mental health in florida presented by: mike hansen, ceo/president florida council for community...
TRANSCRIPT
Mental Healthin FloridaPresented by:
Mike Hansen, CEO/PresidentFlorida Council for Community Mental Health
nami Florida Annual ConferenceSaturday, December, 2014 | Orlando, Florida
A Viable System of Mental Health Services Avoids:
• Higher crime rates and strain on law enforcement• The use of jails as defacto hospitals• Increased use of hospital emergency room services• Increasing the homeless population• Decreased community quality of life
Risks to Mental Health Delivery Systems Infrastructure:
• Inadequate state funding• Florida ranks 49th in per capita mental health funding• No rate increases for funding of mental health services
for 20 years• Failure to optimize Medicaid resources
2014-2015 DCF/ME Behavioral Health Needs Assessment Survey:Unfunded Service Need $125,866,311Unmet Service Need $512,208,011
Total Service Need $638,074,322
Top Nine DCF BH Service Needs:Service/Program Funds Needed % of Total
Crisis Stabilization Beds $104.23 mil 16.3%Residential Care $80.06 mil 12.6%Outpatient $73.89 mil 11.6%Medical $52.76 mil 8.3%Case Management $34.07 mil 5.3%Crisis Support/Emergency $29.75 mil 4.7%Detox $29.09 mil 4.6%FACT $22.08 mil 3.5%Prevention $17.75 mil 2.8%
Subtotal $444.26 mil 69.7%Other Services/Programs $193.80 mil 30.3%
TOTAL $638.07 million 100%
Medicaid Rates:Service/Procedure Actual Medicaid % of
Cost Reimbursement Cost
Medication Management$118.69 $60.00 50.6%Psych Eval by MD $368.41 $210.00 57%Psych Eval by ARNP $314.77 $150.00 47.7%Adult Case Mgt $17.75 $12.00 67.6%Child Case Mgt $19.89 $12.00 60.3%Psychosocial Rehab $17.10 $9.00 52.6%Individual Therapy $25.01 $18.33 73.3%Bio Psychosocial Assessment $99.11 $48.00 48.4%Medication Asst. Treatment $87.66 $67.48 77.0%TBOs $24.43 $10.00 40.93%
Crisis Stabilization Unit Facts:Thank you for your support in the last legislative session!
Number of CSUs 65Number of Licensed CSU Beds 1,096Number of State Funded Beds 651Statewide Utilization (All funders) 87%
DCF Average Reimbursement $298.69Medicare Rate $751.61Medicaid HMO Rate $800.00 - $1,000.00
Three Year Plan:Governor’s Tax Cut + Demands = $300 million unspent
*State of Florida, Long-Range Financial Outlook Fall 2014 ReportAdopted by the Legislative Budget Commission September, 2014View the entire document here.
*State of Florida, Long-Range Financial Outlook Fall 2014 ReportAdopted by the Legislative Budget Commission September, 2014View the entire document here.
*State of Florida, Long-Range Financial Outlook Fall 2014 ReportAdopted by the Legislative Budget Commission September, 2014View the entire document here.
*State of Florida, Long-Range Financial Outlook Fall 2014 ReportAdopted by the Legislative Budget Commission September, 2014 View the entire document here.
New Issues by GAAA Section
Fiscal Year 2015-2016 TOTAL
Fiscal Year 2016-2017 TOTAL
Fiscal Year 2017-2018 TOTAL
Section 2 - Pre K-12 Education 236.3 82.6 40.2
Section 2 - Higher Education 214.5 130.7 155.7
Section 2 - Education Fixed Capital Outlay 0.0 0.0 0.0
Section 2 - Human Services 257.4 458.6 520.2
Section 4 - Criminal Justice 25.6 22.7 21.9
Section 7 - Judicial Branch 0.0 0.0 0.0
Section 5 & 6 - Transportation & Economic Development 77.5 54.3 52.1
Section 5 - Natural Resources 172.0 170.8 171.3
Section 6 - General Government 44.4 71.2 66.6
Section 2 & 6 - Administered Funds –Statewide Issues 191.5 174.8 176.6
TOTAL NEW ISSUES 1,219.2 1,165.7 1,204.6
Tier 2 Issues – Critical Needs and Other High Priority Needs
*State of Florida, Long-Range Financial Outlook Fall 2014 ReportAdopted by the Legislative Budget Commission September, 2014View the entire document here.
*State of Florida, Long-Range Financial Outlook Fall 2014 ReportAdopted by the Legislative Budget Commission September, 2014View the entire document here.
Medicaid Low Income Pool (LIP)Existing $2.1 billion goes away!
Prior-year LIP funding $1 billion+Physician UPL $200 million+Hospital payments $960 million
TOTAL $2.1 Billion*State of Florida, Long-Range Financial Outlook Fall 2014 ReportAdopted by the Legislative Budget Commission September, 2014View the entire document here.
How Do We Dig Out?
The Florida Excellence In Behavioral Health Act• Medicaid Expansion• Medicaid Rate Increase• Jail Diversion
Medicaid Expansion:• Opportunities for state to cover the
working poor
• Increase eligibility to 138%
• 100% Federal funding for 2 years – 90% after that and never goes down
Has minimal impact on county cost share!
Projected Consequences of Not Expanding Medicaid in Florida:
Uninsured not qualifying for
coverage (thousands)
Federal Medicaid
funding lost (billions)
Federal Medicaid
funding lost (billions)
Hospital reimbursement
lost (billions)
Hospital reimbursement
lost (billions)
2016 2016 2013-2022 2016 2013-2022
1,060 $6.7 $66.1 $2.1 $22.6
Robert Wood Johnson Foundation, August 2014
Jail Diversion:• On any given day in Florida, of persons with a serious mental
illness, there are approximately 16,000 prison inmates, 15,000 local jail detainees, and 40,000 individuals under court supervision in the community.
• Annually as many as 125,000 people with a mental illness, requiring treatment, are arrested and booked into Florida jails.
• A recent study conducted in jails in Pennsylvania, found that 31% of women and 14% of men being booked into local jails, had a major mental illness.
Jail Diversion continued:These are individuals who have many of the same characteristics of the state hospital patients of the past.
• With adequate community treatment and support services we believe that many in the community can be effectively served.
• Public safety can be preserved, and they can be successful in the community.
• In the end, we will be making a wiser expenditure of public funds.
Florida Sheriffs Association 2015 Top Legislative Priority
Mental Health Issues in the Criminal Justice SystemSupport legislation that:Establishes arrest, jail and court programs targeted at providing mental health treatment services to persons involved in the criminal justice system, with an emphasis on crime prevention and reducing arrest recidivism.Establishes connections between Sheriffs’ Offices and community service providers and ensures offenders selected for community mental health treatment do not pose a threat to public safety.
FCCMH Criminal Justice Initiative
Request Governor Scott to include the following in his 2015-16 Budget:
$12.5 Million GR to be allocated as follows:
$4 Million- Funding for community treatment services including; Mobile Crisis response and Assisted Outpatient Treatment (AOP) for persons who are high users of inpatient, CSU, and Court related services.
$6 Million- Funding for the expansion of the CJ/MH/SA Reinvestment Grant Program. Expanded jail diversion, Crisis Intervention Training (CIT), treatment and support services for persons with MH/SA disorders involved in the CJ System.
$2.5 Million- funding for community re-entry programs treating mentally illreleased from prison or county jails, probation or community control
Florida Council’s Survey Response: Surveyed national models and programs operating in Florida to determine an approach that we will advocate for this coming legislative session:
Current programs in Florida were surveyed to determine what programs existed, how they were designed and staffed, and who funded them.
Survey Response continued:Of programs operating and responding to the survey:
• 33% provided Diversion at Arrest• 77% provided Diversion at the Jails• 88% provided both Court and pre-trial diversion• 55% had clients court ordered into treatment• 44% of programs served individuals on Probation• 66% of the programs served individuals who were
forensic commitment diversions(Persons who were deemed by the courts to be incompetent to stand trial by virtue of a mental illness.)
Survey Response continued :Effective Community Based models include the following Essential Components:
• Crisis Intervention Training (CIT)• Intensive case management• Supported housing and employment• Accessible and appropriate medications• Peer support/ mentors• Integrated treatment- (provide mental health
and addictions treatment)• Multi-disciplinary teams
We Want To Partner With Consumers,Family Members,and other stakeholders
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