reform, and improving access to treatment.
Florida Behavioral Health Conference
Event Dates: August 21-23, 2019
Hilton Orlando Bonnet Creek Resort
14100 Bonnet Creek Resort Lane, Orlando, FL 32821
Registration is now open!
This event has grown into the largest behavioral health conference in the Southeast and attracts more than 1,400 professionals, executives, exhibitors, and volunteers each year. The conference provides attendees with opportunities to learn and apply the most current technology, research, and trends to their daily jobs and to network with other professionals. The Florida Behavioral Health Conference 2019 will host three plenary sessions and over 80 workshops with multiple tracks available for continuing education. Come join us for the behavior health signature event of the Year: The Florida Behavioral Health Conference 2019!