5000 Friends

Shortchanged: Florida’s mentally ill suffer because of underfunding

By Shai Kuruvilla

PALATKA -- Florida has not met its responsibilities to the mentally ill, according to 5000 Friends of Florida Families, an outreach effort by the Florida Council for Community Mental Health.

Florida ranks 47th in the United States in funding for mental health care and 35th in funding for addiction services.

Mental illnesses and addictions contribute to job loss, failure in school, divorce, abuse and trouble with the law.

5000 Families says these afflictions affect thousands of Florida families. However, high quality and affordable treatment of mental illnesses and addictions is not within every family’s reach.

The issue hits close to home in Putnam County.

Kathryn Walburn, administrator for Putnam Behavioral Healthcare, said there has been a large cut in Medicaid, which has a negative effect on their budget, allowing only a few services to be provided for the growing number of people who are sick and need help.

Since July 2005, there has been a $600,000 cut in funding for Putnam Behavioral because of Medicaid reform.

“The funding allows help for only a small portion of those who need it,” said Walburn.

As a result, Putnam Behavioral has to prioritize patients’ needs based on doctor availability.

State funding places a priority on individuals recently discharged from a psychiatric hospital, those discharged from a crisis stabilization unit and those released from prison or county jail.

Walburn said it is common for family members to call many places in search of help and answers to questions about services available, Medicaid and evaluation procedures. These questions are usually left unanswered, adding to the growing frustration of the family.

“These people are extremely distraught and are dealing with family members suffering from mental status changes and completely abnormal behavior,” Walburn said.

She said just having someone to talk to who is trying to help can put the person at ease.

Putnam Behavioral offers outpatient treatment for people with Medicaid. It has two board certified psychiatrists and an advanced registered nurse practitioner who provides counseling and medication to children, adolescents and adults.

Dr. Yumesh Mhatre comes in two Tuesdays a month from Lake City and Dr. Michael Haser of Gainesville comes in once a week.

The ARNP is Julia Weber, who works under the protocol of Dr. Mhatre and is licensed to prescribe some medications. She is available from 9 a.m. to 5 p.m. Monday through Friday.

Putnam Behavioral offers treatment for thought, mood and personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders as well as substance abuse and detoxification treatment.

For those who live in Putnam and have Medicare, counseling is available at the Family Medical Center with a licensed clinical social worker. Putnam Behavioral does not accept Medicare because the reimbursement does not cover the cost of services. Private pay is also not accepted because Putnam Behavioral does not have adequate funding for the staff or resources needed for collection purposes.

Walburn said lack of funding is the reason there is no fulltime practicing psychiatrist in Putnam County. Counseling or medication access is limited to the designated days the doctors are on site. In an emergency situation, Putnam residents have to drive to a neighboring county to receive services.

She said there has been no increase in state funding for mental health in five years, but the cost of living and the population in Florida have been steadily increasing.

“We are expected to operate on the same amount of money as five years ago,” Walburn said. “It is impossible. This causes more jobs to be cut.”

“The state isn’t funding adequately, so the patient, who does not have insurance, is pushed into managed care, which has contracts with hospitals,” said Walburn. Patients can not choose what medicines they take or which hospital they go to. Medicaid revenue has been drastically reduced because of managed care reorganization.

Medicaid has changed some policies under the reorganization, resulting in even less income. Among the changes, case management workers are no longer paid for travel time and each visit needs prior authorization verified.

5000 Friends began in November of 2005 with more than 2,000 registered members.

The group says that the most effective way to get legislators to listen is to write letters asking for improved services, such as counseling, management and medication.

Florida Statutes 394 and 397 deal with both mental health and addictions. According to these statutes, there should be a continuity of care and services to those in need. The mandatory services include detoxification, case management and implementation of the Baker Act, which is the involuntary commitment to a mental health facility. The person must be determined to be dangerous to themselves, dangerous to others, gravely disabled or in need of treatment. Other mandatory services are outreach programs and intervention services.

“We need to increase programs to help more people,” said Walburn.

Those experiencing problems or with questions regarding mental illness or addiction can call Putnam Behavioral at 329-3780.