After years of drastic cuts, Florida's mental hospitals stand to get as many as 160 new workers under a budget proposal approved this week by state lawmakers.
The three remaining state-run institutions would be able to hire badly needed ward attendants to replenish a workforce gutted by layoffs over the past five years.
The deal between the House and Senate calls for 37 permanent workers and a pool of $3 million for temporary employees who would be trained and available to work part-time or when the facilities find themselves short-staffed.
The proposed funding increase comes in response to a series of stories by the Tampa Bay Times and Sarasota Herald-Tribune that traced how state officials cut $100 million from hospital budgets, fired hundreds of workers and left patients increasingly unsupervised.
Since the first of the budget cuts in 2009, violent incidents have doubled, contributing to more than 1,000 injuries of patients and workers, the newspapers found. With 500 workers laid off, employees who remained sometimes found themselves alone on the ward with a dozen or more unstable, dangerous patients.
Fifteen patients killed themselves or were beaten to death while in the state's care.
Lawmakers finalized the plan this week to add about $4 million for new workers. The budget still must be approved by Gov. Rick Scott.
Although the increase amounts to about 1 percent of the mental hospitals' overall budgets, it is seen by advocates and legislators as a small but necessary step toward curbing the violence and misery inside the facilities.
"I think legislators recognized the need for additional resources in the institutions," said Mike Hansen, who heads the Florida Council for Community Mental Health. "They're interested in doing what's right and when the information is brought to them, they do just that."
After the Times/Herald-Tribune stories last year, Sen. Eleanor Sobel, D-Hollywood, pressed the Department of Children and Families, which oversees the mental hospitals, for concrete solutions. At a hearing in January, a top DCF official said it could be weeks before the agency finished a report on issues at the mental hospitals.
Frustrated by the delay, Sobel called DCF's hesitance to ask for money "insane."
The extra money for the hospitals was a last-minute addition. It came after DCF Secretary Mike Carroll met with Senate and House members.
All of the positions will be frontline workers — people who interact directly with patients — said DCF spokeswoman Michelle Glady.
The Times/Herald-Tribune spoke with dozens of current and former workers who said the hospitals were so short-staffed that they were afraid to go to work and sometimes found themselves surrounded by 15 or more patients. They recalled critical posts being empty because there was not enough staff on duty. Some workers were ordered to work double shifts to keep up.
During interviews with the Times/Herald-Tribune last year, Carroll initially said he thought the hospitals had enough workers. After being presented with the newspapers' findings, Carroll agreed that staffing problems needed further study.
"It's crazy that people were doing double shifts," said Miami-Dade County Judge Steve Leifman, a longtime mental health advocate. "You don't want mental hospital employees doing double shifts, being exhausted and letting their guards down."
In addition to the new hires, Florida will spend more than $1.5 million on cameras and body alarms for workers, an important step to protect staff who previously had no way to call for help when fights broke out.
"This is something a lot of us believed in and we made it a priority," Sobel said. "We saw the hospitals adding new beds and I kept asking: Who's going to be around to staff them? This is something we badly needed."
State Sen. Nancy Detert, R-Venice, called mental health the "topic of the year."
The Legislature's proposed budget also would provide additional resources to bolster treatment programs and keep people with mental illness out of jails and prisons. For example, it sets aside about $10 million for transitional housing for homeless people and additional treatment beds for criminal defendants with a mental illness.
Lawmakers also designated more than $6 million for treatment teams that would operate throughout the state and would coordinate psychiatric appointments and treatment plans for children and adults.
"It's really exciting," said Denise Marzullo, of the advocacy group Mental Health America of Northeast Florida. "The concern was that they would just focus on the state hospitals but that's not really the solution. It's encouraging that they addressed state hospitals and care coordination to try to prevent people from ending up in the state hospitals in the first place."
For the mental wards, though, $6 million in new funding and scores of new employees does not fully close the gap after years of deep cuts — including 500 direct care workers fired between 2010 and 2014.
Some critical positions, including doctors and teachers, are down by about half from their peak.
Leifman says these are the types of jobs that the hospitals should address next.
"These patients need to be occupied," he said. "You can't watch TV all day and get any better. One day, these patients will be released and we want them to be in a position where they can do something."