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Bill Cuts Crisis-Unit Funds

Every time there is a mass shooting, everyone agrees there should be more focus on identifying and treating persons with emergency mental health problems.

But a mental-health bill up that comes up this week in Senate Appropriations would have the opposite result, according to consumer groups in mental health.

"We call it the 'Nightmare of the Senate'," said Maggie Labarta, clinical psychologist and CEO of Meridian Behavioral Health Care in Gainesville. 

SB 1726, by the Senate Committee on Children, Families and Elder Affairs, is on the agendafor Thursday's Senate Appropriations Committee.  It was introduced only recently, March 27, and has moved fast.

Florida Partners in Crisis, a non-profit supported by judges as well as treatment providers,  sent out a "Call to Action" about the bill (originally SB 7122) on Monday, asking consumer advocates to call members of the Appropriations Committee to oppose the bill.

It would have the effect of taking away some of the money now going to support "crisis stabilization units" and giving it to hospitals. Crisis units take in patients undergoing a mental-health crisis who appear voluntarily or are brought in under the Baker Act because they are deemed a danger to themselves or others.

Some hospitals are also licensed as Baker Act receiving facilities, and they want some of the money that has been going to crisis units to cover the cost of treating the uninsured.

Labarta says the real problem is that there aren't enough crisis beds at the non-profit stabilization units to take care of all those who need care. But rather than expand the number of funded crisis beds, the legislature wants to redesign the funding formula in a way that would "destroy the Baker Act system," Labarta said.

Instead of paying the CSUs to staff the units at capacity, state contractors would be instructed to pay for actual use. And it appears from the wording of astaff analysisthat contractors would be required to contract with any facility that wants to serve as a receiving facility.

That sounds reasonable, Labarta says, until you consider that crisis units -- generally non-profits -- have to staff the beds whether they're full or not, and the state pays about 2/3 of the cost of staffing the beds.

The state came up with the crisis-unit system in the first place because they can operate for less than half the cost of treating patients in hospitals, she said.

A crisis unit bed is like a fire truck, Labarta said. "Some days it sits in the firehouse. Other days we wish we had a second one because the first one isn't keeping up."

The bill as proposed would give crisis units half a fire truck and hospitals the other half, Labarta said.

Meanwhile, as Kaiser Health News reports, a nationwide study has found that in most states, including Florida, there are far more mentally ill persons in jails than in a state hospital.

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.