Health Care

Gov. Rick Scott expands executive order to review, coordinate Florida mental health services

Judge Steve Leifman started a program in Miami-Dade to steer people with serious mental illness away from the criminal justice system and into treatment centers. Here he presides over jail arraignments in court in July.
Judge Steve Leifman started a program in Miami-Dade to steer people with serious mental illness away from the criminal justice system and into treatment centers. Here he presides over jail arraignments in court in July. Miami Herald Staff

Calling Florida’s funding of mental healthcare “too fragmented,” Gov. Rick Scott on Wednesday expanded an executive order aimed at developing a statewide model of integrated behavioral health services, beginning with pilot programs in three counties, including Broward.

“We have to get better at serving those struggling with mental illness,” Scott said in a written statement accompanying the addendum to the order, which was initially signed in July.

Wednesday’s action expands the pilot program in Broward to Pinellas and Alachua counties, and adds more state agencies, including the Department of Health and the Agency for Health Care Administration, to the mix of public entities charged with reviewing Florida’s taxpayer-funded mental health system.

Scott noted that Florida’s mental health funding flows through multiple state agencies and other organizations, including $1 billion a year through the Department of Children and Families, but that often Floridians suffering from mental illness do not receive the care they need in the most effective setting. Many end up in jails.

In South Florida, mental health providers and advocates said they were encouraged by the governor’s effort. But they also hope the state’s review will include input from non-profits and other organizations that provide behavioral health services to the mentally ill.

Katharine Campbell, executive director of the National Alliance on Mental Illness of Broward County, a nonprofit advocate and provider of behavioral health services, said her organization receives calls every day from people who are desperate and feeling frustrated with the current system.

“If they’re not at the table, you’re missing the voice,” said Campbell, who is also a clinical social worker in private practice. “You have to have a conversation that’s broader than just the state agencies.”

Campbell said a coordinated mental healthcare system has to include services beyond counseling and medication.

“If you have someone with behavioral health needs and they don’t have a home, or they don’t have a job or they don’t have a sense of purpose or they don’t have an income, they’re not going to get anything accomplished,” she said.

Miami-Dade County Judge Steve Leifman, an advocate of diverting mentally ill people from jails, said coordinating care will help but he hopes the new effort explores alternative uses of current resources. Florida’s Legislature increased mental healthcare funding this year, Leifman said, but it’s not always a matter of money.

“It’s not just about putting in new dollars,” said Leifman, who in 2000 started a program in Miami-Dade to steer people with serious mental illness away from the criminal justice system and into treatment centers. “If you continue to put in new dollars to programs that don’t work, it’s a waste.”

Leifman noted that Florida spends 22 percent of its entire adult mental health budget, or about $135 million, on trying to restore competency to about 2,500 people a year.

“We have between 150,000 and 170,000 people a year in Florida who at the time of their arrest need acute mental health treatment,’’ Leifman said, “but 22 percent of the whole budget is going to restore competency.”

Mental health advocates noted that Florida passed up a big opportunity to increase mental health services for the uninsured by refusing to expand eligibility for Medicaid, the public health insurance program for low-income people, as provided under the Affordable Care Act.

However, Florida became the first state to offer a Medicaid health plan designed exclusively for people with serious mental illnesses in 2014. The plan is offered by Magellan Complete Care. As of July 2015, the plan had about 39,000 Floridians enrolled.

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