Robust reforms to Florida’s mental health system

A state commission has proposed some sensible reforms to Florida’s troubled mental health system. The measures would improve services for those who need them, give Florida taxpayers more bang for their buck, and make our communities safer. Gov. Ron DeSantis is expected to back these improvements with the Republican-led legislature.

The recommendations come from the Mental Health and Substance Abuse Commission, which was created after the Florida grand jury investigating the 2018 Parkland school massacre rightly defined the state’s mental health system as “a disaster”. While the panel’s final report to the governor and the legislature isn’t expected until September, the commission’s initial findings, shared recently with the Tampa Bay Times, outline key steps lawmakers should consider when the legislative session begins on March 7th.

As committee chair Charlotte County Sheriff Bill Prummell noted, Florida’s mental health system is a hodgepodge that spends too little on preventive care and doesn’t adequately guide clients along a continuum of services. Nearly 3 million Florida adults have a mental illness, according to the national advocacy group Mental Health America. Yet Florida is often ranked last among states in funding for community-based front-end services intended to help those going through a crisis adjust. Children in need of services often hit an impasse as they emerge from the juvenile system and find themselves searching for providers on their own. And shortages of mental health professionals and disparities in resources mean services can vary wildly from county to county.

A key recommendation in the council’s initial report is that Florida study the “potential impact” of expanding Medicaid eligibility for young adults age 26 and younger who are in the so-called coverage gap and whose parents do not they are insured. Before the pandemic, an estimated 415,000 people in the Sunshine State earned too much to qualify for Medicaid but not enough to get tax credits to help them buy private health insurance through the Affordable Care Act marketplace.

While Florida Republicans have consistently opposed Medicaid expansion, adjusting eligibility criteria would help more young adults access primary and preventive care, helping to stabilize lives and families. And who can object to the collection of more information? The study could set the stage for Florida to make smarter spending decisions, to intervene earlier in schools and other youth settings to offer therapeutic services and ease the transition for youth who need ongoing care as adults.

The report includes other practical recommendations, such as better monitoring of those diagnosed with a mental illness as they bounce between providers and go through treatment programs, schools or the criminal justice system. The panel calls for the creation of a centralized database to track cases as patients receive care, an essential step in avoiding duplication and determining which programs work. It requires funding mental services based on a patient’s specific needs and launching a pilot program in which one agency manages all public funding for behavioral health in a geographic area. This could help break down silos in bureaucracy and better tie funding to results.

These sweeping proposals provide ample opportunity for lawmakers to reform mental health services for the better. Florida could better help people in crisis, maximize the use of its tax dollars, and create safer communities. Now this agenda needs a lawyer in the Legislature.

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