Be wary of FL Legislature in funding for mental health crisis centers

April 20, 2014 

Powerful forces that pushed legislation to strip the state's mental health crisis centers of major funding haven't disappeared. But wiser minds prevailed recently when the Senate Appropriations Committee unanimously approved a bill, SB 1726, that only requires the centers, including Manatee Glens, to create a statewide database to pinpoint the costs of Baker Act patients.

Those patients end up in custody as a threat to the public or themselves and can be held for evaluation for up to 72 hours.Without Crisis Stabilization Unit beds, they would be sent to emergency rooms, private hospitals or jail -- all far costlier than a center dedicated to treating mental health.

The poisonous legislation, SB 7122, would have slashed flat fees based on the number of beds at a crisis center by 75 percent. Current capacity funding allows the state's 117 public and private Crisis Stabilization Centers to remain poised to meet peak needs.

Instead of receiving $300 per day from the state for each bed, including empty ones, the crisis centers would be paid per patient along with 25 percent of capacity funding.

But with the cut, Manatee Glens could not afford to keep all its 18 beds open -- thus reducing the ability to serve peak caseloads.

But private hospitals would benefit handsomely, with the bill dishing out $1,200 per day per patient. The legislation looks like corporate welfare, not sound public health policy.

While a pay-as-you-go system sounds reasonable, mental health emergencies cannot be predicted. This situation is similar to EMS and fire stations, ever vigilant to respond to emergencies.

The state Department of Children and Families paid out some $61.3 million last year for this guaranteed safety net, a fraction of the state's $75 billion budget and a good investment in the expertise and specialized care found at mental health crisis centers.

Manatee objections

"In Manatee County, this bill would result in the closure of most beds in the Manatee Glens Crisis Center for adult and child involuntary Baker Act commitments," Manatee Glens president and CEO Mary Ruiz told Herald reporter Richard Dymond. "The impact on our law enforcement and hospital emergency rooms would be catastrophic."

Manatee County Sheriff Brad Steube and the Florida Sheriff's Association stand in strong opposition to 7122 as a time-consuming diversion of deputies to hospitals and an expensive burden for jails among the pitfalls.

On April Fool's day, no less, the Senate Children, Families, and Elder Affairs Committee heard experts decry SB 7122, postponed additional discussion, but after some senators and the experts left the room, the bill was reintroduced and approved 6-4.

That skullduggery demonstrates the political power in play, and gives pause that the bill will resurface when senators return to Tallahassee on Monday for the final two weeks of the session.

Both Ruiz and Steube expressed encouragement that SB 1726, the database bill, would supplant SB 7122. That should be the case.

The database bill would provide the Legislature with statistical evidence to reform the system next year, should the data suggest change is needed.

But the Legislature has a reputation for sneaking in bad legislation in the waning days of a session. Opponents to the language in SB 7122 must stand on guard.

In an interview Friday, Bradenton Sen. Bill Galvano -- a longtime advocate for mental health care -- expressed doubt that 7122's tough language would return.

Strange end-of-session machinations often occur in the Legislature. That should not be the case with funding for mental health crisis centers.

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