FADAA Executive Committee Meeting
January 7, 2013
9:30 AM - 4:00 PM
Center for Drug Free Living
Attendees
Doug Leonardo, BayCare Behavioral Health – President
Kevin Lewis, Southwest Florida Addiction Services – President-Elect
Frank Rabbito, WestCare Florida – Vice President
Chet Bell, Stewart-Marchman-Act Behavioral Healthcare – Vice President, Legislative Affairs
Helen Benn – Vice President, Minority Issues
Jon Cherry, Lifestream Behavioral Health - Secretary
Lori Brown, Bridges of America
Vivian Demille, Chrysalis Health
John Fowler, DATA
Nancy Hamilton, Operation PAR
Dick Jacobs, Center for Drug Free Living
Sherrie Kincade (for Mary Lynn Ulrey), Drug Abuse Comprehensive Coordinating Office
Laureen Pagel, Sutton Place Behavioral Health
Bert Randolph, The Unlimited Path
Donn Van Stee (for Bob Rihn), Tri-County Human Services
Mary Ruiz, Manatee Glens Corporation
Ashe Terminello (for Richard Brown) ACTS
Bob Turner, Center for Drug Free Living
Staff
Mark Fontaine, Executive Director
Carol Hyden, Executive Assistant
The meeting was called to order at 9:35 a.m. by FADAA President Doug Leonardo.
FADAA Business
Approval of 990
Motion: Approve execution of FADAA FY 2011-12 990 tax return
(Finance Committee Motion)
Motion Passed
FADAA Redesign
Revenue to Fund Policy Staff Position – By increasing dues for full agency members, new revenue will be generated to fund another high level policy position at FADAA. Thirteen of the top dues producing members have been contacted. Eleven have agreed to pay supplemental dues for the remainder of the year; two are hesitant. In November the FADAA Board voted to increase dues. Dues letters will be sent out shortly.
Working with Florida Council for Community Mental Health – Mark Fontaine reported that he talked with Bob Sharpe and that he believes the two associations are back on track to working together. A joint Executive Committee Meeting is scheduled for January 17th and the two organizations have begun working together on the 2013 Annual Conference.
Legislative Session Overview
Governor’s Budget - Mark Fontaine reported that all indications are that non-recurring substance abuse funding will be replaced with recurring funding in the Governor’s budget. Also it is possible there will be additional money to serve pregnant women with prescription drug abuse issues.
DCF Budget - The Department of Children and Families continues to focus on Child Welfare issues and funding. The Department has done an in-depth study of children in the Child Welfare system; 60% of their parents have substance abuse issues.
Legislative Leaders – Sen. Denise Grimsley, who has been appointed Chair of the Senate Appropriations Subcommittee on Health and Human Services, will remain a strong advocate for substance abuse funding. Mark also reported that the field is well positioned with the leaders of the corrections committees both in the Senate and House. Lists of key legislative committees were included in the packet. Mark has met with all of the appropriation chairs except Rep. Cochran (he is attempting to schedule an appointment with him). Joe Negron is chairing the Senate Committee on Patient Protection and Affordable Care Act. Since he welcomes public input during his meetings there will be an opportunity for provider board members and community supporters to testify. The House PPACA Committee has not solicited public input.
State Budget - Mr. Fontaine reported that the state budget is in the black by $800 million at this time; however if the state loses their lawsuit with the state employees over retirement, the state could face a shortfall of $1 billion. The court should rule on the lawsuit shortly.
Legislative Funding Priorities
FADAA Legislative “Asks” – A copy of the 2013 FADAA Funding Priorities was included in the packet. The Executive Committee requested that the $12 million lost in administrative costs be included in the DCF ask. Copies of FADAA’s funding priorities will be sent to members. A draft list of recommendations by the Prescription Drugs and Newborns Task Force was also included in the packet. Mr. Fontaine reported that FADAA has hired Patrick Gauthier to meet with him and Celeste Putnam (FADAA Medicaid consultant) for a day to help craft FADAA’s “asks” regarding the Affordable Care Act. It also might be arranged for Mr. Gauthier to speak to legislators while he is in Tallahassee. Florida Council (FCCMH) is putting together a proposal to fund a mental health prevention intervention course for 15-25 year olds. The Executive Committee agreed that FADAA should support the concept of the mental health intervention course. FADAA’s two Department of Corrections “asks” are the full funding of community treatment beds - $5.4 million (funding currently taken from other parts of the DOC budget) and $3.6 million to restore 200 community beds.
Motion: FADAA support full restoration of Department of Corrections’ community
beds (800 beds) (Chet Bell/Kevin Lewis)
Motion passed
Proposed Legislation/Policy
A list of bills that have already been filed was included in the packet. Sen. President Gaetz indicated that any bills that are not moving through committees the first two weeks of the session or has a House companion will be ignored.
· Sober House – Currently there is neither licensure nor any other requirements regarding sober homes. It is likely that legislation regarding the definition of sober homes will be filed this year. FADAA will support the conversation about regulating sober homes. One option would be implementation of the National Association of Recovery Residences standards.
· Marijuana – The FADAA Prevention Committee has created a draft white paper on marijuana. Mr. Fontaine stated that a revisited version of the white paper will be presented to the Board in February. A FADAA workgroup comprised of Nancy Hamilton, Chet Bell and Bert Randolph will work with Mark Fontaine to begin creating a FADAA statement regarding decriminalization of marijuana, focusing upon the health impact of marijuana use. The statement should include a statement regarding restoration of rights.
· Needle Exchange – The Florida Medical Association is pursing legislation this session regarding needle exchange. They have asked FADAA to endorse their legislation.
Motion: Conceptually support the Florida Medical Association’s legislation
regarding needle exchange. Bring endorsement to a vote at the
February Board meeting. (Dick Jacobs/Jon Cherry)
Motion passed.
· Sentencing and Re-entry – Two pieces of legislation came out of the Smart Justice process: 1) create special prisons to focus on treatment for nonviolent prisoners with 3 years or less left on their sentence; 2) a split sentence bill (supported by Judge May) in which the second half of the sentence would be served in the community under the supervision of the drug court.
· Managing Entities – The Florida Council has discussed developing a bill amending the DCF Managing Entity Statute which would: 1) required 25% of the managing entity board be comprised of providers, 2) guarantee that managing entities are non-profits, and 3) prohibit managing entities from competitively bidding contracts without cause. FCCMH is current looking for legislative sponsors. Executive Committee decided they wanted to see the proposed legislation before making a decision on how to proceed.
· Department of Behavioral Health - The Florida Council has decided not to promote the creation of a Department of Behavioral Health this year. Mark stated that if legislation to create such a department it would be best to propose it to the transition team for the next gubernatorial election.
Healthcare Reform
Mark Fontaine updated the Executive Committee on the status of healthcare reform in Florida. Agency for Healthcare Administration (AHCA) is in the process of shifting the vast majority of Medicaid recipients to managed care for state plan services (Managed Medical Assistance) virtually ending the fee-for-service payment structure. Behavioral health services (substance use disorders and mental health) will be included as part of managed care plans with all other state plan services. The Intention to Negotiate for the Managed Medical Assistance (MMA) managed care plans was issued last week; proposals from health plans are due on March 15, 2013. Each region will have a minimum of two managed care plans. The plans will be phased in beginning January 2014. To respond to the ITN, managed care health plans must propose a network of behavioral health providers to offer substance abuse and mental health services. FADAA will try to obtain a list of contact names for the managed care plans that have expressed interest in negotiating and email it to members. Members need to contact those plans as soon as possible to present their case why the plans should contract with them.
The Department of Children and Families, FADAA and FCCMH will be meeting every two weeks to define the impact of healthcare reform on DCF and the clients served. Executive committee members suggested meetings should include discussion of workforce, residential services and the essential health benefit.
The Associated Industries Foundation will be holding a health summit later this week. Top legislators, industry leaders and health plan leaders will be attending and on the program. Mark has decided to attend.
Mark has approached the Florida Hospital Association regarding creating a large group of organizations who support Medicaid expansion.
Executive Committee members discussed what their agencies are doing to integrate with primary care physicians.
BHbusiness – SAMHSA is sponsoring learning collaboratives for providers to help them prepare for implementation of the Patient Protection and Affordable Care Act. SAAS in collaboration with NIATx, the National Council for Behavioral Health and Advocates for Human Potential (AHP) will be administering the training. FADAA is interested in applying to serve as a collaborative convener. The Executive Committee decided that the course of most value to FADAA members would be the third party contact negotiation training and suggested that FADAA apply to convene that group. They also requested that FADAA staff clarify with SAAS what the role of provider CEO will be in the training.
Department of Children and Families
Relationship with Managing Entities – The Executive Committee discussed concerns they are having with the Department and the implementation of managing entities. Below are topics they felt should be addressed with the Department:
· $12 million cut - Mark will make an appointment with Rob Siedlecki to find out why the DCF budget office cut $12 million across all OCAs. The Children OCA cut is only 2% ($288,000).
· Where is the $178 million in administrative savings coming from?
· Providers have contract extensions, no new contracts
· Business case for bidding – Does Sec. Wilkins understand that they are trying to bid out a system of care that they only partially own? DCF is sole owner for CBCs, but not substance abuse. Action Steps: FADAA send letter for Rob Siedlecki; copy the Secretary. Create a White Paper on competitive bidding, send to Secretary Wilkins to read and then meet with him.
· On what basis has DCF decided that there is overutilization of residential services? Where is the evidence?
It was decided that FADAA staff, providers and their lobbyists would present a united message to legislators that managing entity implementation should be slowed.
Mark stated that FADAA may wish to set up a meeting with the managing entities. Mark will check to see if Bob Sharpe would be interested in having the Florida Council participate as well. The FADAA and FCCMH Executive Committees are scheduled to meet on January 17th in Orlando. The possibility of meeting with managing entities could be discussed at that time.
Monthly Provider Calls – DCF has decided the managing entities should be organizing the monthly provider conference calls instead of them. It is not clear whether all managing entities and all providers will be on the same call. DCF also wants providers to talk first with their managing entities regarding any concerns they have and try to resolve the issues before talking with the Department.
OPG Prevention Grants – Managing Entities are going to take their 4% off the top. One attendee wondered if that could be exempted. FADAA will discuss with the Department of Children and Families.
Child Welfare/FIS Redesign – Mark stated that it was his understanding that DCF is planning on redesigning the roles of FIS workers. FIS workers would function as treatment brokers; they would provider advanced screening for substance abuse and help parents obtain treatment if needed. Once the parent is in treatment, the Child Welfare case manager would follow the parent/family. Hayden Mathieson is in charge of coordinating this initiative for the Department. Executive Committee members expressed several concerns about how the Department may be changing the roles of FIS and Child Welfare workers: 1) the need for enough time to find/hire Masters level people to do the more detailed evaluations (perhaps wait until the new contract year), DCF conducting webinars with line staff without first working with provider CEOs. Mark stated that he would try to organize a conference call between Mr. Mathieson and some of the Executive Committee members to discuss these concerns.
Financial Rule – DCF has begun workshops across the state regarding the Financial Rule. A draft of proposed changes has not been released yet. The Department will be asking for public feedback once released. All managing entity language will be included in the Financial Rule.
Background Screening – Executive Committee members reported that they are still having problems obtaining timely screening results.
Department of Corrections
Contract Renewals – Lori Brown reported that the Department of Corrections is asking providers to take further cuts if they want their contracts extended. The Government Efficiency Task Force Report has just been completed. The Senate study documented how many providers have not had cost of living increases.
New Business
Mr. Fontaine alerted the Executive Committee that CEO pay come up during the legislative session.
Laureen Pagel informed the Executive Committee that the FADAA Small Agency Committee has scheduled a face-to-face meeting in Orlando on January 30th.
Meeting adjourned at 3:05 p.m.
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