Resolution 255-1987
-.-'---..' "-'.::;
County Commission
RESOLUTION NO. 255-1987
A RESOLUTION OBJECTING TO THE FAILURE OF THE
DEPARTMENT OF HEALTH AND REHABILITATIVE
SERVICES TO MAKE AVAILABLE TO MONROE COUNTY
AN ALLOCATION OF $197,000 FOR ITS THREE
CLINICS AS HAD BEEN APPROVED AND EXPRESSING
THE CONCERN OF THE COUNTY COMMISSION OF
MONROE COUNTY FOR THE FAILURE TO BE PROVIDED
FUNDS TO CARE FOR MONROE COUNTY'S BAKER ACT
CRISIS VICTIMS.
WHEREAS, the sum of $197,000 had been allocated to Monroe
County for its three clinics, and
WHEREAS, the aforesaid $197,000, which was appropriated for
Monroe County, was never received, and
WHEREAS, no arrangements or plans have been made to provide
for funds necessary to care for Monroe County's Baker Act crisis
victims, now, therefore,
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, that:
1. The failure to make available to Monroe County the
$197,000 that was allocated for Monroe County for its three
clinics is deplored and objected to officially.
2. The failure of the State to make any provisions in
funding Monroe County's Guidance Clinics is objected to and is a
cause for great concern in Monroe County.
3. The LegislativeiDelegation for Monroe County, comprised
of Representative .'(Saundejs and Senator Plummer, be furnished
copies of this reso~tion by the Clerk of said Board and asked to
/\
use their best offi~s in any way possible to correct the wrongs
expressed and shown=in the resolution.
PASSED AND ADOPTED by the Board of County Commissioners of
Monroe County, Florida, at a special meeting of said Board held
on the 22nd day of June, A.D. 1987.
( Seal)
Attest: DANNY L. KOLHAGE, Clerk
~&L ~,A2~
OF COUNTY COMMISSIONERS
E COUNT~LORIDA
/}
al.rman
APPR VED AS TO FORM
AN~,/ GAL. SUFFICIE,NCV, /) ,
8Y /~~ (!(A-:L // .
Altom."', Office . -Y J-;
THE GUIDANCE CLINIC OF THE l\-lJrDDt.E KEYS, INC.
P.O, BOX 2646
MARATHON SHORES, FLORIDA 33052
743-9491
June 17, 1987
County Commissioner
Mike Puto
700 89th st.,Ocean
Marathon, Fl. 33050
Dear Commissioner Puto,
Enclosed is a copy of a recent letter addressed to Secretary
Gregory Coler by Frank Greenman, Esq. who is president of the
Board of Directors of the Guidance Clinic of the Middle Keys, Inc.
I believe that upon your review, this letter will be self explan-
atory and is consistent with discussions which we have had pre-
viously.
In brief, the Florida legislature made no budget provisions
to assist Monroe County in building a psychiatric crisis stabili-
zation unit which would be able to be licensed under current
Florida law. Unless this is accomplished within the next 12
months, there is no doubt that our current facility at MARC House,
will be forced to close. These beds represent a very important
treatment resource to Monroe County.
Additionally, the loss of these beds within the county would
require treatment in the Dade County area by programs which would
be much more costly. Since Florida law requires the county to
assume 25% of the Baker Act expenditures for treatment I feel
that this should be an extremely important issue to the Commission.
In addition, as spelled out in the enclosed letter, the county
would assume a tremendous increase in responsibility for trans-
portation for these clients to Dade County.
It appears that we must depend upon HRS to redistribute
funds on a statewide level to address our problems within Monroe
County. These decisions will be made within approximately the
next 2 to 3 weeks. I would like to strongly request your perso-
nal contact by letter or telephone with Secretary Coler at 1317
Winewood Blvd., Bldg. 1, Tallahassee, Fl. or 904-488-7721. It is
vital that we obtain his attention to this matter in the immediate
future. I would appreciate being copied on any letters written
on behalf of this issue.
Sincerely yours,
,c) /--7 ~
{jid P:\::c:'::~Y---
Executive Director
- .....""-
THE GUIDANCE CLINIC OF THE }\lIDDLE KEYS, INC.
P,O, BOX 2646
MARATHON SHORES, FLORIDA 33052
743-9491
June 17,1987
ffql7j()O(.) :Z;;-.Jl4
{t~ r,(M. c,..j_
~$lfJ Oc,'O Ai ' .5 ~
/"-., -
(/21ltCt; ..t';" j1/{Jlf/4lsl. ~~
Gregory!... Coler
Secretary
Dept. of HRS
1317 Winewood Blvd.
Bldg. 1
Tallahassee, Fl. 32301
Dear Secretary Coler,
The Board of Directors of the Guidance Clinic of the Middle
Keys has received i~formation that the recently passed HRS budget
makes no provision for remediation of Monroe County's Baker Act
crisis. As I am sure you are aware, in last years legislative
session, a bill was passed requiring licensing of all CSU facil-
ities. It is widely recognized throughout HRS that the Monroe
County facility will be impossible to license in its present con-
figuration and location.
This problem has received the attention of the District 11
Planning Council, District 11 HRS staff and Tallahassee Program
Office staff. ?he District 11 Mental Health Plan places the re-
solution of this problem as one of the highest priorities in the
District. Unfortunately, the recent actions of the legislature
failed to take into account the priorities of the District plan
and did not address the treatment needs of Monroe County.
Based on information provided by HRS, it is the expectation
of our Board that our CSU will be visited by the Office of Lic-
ensing & Certification in August. At that time deficiencies
will be listed with the requirement for a corrective action plan
to be submitted within 60 days of that visit. We have made pro-
vision for construction of a new facility which would enable our
program to provide services in a licensed facility. Our Board is
highly committed to providing these much needed treatment facil-
ities within the County. However, these plans are totally depen-
dent upon adequate operational funding for this expanded facility.
Without these funds, no acceptable corrective action plan will
be possible, and the facility will be forced to discontinue ser-
vices and close.
Our program currently operates a 14 bed inpatient program
which provides treatment in the areas of alcohol and drug detox-
ification as well as psychiatric crisis stabilization. For the
past several years, our allocation of beds for CSU services has
proved to be totally inadequate, resulting in frequent utilization
of alcohol beds for CSU clients. This has not only had detrimental
P=:=r<= J:;
effect on opr ri1cohol and drug abuse treatment progrnms. but has
resulted in crowding of an already inadequate I cal plant.
In addition, we have recently been made aware of a memo from the
Office of Licensing & Certification which is critical of programs
utilizing bed space for crisis stabilization treatment in excess
of those allocated to the program. Our program has frequently
been forced to refer patients who would be treatable in our CSU
facility to much more expensive and restrictive inpatient treatment
in Dade County simply because of lack of bed space within our pro-
gram. For this reason it appears imperative that Monroe County have
the option of following the plans developed for the District, and
expanding our present 14 bed program to a 30 bed program thereby
meeting the treatment needs of the county.
Presently our program is providing treatment to approximately
575 patients on an annual basis. Two hundred of these clients are
psychiatric crisis stabilization patients treated under the Baker
Act. The remaining 375 are receiving treatment in the areas of
alcohol and drug abuse
In the event that HRS is unable to assist us in meeting the
county's treatment needs there seems to be general agreement that
this component of our program will be forced to close within the
next fiscal year. Should that be allowed to occur, it will be
necessary to make other treatment provisions for at least these
575 patients mentioned above. We assume that it will be necessary
to transfer the care of these 200 CSU patients to Dade County.
Our present treatment contracts suggest that treating these 200
patients through arrangements with Harborview Hospital in Dade
County would total approximately $800,000 per year. $600,000
of this cost would fall upon HRS with the remaining $200,000 being
required of Monroe County to meet their 25% mandated share of
Baker Act expenses. In addition, we would anticipate an increase
in transportation costs to Monroe County totaling approximately
$62,000.
We presently have no information relating to any available
treatment facilities to meet the needs of the 375 alcohol and
drug abuse patients. There is no question that our County must
continue to receive these services. In the event that our pro-
gram is forced to close by being unable to meet licensing re-
quirements, there is little question that these treatment needs
would have to be met within the Dade County system which is
already sorely over-utilized by the needs of Dade County. While
we are unable to estimate the cost of transporting these alcohol
and drug patients to Dade County and providing treatment at that
distant site, I feel sure that you will agree that the cost would
be prohibitive.
I feel sure that upon review of this situation, you will
agree with our Board that the loss of our only publicly supported
inpatient treatment facility within the County would constitute
a disaster for the mental health, alcohol and drug abuse treatment
system within our county. Additionally, the Dade County service
delivery system appears to be unable to meet the additional stress
which would be created by the transfer of treatment responsibilities
to the Dade County area. Our current estimate of the cost of meet-
ing treatment needs without our programs far exceeds the cost of
continuing to provide treatment within the County. For this reason,
as well as for other reasons relating to quality of care, I would
page 3
...
hope that we "~"'d have your undivided support towarc" --~isting
our Board an~ ~__ County in meeting this current cris___ Specif-
ically, I would like to request that you and your staff identify
sufficient funds within the HRS budget to allow for the continua-
tion of these services within our County. Both our Board and staff
would like to offer our full cooperation to HRS in working toward
a successful resolution to this issue.
Since ly yours,
~C--.
~(p~&~
ranklin Greenman
President, Board of Directors
Guidance Clinic of the Middle Ke7s
cc:
Shirley Freeman
Seymour Brown
Janet Krop
Richard Matthews
Marsh Wolfe
Board of Directors, Guidance Clinic of the Middle Keys
Ron Saunders
Judge David Kirwan
Judge Regan ptomey
Judge Richard Fowler
Judge Sandra Fowler
Judge Richard Payne
Judge Helio Gomez
Judge Ignatius Lester
County Commissioners:
Mike Puto
William Freeman
~ene Lytton
John Stormont
Mayor Jerry Hernandez
Sheriff William Freeman
Public Defenders Office
State Attorney's Office
Frank Rabbito
Board President, Guidance Clinic Upper Keys
Board President, Mental Health Care Center Lower Keys