'Huge' Revamp Of Mental-Health Services Scrapped

Apr 29, 2015

  An ambitious proposal to revamp the state's system for delivering mental-health services became a casualty of the House's early exit from the Capitol, as the plan's Senate sponsor Wednesday refused to along with changes made by House members.

Sen. Rene Garcia, a Hialeah Republican and sponsor of the Senate measure (SB 7068), reluctantly let the issue die rather than accept an amendment approved Tuesday by the House. The chambers will not be able to work out the differences, at least in part because the House adjourned and went home Tuesday, three days before the scheduled end of the regular legislative session.

"If we're going to do something that's going to benefit the residents of this state and those individuals that are suffering with behavioral health or substance abuse, then we must do it right," Garcia said Wednesday on the Senate floor. "We owe it to them. We can't just simply pass a bill because the leadership in the House is saying, 'Take it or leave it.' "

Both chambers would have changed the way mental-health and substance-abuse services are administered, coordinating the services with primary health care and seeking to increase Medicaid funding for them. Lawmakers also would have required more coordinated care for Floridians with mental illnesses who use the system most --- those most prone to joblessness, homelessness and incarceration.

Sen. Rene Garcia
Credit MyFloridaHouse.gov

And while they had different proposals, Garcia and House sponsor Gayle Harrell, R-Stuart, pushed to reduce what both criticized as a fragmentation of services in the current system.

Both pointed to mental-health and substance-abuse issues as the root causes of child abuse and neglect --- especially following the January death of 5-year-old Phoebe Jonchuck, whose father is accused of dropping her from a bridge into Tampa Bay during a psychotic episode.

"I thought both chambers did an exceptional job writing these bills," said Miami Judge Steve Leifman, who is known for his longstanding efforts to reform the criminal-justice system to better address mentally ill inmates. "It's a shame that the politics of other issues got in the way of getting them passed."

Late Tuesday, Harrell called the amended SB 7068 "a huge initiative" containing "the most significant changes in mental-health and substance-abuse services since the Baker Act was passed 41 years ago."

The Baker Act allows for involuntary examination or commitment if people are likely to have mental illnesses that pose harm to themselves or to others. The process must be initiated by a judge, law enforcement officer, physician or mental-health professional.

But on Wednesday, Garcia said he couldn't accept a House amendment because it rejected a provision "dear to my heart" that would have merged the Baker Act with the Marchman Act. The latter allows for the involuntary commitment of Floridians undergoing substance-abuse crises.

Garcia also objected to a provision dealing with involuntary outpatient treatment and said that while the House had moved closer to the Senate's concept of coordinated care, the amendment was "ambiguous" about how the coordination would occur.

Garcia told colleagues he'd been urged to accept a bill he considered less than adequate, But he said when lawmakers pass inadequate bills and "then we say we're going to come back next year and fix it --- it never happens."

He asked senators to reject the House amendment, which they did unanimously in a largely symbolic vote.

The Legislature's failure to address mental health and substance abuse this year --- after what had seemed a promising start --- came as a deep disappointment to Leifman. He mourned the failure of the proposal that would have combined primary health care with behavioral health care.

Leifman also deplored the loss of a proposed expansion of alternative forensic centers, "which take people who have been charged with low-level felonies who otherwise would have gone to a forensic hospital for competency restoration, kept them local and helped them reintegrate into the community at a much lower cost and with a much greater outcome than the way we do it now."

Leifman said Florida currently spends between 20 and 30 percent of its adult mental-health budget on trying to restore competency for about 2,500 people, when the state has roughly 150,000 people who need mental-health treatment at the time of their arrests.

"The real losers today were people who needed mental-health services," Leifman said.