Item P2
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: Wed., July 20, 2005 Division: BOCC
Bulk Item: Yes _ No XX Department: Commissioner David Rice. District 4
Staff Contact Person: Tamara Lundstrom
AGENDA ITEM WORDING: Request approval of 5200,000 in funding for eontinuation of
Baker Ad Services at DePoo.
ITEM BACKGROUND: DePoo bas indicated a need for 5450,000 to continue providing Baker
Ad Services. The State bas appropriated 5250,000 for FY05-06.
PREVIOUS RELEVANT BOCC ACTION: Resolution of Support #078-2005 approved
February 16,2005.
CONTRACT/AGREEMENT CHANGES:
STAFF RECOMMENDATIONS:
TOTAL COST: $200,000.00 BUDGETED: Yes_ No XX
COST TO COUNTY: $200,000.00 SOURCE OF FUNDS: Ad-Valorem
REVENUE PRODUCING: Yes - No - AMOUNT PER MONTH_ Year -
APPROVED BY: County Atty _ OMBlPurchasing Risk Management _
DIVISION DIRECTOR APPROVAL: !lJcwid fl. ~ c Pf tLL~
(David P. Rice, Commissioner)
DOCUMENTATION: Included XX Not Required_
DISPOSITION: AGENDA ITEM
Revised 2/05
_._-----------_._._--------~-_.__._-_.._---~-------- ~.~ ----------------_._-- - --- -----------------
Briefinq - Baker Act Fundinq in Monroe County
. There are two Baker Act receiving facilities* in Monroe County located in
District 11.
0 Guidance Clinic of the Middle Keys Crisis Stabilization Unit located in
Marathon (11 beds).
0 Lower Keys Medical Center (aka DePoo Hospital) located in Key West (15
adult/10 child psychiatric beds).
. The Guidance Clinic of the Middle Keys Crisis Stabilization Unit is a state funded
public receiving facility.
. Lower Keys Medical Center (aka DePoo Hospital) is a private (does not receive
state funds) receiving facility and is the only Baker Act receiving facility in the
Keys that provides medical care.
. During FY 2004-05 District 11 provided $180,073 to Lower Keys Medical Center
(aka DePoo Hospital) in lapse funds on an emergency basis to keep the hospital
from withdrawing their designation as a Baker Act receiving facility.
. The Lower Keys Medical Center (aka DePoo Hospital) reported that during FY
2003-04 they provided Baker Act services for 391 Dp.rsnn<:: Thrr\f.nh nri,,...,,4-_
"" . r.4"-~_
;'I;:)UI cllll.;t:: elllU rVleOlcard they reported they were able to be reimbursed only 4
cents on every dollar spent.
. The Lower Keys Medical Center (aka DePoo Hospital) reports that they will
cease providing Baker Act services by July 25, 2005, due to lack of funds to
provide indigent care, if funding ;s not available.
. The withdrawal of Baker Act services by Lower Keys Medical Center (aka DePoo
Hospital) will result in persons being transported by law enforcement a further
distance to The Guidance Clinic of the Middle Keys Crisis Stabilization Unit in
Marathon. Persons with medical problems who also need psychiatric services
under the provisions of the Baker Act would need to be transferred to Miami for
continued medical and Baker Act services.
. The current Baker Act allocation to District 11 is in accordance with the statewide
formula. It is unlikely that District 11 will receive additional Baker Act funding in
FY 05-06. The district would have to shift funds from Dade County to cover an
increase in Monroe County.
. The Governor's FY 2005-06 Recommended Budget contains $6.4 million for
crisis services for the Baker Act. $6.4 million is recommended by the Senate and
$5 million recommended by the House. Any new funding will be allocated
according to the legally mandated equity formula.
*Baker Act receiving facilities are designated by the department to hold and treat
persons with an acute psychiatric emergency on an involuntary basis.
1
...--.""'"
LK MEDICAL CENTER
~
Lower Keys
April 25, 2005
Sylvia Quintana
District 11, Substance Abuse and Mental Health
Florida Department of Children and Families
401 N. 2nd Avenue, Room 1007 North Tower
Miami, Florida 33128
Dear Ms. Quintana:
Lower Keys Medical Center/dePoo Facility has been a Designated Baker Act Receiving
Facility for many years. Our organization has always demonstrated a commitment to
providing psychiatric services to our community and recognizes the tremendous need
for Baker Act services.
As one of only two Baker Act Receiving Facilities in Monroe County, and the only facility
that is able to provide for the medical needs of the Baker Acted patients, the Lower
Keys Medical Center admits the majority of Baker Acts in the County, yet in the past,
has not received Baker Act funding. I appreciate all of the support that your agency has
provided as evidenced by the contract for funding through lapsed funds for the period
April 2005 to June 2005.
Without continued funding, the Lower Keys Medical Center will not be in a position to
continue our Baker Act Designation. The hospital was advised that Representative
Sorenson's bill earmarking funding for dePoo was not introduced. Sadly, if funding
cannot be secured by June 30, 2005, our organization will be unable to continue to
function as a Baker Act Receiving Facility and provide the associated services.
Representatives of the Lower Keys Medical Center have worked cooperatively with
community agencies and the DCF since 1999 in an effort to secure funding which would
enable the hospital to continue to provide Baker Act services and the opportunity to
continue our designation. In anticipation that the funding will not be forthcoming, the
Lower Keys Medical Center regrettably must provide the required ninety-day (90) notice
of intent to terminate Baker Act Designation, effective July 25, 2005.
The decision to terminate the Baker Act designation was very carefully considered and
was very difficult to make. The Lower Keys Medical Center recognizes the serious
impacts that will result as a consequence of this termination. Unfortunately, the lack of
POBox dePoo Buildmg
Key West, Fl33041.91 07 1200 Kennedy Drive
Ph. 305.294-5531 Key West, Fl 33040
Fax 305-294-8065 Ph. 305-294-5531
Fax 305-294-8844
------ .- --~----_.__.~~._........
funding and associated detrimental financial impact to our facility has necessitated this
decision.
The leadership of our hospital can only hope that the funding levels that seemed
possible to secure become available, in which case the Lower Keys Medical Center
would consider withdrawing the intent to terminate and welcome the ability to continue
Baker Act Designation.
'-
:,...- "
- " Februal)' 2005
Commissioner Rice
RESOLUTION # 078-2005
A RESOLUTION OF THE MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS, MONROE COUNTY, FLORIDA,
SUPPORTING BAKER ACT REFORM AND SUPPORTING
EFFORTS BY THE LOWER KEYS MEDICAL CENTER TO
OBTAIN FUNDING FOR ITS DEPOO FACILITY FOR BAKER
ACT SERVICES; PROVIDING FOR AN EFFECTIVE DATE
WHEREAS, the Baker Act, a Florida Law, allows for involuntary examination of persons
thought to be a danger to themselves or others fOf a period of up to 72 hours and
WHEREAS, mental health and law enforcement professionals have come to understand that
legal limitations inherent in the Baker Act lend to insufficient care of the mentally 111; and
WHEREAS, there is a tenskm between the right of the mentiaUy ill person to be "free" and the
right to obtain treatment that the person m~y be too ill to recognize he or she needs; and
WHEREAS, Baker Act reform would allow, as 41 other states already allow, court-ordered
involuntary commitment and outpatient treatment; and
WHEREAS, in Key West, the DePoo Facility of the Lower Keys Medical Center ("Depoo") is a
Baker Act receiving facility; and
WHEREAS, in 2003, DePoo received approximately 400 Baker Act patients, or 57% of all such
Baker Act patients in Monroe County; and
WHEREAS, DePoo has been unsuccessful in obtaining necessary funding to care for Baker Act
patients in the Lower Keys, thereby jeopardizing its ability to provide this service in the future; and
WHEREAS, the Monroe County Board of County Commissioners recognizes the urgent need to
care for the mentally ill in the community, as well as the connection between mental health and
homelessness;
"-
,
NOW THEREFORE, BE IT RESOLVED BY THE MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS, MONROE COUNTY, FLORIDA, AS FOLLOWS:
Section 1: That the Baker Act reform is hereby supported.
Section 2: That funding for the DePoo Facility to provide full services to Baker Act patients is
hereby supported.
Section 3: That the County Clerk is hereby authorized to transmit certified copies of this
Resolution to the Department of Children and Family Services, to the Key West City Council, City of
Key West, and to Senator Larcenia Bullard and State Representative Ken Sorensen.
Section 4: That this Resolution shall go into effect immediately upon its passage and adoption
and authentication by the signature of the presiding officer and the County Clerk.
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of said Board held on tile 16th day of February, A.D., 2005.
Mayor Dixie M. Spehar Yes
Mayor Pro Tem Charles "Sonny" McCoy Yes
Commissioner George Neugent ....ll.s..
Commissioner David P. Rice ....u.a
./{;(:;;.~~~~( Commissioner Murray E. Nelson ~
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C: <t DIXIE M. SPEHAR
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