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A Times Editorial

Plan improves care while saving money

As Florida lawmakers look to solve the state's budget crisis, here's an idea the Legislature needs to embrace: Funnel state funds to preventive treatment for the severely mentally ill to ultimately lower the demand for forensic hospital beds.

The Community Mental Health and Substance Abuse Treatment and Crime Reduction Act, SB 2018, has the backing of an impressive array of criminal justice professionals and mental health advocates. Sponsored by Republican Sen. Mike Fasano of New Port Richey, it is the top legislative priority of the Department of Children and Families.

The current system, says DCF Secretary George Sheldon, is "the definition of insanity." The state pays, after the mentally ill are arrested, to make them competent to stand trial, but not for early treatment that would keep them out of jail in the first place. The fix proposed by the legislation would move resources from the criminal justice system to mental health services offered in specialized home and community-based settings.

Initially, the legislation would authorize pilot programs in places like Broward and Miami-Dade counties where state mental hospitals are being overutilized. But the intention is to eventually shift the state's method of responding to our mentally ill population. That would serve the dual purpose of protecting public safety and providing the medication and support services for a large proportion of the mentally ill to lead more stable lives.

Florida cannot afford not to move in this direction.

Every year, as many as 125,000 mentally ill people are booked into the state's jails and prisons, typically for minor offenses resulting from their illness. The coalition supporting Fasano's plan contends such growth would require Florida to build as much as one additional prison each year for the next decade to meet demand.

Already, the state spends more than $200 million annually to fund 1,700 forensic hospital beds for acutely mentally disabled people who are arrested. In 10 years, the cost is expected to rise to $500 million.

Supporters say the proposed legislation would actually save the state money not only by lessening demand for forensic beds because arrests are avoided but by tapping into federal benefits available to the mentally ill and indigent through Social Security and Medicaid. The new approach would include treatment and rehabilitative services as well as addressing housing and other basic needs. Caseworker oversight of individuals would be intensive and ongoing as a way to prevent the mentally ill from reaching forensic hospital beds, emergency rooms or jails.

A similar legislative effort failed last year, but with the state in dire financial straits, there is even more urgency to pass this needed reform. Smart people from law enforcement, corrections and the mental health community back this plan, which arose from a study initiated by the Florida Supreme Court and led by Judge Steven Leifman of Miami-Dade County. Significantly, the judge says the plan won't require more money because it will just redirect the state's current spending. All that is needed is the green light from lawmakers. They should give it.

Plan improves care while saving money 03/19/09 [Last modified: Thursday, March 19, 2009 7:00pm]
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