EDITORIAL: To Florida Legislature: Don't neglect indigent, mental health care

Jan. 10--When the Florida Legislature convenes on Tuesday for an early election-year regular session, one of the key issues will be health care reform. Medicaid expansion apparently will not be on the table after last year's contentious debate divided the House and Senate once again. Lawmakers are turning their attention to other ideas, including an improvement in access to health care while driving down costs.

Manatee County is moving down a similar path as officials and citizens work on formulating a health-care plan as the indigent care trust fund evaporates and find a new dedicated revenue stream for this expensive program.

Like last year, lawmakers must determine whether to backfill $400 million in federal reductions in payments to hospitals to help cover charity care costs. That federal program, known as the Low Income Pool, subsidizes such safety-net hospitals as Manatee Memorial and other local health care providers who treat low-income working and uninsured residents.

Medicaid expansion would have solved this by providing coverage to more than 600,000 Floridians who cannot afford health insurance. The Affordable Care Act linked LIP to acceptance of Medicaid money, and the federal government is phasing out the program.

While the Senate wanted to accept $2.8 billion in Medicaid expansion money, the House refused and even adjourned days early last year -- in violation of the state Constitution. Since the chambers remain deadlocked on this issue, it's unlikely to come up again. That's unfortunate, another missed opportunity to provide health care to thousands and avoid spending millions in state money on LIP.

Should the Legislature balk at backfilling LIP, the repercussions would be severe -- threatening some hospitals with closure. Lawmakers must fund this vital health care program, or communities will suffer.

Mental health

Another key issue is mental health. As the nation becomes more focused on this in the aftermath of mass shootings linked to mentally ill gunmen, Florida lags severely on funding -- ranking 49th in the nation on per capita expenditures for various programs.

Manatee County's short list of legislative priorities includes more state spending on such mental health services as supportive housing, employment and education for people with mental health or substance abuse issues. Several commissioners will be in Tallahassee this week to lobby on this and other priorities.

This should be a no-brainer but seems to be a heavy lift. While lawmaker awareness appears to be improving, last year's session saw a host of bills that placed additional resources into behavioral health and addiction treatment failing.

Manatee County carries the tragic distinction of being the state's epicenter for heroin addiction with an overwhelming number of drug and other substance abusers seeking treatment. The county's mental health care system is overburdened and lacks the resources to keep pace with demand.

Many people in need of treatment land in the criminal justice system, and the state's jails end up as a behavioral health provider, an overly expensive and inefficient proposition as corrections units are not set up to handle this.

Oftentimes, drug addicts merely undergo withdrawal for a short time and return to old habits once released.

Homeless people suffer from substance abuse and mental illnesses to a greater extent than the general population, but there, too, services are often limited due to lack of resources.

The burden on society comes on many levels, such as the increased costs at hospital emergency rooms, the courts and law enforcement.

As the Florida Association of Counties states in its list of legislative priorities, increased funding and coordination of services would not only improve early identification, intervention and treatment of mental health disorders, but would improve outcomes for individuals and families. That's surely a worthwhile and noble pursuit that would help solve social problems.

The subsequent reduction in costs borne by local governments, businesses and society would also improve communities. Lawmakers should listen to all these cries for help.

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