LEGISLATIVE UPDATE ON MENTAL HEALTH SERVICES IN FLORIDA
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1 LEGISLATIVE UPDATE ON MENTAL HEALTH SERVICES IN FLORIDA Implications for nursing practice Presented by Edward Briggs MS DNP ARNP-BC President Florida Nurses Association objectives Review the Florida Legislative process Discuss the current Florida Legislative Environment Review and discuss legislation being considered by Florida Legislators that impact on healthcare delivery Review and discuss legislation being considered by Florida Legislators that impact on nursing practice Discuss how to impact Florida Legislation that impacts on nursing practice and mental health services in Florida Disclaimer Opinions expressed by the speaker are not intended to represent those of the Florida Nurses Association, it s board, members or affiliate organizations. I, Edward Briggs, have nothing to disclose or possess any conflict of interest in this presentation. 1
2 A moment of reflection It was the best of times, it was the worst of times! Old Chinese curse May you live in interesting times! How a bill becomes a law Bill has a house/senate sponsor Speaker of House or Senate President assigns committees 60 day legislative cycle more committees = failure Committee hearings including public comment. Passes or Dead Amendments or reconciliation Floor vote Passes or Dead Governor signs into law or vetoes History and discussion Session runs from March 3, 2015 to 5/1/2015 Budget surplus Implementation of Amendment 1 Not an election year however presidential election in 2016 and talk of Rick Scott running Division between Governor Scott and the Legislative Branch 2
3 History and discussion Challenges facing Florida s healthcare delivery system: Patient Protection and Affordable Care Act/Medicaid Expansion Aging and increase occurrence of chronic illness Insufficient availability of primary care providers Hospital and Healthcare provider financial constraints Healthcare Workforce Innovation House Select Committee Political Realities Partisan Political Environment GOVERNOR SCOTT S BUDGET Governors Budget is a guidepost of legislative priorities of the governor. Governor will present the budget to the Legislative branch for consideration and action. Legislative Branch will consider the Governor s budget and then develop their own budget(s). The Governor has the power of the line item veto. GOVERNOR SCOTT S BUDGET $80 million of the budget go to the Department of Children and Families, with a focus improving child safety and eliminating preventable child deaths. Nearly $22.4 million is earmarked for substance abuse and mental health services A total of $24.6 million toward improving case practice to protect children in the states care. That includes the Florida Abuse Hotline and additional attorneys for DCF to be able to seek injunctions against domestic abusers. $14 million is allotted for recruiting, training and retaining a high-quality workforce. 3
4 GOVERNOR SCOTT S BUDGET $2.5 million in funding for criminal justice transitional reentry mental health services to be implemented under a four county pilot program. Services will include up to nine months of case management, treatment, therapy, medication management, and transitional and supportive housing. The proposed budget also includes $2.4 million to continue and expand residential substance abuse and mental health treatment for offenders on community supervision. GOVERNOR SCOTT S BUDGET SFY 2016 Governor s Proposed Budget County Funding Highlights Health and Human Services 1. Funding equal to $382,036,004 for Community Mental Health Services, a nearly $70 million increase compared to the previous year. 2. Funding equal to $147,343,425 for Community Substance Abuse Services, an approximate $5 million increase compared to the previous year s budget. 3. Funding equal to $833,881,705 for County Health Units. (stable) 4. $3M for the Public Safety, Mental Health, and Substance Abuse Local Matching Grant Program, which supports county programs that serve adults or youth who are in behavioral crisis and at risk of entering the criminal justice system (Stable) 5. $2,000,000 in recurring general revenue for Homeless Housing Assistance Grants, to be distributed to local homeless coalitions throughout the state. SUMMARY OF BILLS FILED List is as of February 2, 2014 Bills have been assigned to committees but dates to be heard on the committee floors have not been place on the agendas (to date) Bills without companion is the opposing house will not be heard Perennial Bills have not been included in the List i.e. Bills to outlaw elective terminations of pregnancy, etc. 4
5 HEALTH POLICY/MENTAL HEALTH HB 141/SB 114 Conceals any identifier for consultants treating impaired providers. Include family members. PALLIATIVE CARE BILL HB 511/SB 438 Sponsors Placensia/Sobel Requires that the Department of Health develop a community education program regarding the benefits and services of a Palliative Care Facility/Program INVOLUNTARY TREATMENT BILL SB 474 Facilitates continuing incarcerated patients on their prescribed psychiatric medications 5
6 MENTAL HEALTH SERVICES HB 335/HB 476 Sets requirements for psychiatric nurse practitioners to have national certification Provides psych ARNP s with the ability to initiate and rescind a Baker Act. HIV TESTING HB 321/SB 512 Defines Community Health Setting versus Healthcare Delivery Center Requires notification of individuals receiving test if test is confidential or anonymous Requires instruction of how data will be handled if confidential Requires providing list of available anonymous test sites. BAKER ACT BILL HB 505/SB 486 Sponsors Jacobs/Sobel Requires the Department of Health to create a task force to review current Baker Act criteria/guidelines and to make any recommendations for change. 6
7 MEDICAL MARIJUANA SB 528 Sponsor Brandes Allows for the Medicinal prescribing of marijuana products to treat approved conditions Creates guidelines for the harvesting/distribution and sales of Medical Marijuana CONTROLLED SUBSTANCES HB 281/SB 532 Sponsors Pigman/Grimsley Allows Nurse Practitioners and Physicians Assistants to order controlled substances in an acute care facility. EXPERIMENTAL THERAPIES HB 269 Sponsors Sets requirements for the utilization of experimental medical therapies in extreme conditions Relieves manufacturers from any liability in these cases. 7
8 SEXUAL REASSIGNMENT HB 82/SB 204 Makes it illegal from counselors/therapists/psychologist/psychiatrists from counseling individuals under the age of 18 in sexual reassignment treatment options INFECTION CONTROL HB 474 Sponsor Edwards Allows for an experimental needle exchange program to be managed from the University of Miami OVERDOSE RESCUE HB 155 Sponsor Pilon Allows for the prescribing, sales and distribution of rescue autoinjectors of Narcan for the treatment of opiate overdose. 8
9 ADVANCED PRACTICE NURSING HB H47/SB 614 Pigman/Grimsley Pigman: Allows for advance practice nurses to practice without a collaborative agreement with a physician, allows for the prescribing of controlled substances, initiation of Baker Acts, signing of death certificates, etc. Grimsley: Allows for the prescribing of controlled substances by advanced practice nurses. 9
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