Florida Bills Would Increase Funds, Managed Care in Mental Health Delivery

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Mental health advocates say Florida ranks near the bottom of states for spending on mental health. Bills introduced last week would draw down more federal Medicaid dollars to increase payments to providers, expand services, and prevent those at risk from ending up in prison. The system also has limited experience with managed care.

Legislation introduced in the Florida Senate would overhaul the state’s mental health system, tapping more Medicaid dollars and expanding managed care service delivery. The bills seek to transform a system that mental health advocates say is woefully underfunded and hasn’t undergone such a review since the 1970s. As a result, one editorial stated, the largest mental institution is Florida’s prison system.

The Senate Appropriations Subcommittee on Health and Human Services released 2 bills March 13, 2015, that would do the following:

· Require 2 Florida agencies that handle child welfare and health administration to create a plan by November 1, 2015, to increase federal Medicaid funds for mental health and substance abuse. Provisions could include expanding Medicaid for the “severely and persistently” mentally ill.

· Remove a requirement that Medicaid mental health managed care contractors be non-profit. In the past year, the state has experimented with a Magellan health plan that offered comprehensive health services to those Medicaid recipients who have mental illness. However, the lack of overall funding has brought complaints that some providers’ payments have been cut to 60% of actual costs.


· Care would have to be provided in the least restrictive setting possible, and the law would set new governance standards for contractors.

· Add substance abuse to the list of ailments that should be targeted for treatment by the child welfare agency, in part by creating a pilot program to target those with mental illness or addictions for treatment before they end up in jail.

Through this legislation, Florida could revisit the question of Medicaid expansion under the Affordable Care Act (ACA), which generally calls for greater parity for medical and mental health services. Florida has not expanded Medicaid; its Assembly speaker rejected a high-profile pitch from hospitals and business groups to do so earlier this year.

Mental health advocates and Florida news outlets have called on the Legislature to address mental health service delivery since the start of 2015. Critics of the current system cite a Kaiser Family Foundation ranking that put Florida 49th among states for spending on mental health. The report said Florida spends $39.55 per person, compared with a national average of $122.56.

Florida has experienced rapid population growth, but spending on mental health has not kept pace, advocates say. An estimated 3.9 million people in Florida have some type of mental health problem, out of a total population of 19.5 million.

Mike Hansen, president and CEO of the Alliance for Community Mental Health Centers, welcomed the legislation and called the package, “transformational.”

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