TALLAHASSEE — In Florida’s mental health system, it’s almost impossible to find areas to cut spending.
As a pandemic ravages the state’s economy, the already under-funded system has become an even more critical lifeline for some of Florida’s most vulnerable populations.
But cut is exactly what the state must do, as Florida came up almost $1.9 billion short of its projected revenue during the 2019-20 fiscal year. Starting in March, COVID-19 decimated tourism and left 10.4% of Floridians jobless by May. State agencies — including the Department of Children and Families, which oversees mental health services among many other things — are being asked to hold back on planned spending so the state can report a balanced budget, as is Constitutionally required, for the fiscal year that began July 1.
To the state’s “managing entities,” which contract with the Department of Children and Families to oversee local mental health and addiction treatment programs, the cuts would mean reducing essential services for those who need them most.
“It’s a tsunami coming down,” said Linda McKinnon, the president and CEO of Central Florida Behavioral Health Network, the state’s largest managing entity. “We’ve been so underfunded for years, there is no ‘fluff’ in the system.”
At the same time as these cuts, however, the state has put out a bid to hire an outside public relations firm to execute a statewide messaging campaign about behavioral health. The budget for the campaign is up to $915,000, according to an evaluation template for a request for proposals obtained by the Times/Herald.
After multiple requests for answers about the bid’s details, the Department of Children and Families responded after this story was published Friday night and said the campaign will be funded by a federal grant from the Federal Emergency Management Agency (FEMA).
Regardless, advocates around the state say they are concerned by the proposal.
According to Florida Association of Managing Entities CEO Natalie Kelly, the entities that provide services do a lot of their own marketing locally, reaching those in the community who need the help. McKinnon, of Central Florida Behavioral Health Network, said her organization plans to spend $400,000 on media for outreach next year.
And the public relations contract, which goes before a group of evaluators August 10, specifically deals with behavioral health — just one of the services provided by the Department of Children and Families. The agency oversees a broad swath of social services from child welfare to domestic violence shelters to substance abuse and mental health programs.
“I think at some point it’s a great idea. The time is not the right time,” said Kelly when asked about the contract. “Right now we need to focus on making sure services are available.”
The state is now asking managing entities to justify those services, according to a copy of the budget-cutting exercise sent by the Department of Children and Families. Organizations that oversee local providers are being asked to explain the impact a reduced budget would have on operations.
Providers worry what these cuts could mean for a state that’s showing increasing signs of mental health stress. For example, Christine Cauffield, the CEO of Lutheran Services Florida Health systems, the state’s second-largest managing entity, said Duval County has seen a 40% increase in overdose deaths since the start of the pandemic. Suicides and domestic violence calls are spiking there as well, she said.
Citrus Health Network CEO Mario Jardon wrote in an email that the demand for services already outweighs the availability of state funding.
Providers are also bracing for a costly influx in demand for their services as hurricane season ramps up and as children around the state return to school. Often, advocates say, schools are the first to report signs of trouble at home that ultimately result in state-funded mental health or addiction treatment.
At a discussion about mental health in Tampa earlier this month, Gov. Ron DeSantis touted legislative wins for mental health and child welfare funding even after historic budget vetoes. First Lady Casey DeSantis, who joined her husband at that discussion, has also fashioned mental wellness into a platform, touring the state to discuss and roll out mental health services.
“There’s no doubt about it that the pandemic is impacting mental health,” she said at the Tampa event. “I think it’s safe to say that we are putting this into high gear … this is important, and this continues to be important.”
A long-squeezed agency
The Department of Children and Families has been tight on cash for years, having never recovered from cuts made in the aftermath of the Great Recession 12 years ago.
“We’re in a hole and we’re going to have to dig a little deeper in the hole,” said Kurt Kelly, CEO and president of the Florida Coalition of Children. Kelly, a former lawmaker, took office after a 2007 special election — just as the state began to grapple with the recession. “This is more than an exercise. This is a reality check.”
Kelly, whose organization oversees group homes, foster care, adoption services and various in-home support programs, said a 3% budget cut for child welfare services would equal about $15 million. A 6% cut, or $30 million, would be “devastating,” he said. He hopes the department looks inward at agency-level cuts before going to the community partners.
Mike Carroll, a former Department of Children and Families Secretary under then-Gov. Rick Scott who works with Cauffield at Lutheran Health Services, said the budget cuts should come from new or untested programs, not from essential services.
Not the only ones
On the day he signed Florida’s 2020-21 budget, DeSantis said he planned to hold back about $750 million in agency spending.
“I’m convinced that we’ll be able to weather the storm and do it right,” DeSantis said that day, June 29.
True to DeSantis’ word, the Department of Children and Families is not the only agency being asked to cut back. The Department of Financial Services, which is headed up by Chief Financial Officer Jimmy Patronis, was tasked with showing the state what an 8.5% budget cut would like. The deadline is October 15.
The Department of Agriculture and Consumer Services, headed by Nikki Fried, the sole Democrat in the Cabinet, faces the same 8.5% cut and October 15 deadline.
The Department of Legal Affairs, headed by Attorney General Ashley Moody, is expecting a 1.5% per quarter cut for the 2020-21 fiscal year, spokeswoman Lauren Cassedy wrote in a statement.
Federal help wanted
But at the Department of Children and Families, finding places to cut will be especially difficult. Federal dollars are off limits. State programs that are tied to federal matching dollars are difficult to cut. During weekly calls with DCF Secretary Chad Poppell, the groups overseeing the department’s local programs have asked him to meet with the governor’s office to see if federal dollars from the Coronavirus Aid, Relief, and Economic Security (CARES) Act can be used to fill in the holes instead.
Thus far, Congress has not allowed states to plug budget holes with CARES Act money. However, the most recent proposal from Senate Republican leadership would allow states to make up such funding gaps with federal relief.
Florida’s junior senator, Scott, has been outspoken in his opposition to this provision.
“I don’t believe we ought to be bailing out prior bad budgets,” Scott said in a radio interview with WBUR on Friday. Congress gave Florida $8.3 billion during that first round of funding.
Scott’s office has also asked all 50 states how, specifically, they spent the first round of federal relief money. DeSantis’ office has not responded. By law, states have already had to report some of their expenditures to the U.S. Department of the Treasury, but it’s unclear if those reports will be made public.
Advocates on the ground in Florida, meanwhile, are desperate for help.
“It’s still a matter of contention at the federal level whether to give money for agencies to help budget shortfalls,” Carroll said. “I think it’s crazy not to.”
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