Getting more mental health professionals into our classrooms Another Viewpoint
South Florida Sun-Sentinel
June 6, 2022 Monday
1 Edition
When I was first elected to the Florida House of Representatives, in 2016, my initial goal was to become a champion for education reform, but after I was elected, I learned of the many mental health pitfalls awaiting so many children here in Florida. Nearly six years ago, during my first legislative session, I passed House Bill 1183, a comprehensive mental health reform focusing on children’s mental health, specifically on the Baker Act. HB 1183 established a Baker Act Task Force to meet monthly to investigate the proliferation of the use of the Baker Act, on minors, and put in place certain regulations that receiving facilities that admit minors must adhere to.
After HB 1183 passed, the Legislature and was signed into law by then-Gov. Rick Scott, I knew my work was only beginning with regard to mental health reform in our state. During the 2019 legislative session, I filed and passed House Bill 361 and House Bill 363, which implement several recommendations of the Baker Act Task Force. Both bills became law after being signed by Gov. DeSantis.
I have spearheaded mental health reform in the Legislature, and I don’t plan to stop. This past session, I expanded my focus beyond just the Baker Act in passing House Bill 255, which focuses on applied behavior analyses (ABA), an umbrella term referring to the principles and techniques used to assess, treat and prevent challenging behaviors while promoting new, desired behaviors. ABA has been recognized as a treatment option for a range of behavioral health conditions, with an emphasis on the treatment of autism spectrum disorder (ASD).
Autism spectrum disorder impacts the social, emotional and communication skills of affected individuals. The disorder includes a range of conditions that were previously diagnosed separately, such as autism, Asperger syndrome and other non-specific developmental disorders.
ABA has become widely accepted among health care professionals, is used in many schools and treatment clinics and is considered an evidence-based best practice treatment by the U.S. Surgeon General, American Psychological Association, American Academy of Child and Adolescent Psychiatry, and American Academy of Pediatrics.
Current law requires public K-12 schools to allow certified, licensed applied behavior analysts and mental health professionals to provide ABA services in a classroom setting. However, this requirement does not apply to behavior technicians working under the direction of these professionals.
Under HB 255, a registered behavior technician who holds a nationally recognized paraprofessional certification in behavior analysis, practices under the supervision of either a certified behavior analyst or licensed mental health professional, and who is employed by an enrolled Medicaid provider, must be allowed to provide ABA services in the classroom setting.
This bill is greatly needed so that children will have greater access to the mental health care they need and our education system will be relieved of some of the stress from the shortage of mental health professionals.
State Rep. David Silvers, D-Lake Clarke Shores, represents District 87, which includes parts of West Palm Beach, Lake Worth Beach, Palm Springs and Greenacres. He is running for re-election in 2022.
Genetic counselors now are licensed professionals in Florida, and lives will be saved ANOTHER VIEWPOINT
South Florida Sun-Sentinel
July 26, 2021 Monday
1 Edition
This legislative session, I had the honor to sponsor and pass the Genetic Counseling Patient Protection Act, which will improve Floridians’ access to critical health care services as well as access to workforce opportunities in a rapidly growing career field.
Genetic counselors are highly trained medical professionals who play an important role in our current era of health care as the demand and complexity of genetic testing continues to grow. They provide an invaluable service to families who may be impacted by cancer, hereditary genetic challenges, or any growing number of diseases that are influenced by genetic factors.
They identify risk levels of individuals and their family members for certain disorders or diseases; communicate appropriate next steps, including whether to perform genetic testing; ensure that the correct genetic tests are ordered; investigate information on the genetic variations present; interpret test results and information about the disorder; analyze inheritance patterns to determine risks of recurrence and review available options with the family.
Genetic counselors also provide supportive counseling to families to cope with diagnoses and make major medical decisions. They serve as important patient advocates, ensuring that those under their care are connected to appropriate services. They serve as educators and resources for other health care professionals as well as the public.
Why is this important? If a patient is incorrectly told they are at a certain risk level, they may not act to prevent further complications for themselves or their families, or they may go through with a life-changing surgery that may be unnecessary. They may not be properly diagnosed and, as a result, go untreated or unsupported. They may run into greater barriers to accessing preventive screenings. To give an idea of how effective genetic counselors are, studies have shown genetic counselors can save hospital systems, on average, up to $50,000 per month with the appropriate use of genetic testing.
Despite being widely used, genetic counselors were not recognized as licensed health professionals in the state of Florida, severely restricting access to their services for Florida patients. As a result, Florida has one of the lowest genetic counselor-to-patient ratios in the country and, by far, the lowest among the 10 most populous states. This is personal to me – several generations of my family have been directly impacted by cancer, breast cancer in particular. After consulting with several genetic counselors regarding the lack of access for Floridians, I felt it was imperative to help create this new state licensure. Having greater access to licensed genetic counseling will help people get the information they need sooner, so they can address whatever ailment they may be predisposed to, whether it is a BRCA gene mutation that can lead to breast cancer or being a carrier of the Tay-Sachs disease.
The Genetic Counseling Patient Protection Act establishes state licensure for those providing genetic counseling services, allowing them to be recognized health care providers in Florida. This will not only keep and grow our skilled workforce in the state, it will ensure better access to a critical health care service for Florida’s families. I am proud to say that the governor signed this into law this past June, and it went into effect July 1, ushering in a new health care field that hopefully will save and improve many lives.
David Silvers is the state representative for District 87, which includes parts of Palm Beach County.
Time to fix coverage gap for mental health; Insurance policies in Florida can severely limit access to treatment
Palm Beach Post (Florida)
March 3, 2021 Wednesday
FINAL EDITION
If ever there was a time to modernize how we treat mental health and substance use treatment; the height of a global pandemic certainly seems like such a time.
It is a near-constant refrain that most of us believe that something — anything — must be done to improve how we address the very serious mental health issues in our state.
Here is one simple, yet effective policy change that can directly help people and change how we address our failing mental health system.
When patients are diagnosed with a mental health condition, too often they find that insurance fails to cover, or inadequately covers, treatment for that condition. In Florida, we know that the insurance policies we allow can severely limit access to mental health treatment, and the resulting gaps in coverage have the effect of making treatment too expensive. Note, these are people with full health insurance coverage, yet even they cannot get the coverage they need.
This must change.
A well-conceived federal law that has been in place for over a decade — pre-dating the Affordable Care Act — is supposed to ensure that mental health or substance abuse disorders are treated just like other health care services. It’s called “mental health parity.” But in our state, health insurers can functionally ignore the law.
I have introduced a bill (House Bill 959) to close the coverage gap loophole and put our state in alignment with federal law. If my bill passes and is signed into law by the governor, insurance companies would not be able to discriminate against patients who need mental health or substance use disorder treatment.
This is vital because, by at least one estimate, nearly half of those with health care policies reported that their plans limited the number of visits to a mental health professional, while no such limits were placed on traditional medical or surgical visits. Over half of them also reported that they were mandated to go out of network to receive basic mental health services — most often, to pay much higher out-of-pocket costs. Perhaps the saddest statistic of all, three in 10 were forced to get repeated authorizations at each stage of treatment for the same diagnosis and treatment plan — a violation of law for something like arthritis or diabetes.
Though a simple change, it won’t be easy to enact. Many people — including many medical professionals — simply do not see these disorders as being on the same plane as a treatment for a disease like cancer. The insurance lobby will sow fear about rising costs and the unknown impacts of the law.
The good news is that as other states have come into compliance, we now have data showing that closing this loophole and offering patients early treatment for mental health and substance use-related disorders can and will save both lives and money.
With a growing mental health crisis, this is the time to do something good, even if it is hard.
David Silvers (D) represents District 87, in central Palm Beach County, in the Florida Legislature.
Your Turn
David Silvers
Guest columnist