Sticking points in budget talks include mental health, drug treatment money

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A sticking point between the House and Senate in upcoming budget talks is likely to be the cuts the upper chamber wants to make in Florida’s mental health and substance abuse treatment programs, reports Margie Menzel of the News Service of Florida.

Although the House budget fully funds the programs, echoing Gov. Rick Scott’s recommendations, the Senate plan includes a 32.4 percent cut to adult mental health programs and a 21 percent cut to adult substance abuse treatment.

“We did have to balance our budget,” said Sen. Joe Negron, R-Stuart and chair of the Senate Health and Human Services Appropriations Budget Subcommittee, defending the plan on the floor last week. “We did make a modest reduction in adult mental health and adult substance abuse.”

In stating his case, Negron noted public testimony before his subcommittee “that we had completely eliminated substance abuse treatment. You know, $100 million is not an elimination of anything.” It’s a reduction of $23.8 million, he said.

But opponents of the cuts say they would be devastating.

The plan has been criticized by treatment providers, who would lose millions, and by law enforcement interests such as the Florida Sheriff’s Association, who say they rely heavily on a safety net of community mental health and substance abuse services.

The sheriffs, the Florida Council for Community Mental Health and the Florida Alcohol and Drug Abuse Association, all call the Senate cuts anything but “modest” – and say the savings would evaporate quickly.

“It wouldn’t be too difficult for the cuts to substance abuse to almost immediately cost the state more money,” said Mark Fontaine, FADAA’s executive director.

The costs would go up in three ways, he said, if community substance abuse programs lost a quarter of their funds and, as a result, 37,000 Floridians lost their access to treatment.

-Increased prison costs, because 65 percent of inmates have substance abuse problems and 25 percent of people currently in treatment programs have a criminal justice history.
-Increased child welfare costs, since 46 percent of Floridians in substance abuse treatment have dependent children; of kids in foster care, 50 to 80 percent are there due to their parents’ substance abuse.
-Increased health care costs, because people with untreated substance abuse problems are 46 percent more likely to visit an emergency room.

All told, said Fontaine, a cut of $31.3 million to substance abuse treatment would cost taxpayers $120 million.

And when mental health cuts are added to the mix, providers will be reduced to offering only detox and crisis stabilization units, said Chet Bell, CEO of Stewart-Marchman-Act Behavioral Healthcare in Daytona Beach.

“If the Senate’s proposal were to go forward in both mental health and substance abuse services across the state,” he said, “the rest of the system of care – residential, out-patient, psychiatric services in the community to make sure [patients] remain stable, would largely be gone.”

Also dismantled, Bell predicted, would be the state’s drug courts.

The precariousness of treatment is partly due to Florida’s already-low ranking in providing such programs – 35th among all states and the District of Columbia in per capita publicly financed substance abuse care and 50th in mental health care.

That translates to a 54 percent unmet need for adult mental health services and a 38 percent unmet need for adult substance abuse services, according to the Florida Council for Community Mental Health.

So providers and law enforcement officials are hoping the House plan prevails.

Fontaine praised House Speaker Dean Cannon, House budget chief Denise Grimsley and House HHS Appropriations chair Matt Hudson for supporting the continued funding.

Negron acknowledged that the House budget contains “larger and more robust numbers in both mental health and substance abuse. My view was that, for instance, they have a 2.5 percent cut to nursing homes. I have a zero-percent cut in our budget because I feel like that’s a higher priority.”

“We did not cut any programs for children,” added Negron. “I think children are more important than adults.”

But Sen. Ronda Storms, R-Brandon and chair of the Senate Children, Families and Elder Affairs Committee, urged Negron to find a way to provide more mental health and substance abuse treatment to adults – if only to help their children.

“We see the ramifications of that across the board,” she said. “If they’re not receiving treatment, then the children come into (state) care, because you’ll have a two-year-old who has not had his diaper changed – so his little skin is rotting off because his mother is in a drug-induced stupor.”

The House and Senate were scheduled to begin conference committee meetings on the budget Tuesday evening.

Peter Schorsch is the President of Extensive Enterprises and is the publisher of some of Florida’s most influential new media websites, including SaintPetersBlog.com, FloridaPolitics.com, ContextFlorida.com, and Sunburn, the morning read of what’s hot in Florida politics. SaintPetersBlog has for three years running been ranked by the Washington Post as the best state-based blog in Florida. In addition to his publishing efforts, Peter is a political consultant to several of the state’s largest governmental affairs and public relations firms. Peter lives in St. Petersburg with his wife, Michelle, and their daughter, Ella.