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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