After an ambitious effort to revamp Florida's mental-health treatment system died at the end of the last legislative session, state officials are readying a new round of proposals for 2016.
Gov. Rick Scott has proposed an increase of $19 million for mental-health and substance-abuse treatment services in his recommended budget for the next fiscal year, with the lion's share going to treat people with mental illnesses in the community instead of in a state-run institution.
Rep. Charles McBurney, R-Jacksonville, is back with a bill (HB 439) that would create a statewide framework for counties to offer treatment-based mental health courts -- similar to a measure he sponsored last spring, only to see it die when the House adjourned three days early amid a budget dispute.
State Sen. Rene Garcia, a Hialeah Republican who chairs Senate Health and Human Services Appropriations Subcommittee, is working with treatment providers as he readies a new version of SB 7068, a sweeping reform bill he sponsored in 2015. That measure, along with a similar House bill spearheaded by Rep. Gayle Harrell, R-Stuart, were also casualties of the truncated session.
"We're working together" on a reform measure for 2016, Garcia said Monday. "I think this is one piece of legislation that both the House and the Senate -- along with the governor's office and the executive branch -- agree that we have to get done."
Last month, Garcia and Rep. Jose Oliva, a Miami Lakes Republican who is in line to become House speaker in 2018, co-hosted the Mental Health and Substance Abuse Policy Summit in Miami with judges, doctors, providers, state officials and advocates taking part.
Garcia also said he'd discussed his plans with Scott and Senate President Andy Gardiner, R-Orlando.
"The president's on board," Garcia said. "One of the things I mentioned is that we are going to need some extra funding in order to make sure that Florida's not next to the bottom as it relates to mental health and substance-abuse funding."
For now, Garcia said, Scott and Gardiner "want to see the proposal, because one of the things we want to ensure is that there's not a duplication of effort going on in communities. And we see that a lot of times where, in Miami-Dade County or Orange County or Leon County, they have different providers doing the same thing. Obviously we want to maximize the existing dollars, and the way you do that is by limiting the scope of who can do what."
Last year's failed legislation would have required more coordinated care, especially for Floridians who use the system most. It also would have coordinated mental-health and substance-abuse services with primary health care and changed the bidding process for state mental-health contracts.
"Part of what we have to address is both the policy in how we do things, and the resources to do them," said Mark Fontaine, executive director of the Florida Alcohol and Drug Abuse Association, which represents substance-abuse treatment providers. "I think we are now having those conversations."
Already, Scott and Department of Children and Families Secretary Mike Carroll have laid the groundwork for the Legislature's discussions. Scott signed executive orders in July and September establishing DCF pilot programs in three counties to conduct a countywide inventory of all state programs that address mental-health needs. The governor said at the time that the pilot programs would help the state track its mental-health services across the agencies and funding sources that address those needs.
Carroll said the executive orders are helping his agency understand whether it has "the most effective coordination of care. Are all those pieces talking to each other? Because the way that system is funded -- between federal dollars, state dollars, local dollars and then private dollars -- there is lots of money on the ground."
Both Carroll and Harrell, who chairs the House Children, Families and Seniors Subcommittee, contend that providing mental-health and substance-abuse treatment to parents helps to prevent child abuse. Scott's budget recommends $2.8 million to expand the use of Family Intensive Treatment teams, which provide services to families at risk for child abuse or neglect, to six counties with high numbers of abuse reports.
As to the DCF-run state forensic mental-health hospitals, which recent media reports have excoriated for a lack of safety, Carroll said the state must have a long-range strategy in order to make decisions about the sprawling facilities.
"Even if we were to upgrade the facilities, what do we do with all the other land and other buildings?" he asked. "There's going to be some difficult decisions for folks to make. ... We shouldn't do this willy-nilly."