Item K17BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
ADD -ON
Meeting Date: Wed. February 16, 2011 Division: BOCC
Bulk Item: Yep No XX Department: Comm. David Rice
Staff Contact /Phone #: Tamara Lamarche, X6000
AGENDA ITEM WORDING: A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA, TO THE COUNTY'S STATE
LEGISLATIVE DELEGATION, ON BEHALF OF THE NUMEROUS INDIVIDUALS
RESIDING IN MONROE COUNTY THAT RECEIVE MENTAL HEALTH AND
SUBSTANCE ABUSE SERVICES FUNDED THROUGH THE DEPARTMENT OF
CHILDREN AND FAMILIES TO VARIOUS SERVICE PROVIDERS, AGAINST ANY
FURTHER CUTS TO THE MENTAL HEALTH AND SUBSTANCE ABUSE STATE
FUNDING.
ITEM BACKGROUND: The Florida Senate Budget subcommittee on Health and Human Services
will be considering this issue in committee beginning Tues. Feb. 15, 2011. The Resolution must be
received by our County's Legislative Delegates and the Chair of the Senate Subcommittee in time for
their discussions on this funding issue.
PREVIOUS RELEVANT BOCC ACTION:
CONTRACT /AGREEMENT CHANGES:
STAFF RECOMMENDATIONS:
TOTAL COST: INDIRECT COST:
DIFFERENTIAL OF LOCAL PREFERENCE:
COST TO COUNTY:
UDGETED: Yes No
SOURCE OF FUNDS:
REVENUE PRODUCING: Yes No AMOUNT PER MONTH Year
APPROVED BY: County Atty _ OMB /Purchasing
DOCUMENTATION: Included XX Not Required
DISPOSITION:
Risk Management
AGENDA ITEM #J�)j
Commissioner David Rice
RESOLUTION NO. - 2011
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, TO THE COUNTY'S STATE
LEGISLATIVE DELEGATION, ON BEHALF OF THE NUMEROUS
INDIVIDUALS RESIDING IN MONROE COUNTY THAT RECEIVE
MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FUNDED
THROUGH THE DEPARTMENT OF CHILDREN AND FAMILIES TO
VARIOUS SERVICE PROVIDERS, AGAINST ANY FURTHER CUTS TO
THE MENTAL HEALTH AND SUBSTANCE ABUSE STATE FUNDING.
WHEREAS, there are numerous individuals residing in Monroe County receiving mental
health and substance abuse services through programs funded by the State through the
Department of Children and Families to the area service providers;
WHEREAS, the Florida Legislature is raising serious questions regarding whether or not
the state can simply rely on the Medicaid program for its mental health and substance abuse
care, and eliminate all or most of the mental health and substance abuse services administered
through the Department of Children and Families; and
WHEREAS, Medicaid does not cover many mental health and substance abuse
individuals because they do not meet the restrictive federal disability criteria or their income
levels are slightly above the poverty income threshold that qualifies them for Medicaid; and
WHEREAS, Florida would lose all federal mental health and substance abuse block grant
funding for failing to maintain a state treatment system; and
WHEREAS, if the Legislature is successful with their proposals, Monroe County will see a
marked increase in emergency room and hospital admissions, forensic commitments, county
jail admissions, prison incarcerations, and homelessness would undoubtedly increase; and
WHEREAS, the Courts and law enforcement would lose their safety net of emergency
room crisis services they have depended upon for decades; and
WHEREAS, Florida ranks 49 in mental health funding and 35 in substance abuse
funding. It is an undisputed fact that investing in mental health and substance abuse services
saves tax payer dollars by keeping individuals out of costly hospital stays, jails, and the other
services mentioned above.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners for Monroe
County, Florida:
Section 1: The foregoing recitals contained in the preamble to this Resolution are
incorporated by reference herein.
Commissioner David Rice
Section 2: This Board supports a copy of this Resolution being sent to the County's
Legislative Delegation and to the Chair of the Senate Budget subcommittee of Health and
Human Services requesting the State to continue funding mental health and substance abuse
services with no cuts to an already poorly funded system.
Section 3: The County Clerk shall forward this Resolution to all appropriate persons
and parties for the County's Legislative Delegation: Rep. Ron Saunders, State House of
Representatives, 316 The Capitol, 402 South Monroe Street, Tallahassee, FL 32399 -1300;
Sen. Larcenia Bullard, Florida Senate, 218 Senate Office Building, 404 South Monroe Street
Tallahassee, FL 32399 -1100; and to Sen. Joe Negron, Chair of the Senate Budget Subcommittee
for Health and Human Services, 404 S. Monroe Street Tallahassee, FL 32399 -1100.
Section 4: This Resolution shall take effect upon its adoption.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida at a regular meeting held on the 16 day of February 2011.
Mayor Heather Carruthers
Mayor Pro Tern David Rice
Commissioner Sylvia Murphy
Commissioner George Neugent
Commissioner Kim Wigington
BY:
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
By:
Deputy Clerk
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
Mayor Heather Carruthers
- AS TQ E.
x v.l A. H 7
7 i1V11
A TIME FOR TRANSFORMATIONAL LEADERSHIP
The announcement of a proposed plan by the Florida Senate to essentially strip Florida
structurally and systemically of Florida's Adult Mental Health and Substance Abuse funding, is
of grave public importance and must be urgently addressed.
Yesterday, details of a draft submission were revealed to the Department of Children and
Families, including:
• Across the State, 65 Crisis Stabilization Units, (1000 beds) serving more
than 62,000 people, in need of acute care, would be closed.
• All emergency community mobile crisis, outreach and emergency
response teams, would be eliminated state -wide.
• All adult residential treatment facilities would be closed.
• Emergency psychiatric hospital admissions, under the Florida Baker Act,
would no longer be available to police officers or the courts.
• More than half of the mental health budget is dedicated to the criminal
justice system and will therefore be deleted, placing the community at
risk.
When, Governors, legislators and policy makers struggle to balance State budgets, the
consistent and thoughtful approach has been to focus on "problem solving" leadership
strategies, which are well reasoned, stabilizing and evidence based. There are smart ways for
States to save money. Breaking threadbare public health safety nets, which, is all we have in
Florida, (Florida ranks 49 in mental health funding in the nation) is both counter - intuitive and
ill advised.
Governor Scott comes from a health care background, and therefore, should appreciate the
cascading and collateral damages, in costs and lives, that would occur, if the Florida Senate's
proposed cuts prevail. Yesterday's announcement, that this proposal seeks to "eliminate" all
or most of the Adult mental health services, administered by the Department of Children and
Families, would in no uncertain terms lead to both a public safety and public health disaster. As
the Presiding Judge of Broward's Mental Health Court, and a former member of President's
New Freedom Commission on Mental Health, the following facts must be understood and
integrated into any legislative and executive decision making. This is essential, in order to
effectively protect and provide for the safety and welfare of all Floridians:
1) 1 out of every 4 adult in the U.S, suffers from some form of mental illness.
2) A vast majority of those with mental illnesses also suffer from co- occurring substance
abuse addictions. Many are without Medicaid or health insurance coverage.
3) Public health and public safety are inextricably linked. There is an over - representation of
persons with untreated mental illness (est. 16 %) in Florida's correctional system. The
majority of which suffer from substance abuse disorders. Ironically, Florida, has led this
nation and the world in innovations, such as Drug Courts and Mental Health Courts.
Research and findings, focused on the economic impact of these and other public health
problem solving, strategies, have been overwhelmingly positive; yielding multi - million
dollars in cost savings. Therefore, due to budget shortfalls, the majority of States are
strategically working to implement policies that will reduce the costs of incarceration,
not expand them.
4) Along with the significant financial and economic strife, come extraordinary emotional
and psychological problems, which, over the past several years, have only led to greater
and more urgent demand, for scarce community mental health and substance abuse
services. Our State's public and private mental health care and substance abuse
provider systems have heroically struggled to meet current demand.
5) All across the U.S. and Florida, our returning Veterans are desperately in need of highly
individualized and comprehensive medical and mental health services. This has led to
enhanced crisis and community based services across the mental health care and
criminal justice systems.
6) Florida's mental health and substance abuse delivery system is called a safety net, due
to the fact, it is essentially crisis driven. As a bottom of the pyramid sector, Social
Services in Florida has always been underfunded. This represents all facets and
components of our system, which, over the course of many years, has been
painstakingly stream lined, and compressed, in order to manage current budget
shortfalls, and serious resource limitations. This includes; mental health acute care crisis
facilities and detoxification beds, residential treatment beds, and community based
mobile crisis units and Assertive Community Treatment Case management Teams. It
also includes resources for our vulnerable geriatric population, where needs are both
urgent and complex.
7) There is simply no meaningful or safe place to cut. Unfunded mandates, such as, The
Mandatory Outpatient Treatment Legislation, linked to public safety and cost savings,
remains unfunded and never implemented.
8) Florida's mental health funding through the Department of Children and families, is
inextricably tied to the Medicaid funding stream. Without the Florida Department of
Children and Families receiving core mental health funding, the basic mental health care
system will collapse. The economic recession of our State does not have to lead to
community and personal devastation.
Challenging times calls for transformational leadership. According to leading
economists and experts in change leadership, the complex challenges of the 21 century
requires leaders who have vision, humanism, shared value, and the ability to create a
sense of stability. More importantly, that even through hard times, humanity and public
safety will be preserved and protected, while new opportunities for growth emerge.
In my view, The Florida Senate budget proposal represents a threat to our entire
State's security on every level. It must be reversed. As noted above, there are smart
ways to reduce costs and protect Florida's citizenry. For example, the one only has to
listen to the recent inaugural speech of Georgia's Governor, Nathan Deal (R), who
declared that "jailing drug addicts" is "draining to our State" and "unsustainable." He
pledged that, "for offenders who want to change their lives, we will provide the
opportunity to do so with day reporting Centers, Drug, DUI and Mental Health
C:ourts ... and expanded treatment options." This attitudinal and policy shift can be heard
all across America from Governors, criminal justice stakeholders, and public health
professionals, and policy makers. The recognition there are "smart" ways to meet State
budget deficits, ways which are problem solving - not problem generating, is the
direction Governor Scott and our State need to go. The Senate proposal would, for
example, lead to more crime and arrests, more homelessness, and have a crushing
impact on our hospital system. This will lead to a watershed of new costs and problems
for our State.
In the interest of the public safety and public health of all citizens of Florida, I
appeal to the members of our Legislative Branch to repudiate this measure and preserve
the public safety, public health and productivity of Florida's citizenry.
Respectfully Submitted,
Judge Ginger Lerner -Wren
Administrative Judge Broward County Mental Health Court
Jwr en @17th.flcourts.or
Judgeglw @aol.com
954 -831 -7240