The District Commission is making progress with the Central Mental Health Reception Facility
BY JENNIFER CABRERA
bottom line: The district commission voted to establish an inpatient central mental health reception facility on the same site as Meridian Behavioral Health Services. They have budgeted $500,000 from their general fund plus $1.5 million in ARPA funding and are asking the City of Gainesville to also increase their contribution from $250,000 to $500,000. They hope a centralized reception facility will improve the experience of residents who struggle with mental health issues and are often sent to prison because there are no other immediate options in a crisis.
At its May 10 regular meeting, the Alachua County Commission discussed options for a centralized reception system for Alachua County.
Deputy District Manager Carl Smart said the staff considered a standalone system in their own building, a virtual triage system and co-housing the district’s program with an existing crisis stabilization unit.
Stuart Wegener, criminal justice liaison with the Department of Court Services, said the August 2021 County Commission request read: 1) Staff to direct and organize funding to advance the idea of a Central Receiving Facility (CRF); 2) Authorizing the Chairperson to send a letter of invitation to the City of Gainesville and area hospitals to participate operationally and financially in the program; 3) development of plans for an operational and regulatory body for the CRF; 4) Work with Meridian to create a 3-5 year plan detailing partners and funding sources with the goal that this could be sustainable without ongoing allocations from the county general fund. Wegener said that staff have reached out to the Alachua County Public Safety Coordinating Council (PSCC) to help gather evidence and generate ideas because the PSCC’s goal is to find ways to reduce pollution of the prison, and a CRF would help address overstretching of the correctional facility and relieve the existing system of crisis services through a coordinated care system. The staff then developed a sub-committee of the PSCC, made up of PSCC members and community stakeholders.
David Johnson, program manager for the county’s Justice and Mental Health Grants Collaboration Program, said staff do not recommend the virtual triage option, which “with [iPads] basically in the back seat of police cars to connect people in crisis directly to a mental health therapist.” He said this could be a complementary program to a CRF, but the staff focused on the standalone and co-located ones options. He said having a CRF located on-site in a Crisis Stabilization Unit (CSU) would reduce transportation costs because patients would simply walk through a door if staff decided CSU was the best option for them may be. However, the existing CSUs are not centrally located in the county or city of Gainesville. Agreements on patient transfers are also necessary with other reception facilities, such as partner hospitals.
Johnson said a standalone facility would be very difficult to implement because it would have to be a quasi-hospital facility with “very significant capital requirements.” He said the operating costs would also be double the operating costs of a facility in the same location. It would also be difficult to get the facility licensed before construction, increasing the risk. Therefore, he said, they do not consider a standalone facility “the viable or responsible path because of the cost, the time it would take, and the uncertainty of being able to get it up and running.”
Both Alachua County and the city of Gainesville have committed $250,000 to the effort, and a bill is in the budget awaiting the governor’s signature. The facility may be able to access other government grants through Lutheran Services of Florida.
Commissioner Mary Alford (who has since resigned) said she would “love to see this get up and running as soon as possible” but with rising prices and supply chain issues for building materials “I’m really worried about the timeline for new building work… We’ve talked about this for years… and now we’re at a point where it’s absolutely the worst of times [in decades] to build.”
“I spoke to a mother yesterday whose son was sent back to prison who has been to prison over 20 times and has a diagnosed behavioral problem that is hardly ever addressed because she is constantly confronted with the drug problem and often goes with other behavioral health concerns together, and this mother has been doing it for 22 years, something I can relate to and there’s a lot of frustration in the community. – Commissioner Mary Alford
Alford said she prefers a standalone facility, “nothing against Meridian. I just feel like — well, I know that patients I’ve dealt with… almost anyone would prefer a self-contained facility because of the trauma that’s inflicted on the people who come through the system… If someone says that he went to Meridian, that’s a stigma they don’t want… We have to do the quickest. I don’t care about the cheapest right now… I spoke to a mother yesterday whose son has been sent to prison again who has been to prison over 20 times and has a diagnosed behavior problem that is hardly ever addressed because she is constantly dealing with the problem of substance abuse that often accompanies other behavioral health issues and you know this mom has been doing this for 22 years which is something I can relate to and the frustration in the community is great.”
Alford said if a virtual triage system could be effective “for certain audiences,” she would be in favor of doing it sooner or later.
Commissioner Anna Prizzia pointed out that building and certifying a stand-alone facility could take years. She said the “best and most efficient option” would be to co-locate the facility with Meridian. She asked about the budget shortfall, and Smart said if the board decides to go ahead with a same-site facility, employees are asking the county to increase their pledge from $250,000 to $500,000 and also asking the city of Gainesville to do the same .
Commissioner Ken Cornell said mental health needs have increased for all ages during COVID, which is why he believes the facility is an appropriate use of American Rescue Plan Act (ARPA) funds. He submitted an application to implement a CRF as an inpatient campus co-located with a Crisis Stabilization Unit, specifically Meridian Behavioral Healthcare. Part two of the motion was to increase county funding from $250,000 to $500,000 and ask the City of Gainesville to do the same. Part three was for the staff to bring back a funding source, including determining if ARPA funds can be used for this purpose.
County manager Michele Lieberman told the board that they previously committed $250,000 to build the facility, along with $1.5 million in ARPA funding to help fund operations for a couple of years. She said the county hasn’t identified a source of funding for the operation once the ARPA money is gone, but the ARPA money could be converted to capital to build the facility.
A community advisory board is currently being negotiated, but currently consists of representatives from Meridian, the North Florida Regional Medical Center, UF Health Vista, a district commissioner, the district attorney, the public defender, the mayor of Gainesville, the police chief, and the sheriff.
The motion was passed unanimously.