Miami-Dade has already paid for the mental health center. It’s time to open it | Opinion
For more than five decades, I worked in Florida’s behavioral health system. As president and CEO of South Florida Behavioral Health Network — now Thriving Mind — the state-designated entity responsible for planning, funding and overseeing publicly funded behavioral health services in Miami-Dade and Monroe counties, I had a front-row seat to the challenges facing people with serious mental illnesses and the systems that serve them.
That experience leads me to a simple conclusion: The Miami Center for Mental Health and Recovery is not a cost problem. It is a cost solution.
Miami-Dade County Commission Chairman Anthony Rodriguez recently requested an independent review of the proposed operating budget for the center. Public officials should ask difficult questions. But after reviewing the proposals submitted by WestCare and The Advocate Program, I believe the debate has focused on the wrong issue.
The question is not whether the center costs money. The question is whether Miami-Dade can afford to continue paying for the consequences of untreated mental illness.
Approximately three-quarters of Miami-Dade’s jail population has identified mental health treatment needs. In some months, that figure has exceeded 80%, according to data was analyzed and reported by staff from the 11th Judicial Circuit Criminal Mental Health Project. Individuals with serious mental illnesses remain incarcerated far longer than other inmates, often cycling repeatedly through jails, emergency rooms, homeless shelters and crisis units because they cannot access coordinated treatment and recovery services.
The financial impact is staggering. The Criminal Mental Health Project analyzed data published by the county’s Office of Management and Budget and the Corrections and Rehabilitation Department, as well as unpublished data provided by Jackson Health System. The organization found that Miami-Dade spends approximately $414 million annually incarcerating people with mental illnesses. Over the past decade, the county has spent roughly $3.9 billion on jail operations, with an estimated $2.5 billion attributable to inmates with mental health needs.
The Miami Center for Mental Health and Recovery was specifically designed to address this problem.
Its initial target population consists of approximately 1,049 individuals with repeated mental-health-related jail bookings. The analysis found that this small group accounts for 21% of all mental-health-related jail bed days, has an 89% homelessness rate and costs taxpayers approximately $17.7 million annually. Over five years, they generated more than 317,000 jail bed days and approximately $117 million in incarceration costs alone.
The county is already paying for these individuals. The only question is whether it will continue paying through incarceration and crisis care or invest in treatment, recovery, housing support and coordinated services that address the underlying causes of their repeated involvement in public systems.
Miami-Dade has also already invested in the solution. In 2004, voters approved General Obligation Bond funding to create a mental health diversion facility. The county later approved additional bond funding and Jackson Health System contributed another $8 million bringing the total public investment to approximately $52 million. More recently, the county allocated $10 million in federal ARPA funding to support operations.
Some critics have suggested the center will cost taxpayers $30 million annually. That claim is unsupported by the proposals under consideration.
According to WestCare’s proposal, annual clinical operating costs are approximately $10.3 million and include crisis stabilization, residential treatment, substance use services, medication-assisted treatment, care coordination, and recovery supports. The annual cost of operating and maintaining the building is estimated at an additional $5 million. Combined, total annual costs are approximately $15 million — not $30 million.
Equally important, taxpayers will not bear the full burden. Funding will come from a combination of Medicaid reimbursements, opioid settlement funds, state and federal resources, Homeless Trust funding, private philanthropy and other non-county sources.
Most importantly, the center’s first three years can be funded without relying on Miami-Dade County General Revenue while outcomes are independently evaluated.
The Miami Center for Mental Health and Recovery is not a luxury or an experiment. It is the next logical step in a decades-long effort to reduce homelessness, improve public safety, provide treatment instead of incarceration and spend taxpayer dollars more wisely.
The facility is built. The providers have been selected. The funding streams have been identified.
Every year we delay opening this facility, taxpayers continue paying for failure while families continue paying the human cost.
Miami-Dade has studied this issue for more than two decades. The time for another analysis has passed.
The time to open the center is now.
John Dow is the former president and CEO of South Florida Behavioral Health Network (now Thriving Mind.)