Gwendolyn Warren, executive director of the county’s Health and Community Services department, talks to Pinellas County Commissioners Dec. 3 about a plan to improve behavioral health services.
CLEARWATER – Pinellas County Commissioners listened attentively during a Dec. 3 work session as top officials from five behavioral health care providers gave an overview of what they do.
The goal was to provide enough information for commissioners to give direction to county staff who are working on a plan to improve service delivery. The target date to present the plan is the spring of 2014.
“Behavioral health care services are a critical component for maintaining a healthy and stable community in Pinellas County,” according to a report from Gwendolyn Warren, executive director of the county’s Health and Community Services department.
In fiscal year 2013, the county provided more than $8 million in supportive funding to local providers to deliver behavioral health care to Pinellas County residents. Those service providers include Directions for Living, Suncoast Centers Inc., Boley Centers, Operation PAR and Personal Enrichment through Mental Health Services.
Collectively, the five facilities have 218 years of experience. Suncoast Center began in 1944 and has a staff of 270. Boley Center started in 1970 and has a staff of 173. Operation Par also started in 1970 and has a staff of 457. Directions for Living and PEMHS began operations in 1981. Directions has a staff of 325 and PEMHS has 220 people on its payroll.
Nancy Hamilton, CEO of Operation PAR, told commissioners that the five service providers are individually accredited through the national Commission on Accreditation of Rehabilitation Facilities, which rates on effectiveness, efficiency, access and satisfaction.
During fiscal year 2012-13, they served 60,851 unduplicated clients, plus another 80,000 contacted through outreach programs. They provided almost 2 million unique services. An average of 90 percent of their funding goes to direct services.
Hamilton said over the years, the five had made many improvements in how they interact. They improved how they provide referrals to ensure people connect with the provider with the best service for their individual needs. All now have a 24-hour access number and walk-in appointments are available.
Hamilton said the providers are aware that the county commission is focusing on the problem of poverty in Pinellas.
“Poverty, in and of itself doesn’t mean someone will have a substance abuse or mental health problem,” Hamilton said.
Estimates show that about 20 percent of the population, ages 20 to death, will have a substance abuse problem and about 20 percent will suffer from a mental health issue. Hamilton said much depended on the circumstances of the individual.
In 2012-13, collectively the five received $91 million in funding with 39 percent coming from the state, 17 percent from Medicaid, 13 percent from federal sources, 10 percent local sources, 7 percent from the county, 7 percent from paying clients, 4 percent from third parties and 3 percent from charitable donations and other sources.
State funding is not increasing, Hamilton said, and “sometimes Medicaid is reapportioned,” meaning the program changes where the money can be spent.
“State and federal funding over the years has not been stable,” she said. “It is constantly shifting.”
Tom Wedekind, CEO of PEMHS, said the money to provide care for someone Baker Acted has not changed since 1992 despite increasing costs.
Hamilton said some states provide a per capita amount to fund behavioral health services, so as population increases, so does the money.
“Not Florida,” she said. “Every year we fight over the same dollars.”
Collectively, the five offer services that include primary prevention programs, intervention services, treatment and aftercare and continuing care.
They provide long- and short-term support. They help those who need it with financial support, so they can afford their medications. They make sure they have food, are taking their medications and can get to doctor’s appointments, said Barbara Daire, president and CEO of Suncoast Centers.
She said all the providers work with the homeless and partner with Veteran’s Administration to provide services to veterans who don’t qualify for help from the VA. They have staff at Safe Harbor homeless shelter. They work with people suffering from post-traumatic stress disorder. They assist the elderly.
“One in five will have a mental health instance in their life,” Daire said.
All the partners can work with those needing help with mental health or substance abuse, but we do have a primary role, she said.
Hamilton said proper assessment is critical to providing help so there are few surprises during the course of treatment. She said providers take into account mental, spiritual and social aspects among others to determine what is needed to provide the best help.
She talked about the tremendous benefit the five now has due to the ability to share the same electronic records.
“It truly is a miracle,” she said. “We’re very excited about it.”
Daire said the providers have a very cooperative system.
“We all meet monthly. We go to social services meetings. We try to be a part of everything to learn to do things smarter, better and less expensive.”
She pointed out that “we don’t all do all for all, so it is important to partner.” She added that they all worked more effectively together.
“In Pinellas we take for granted the 40 years of service from this incredible group of service providers,” said Commissioner Susan Latvala. “They work so well together.”
“We’re lucky to have you,” Commissioner John Morroni added. “You’ve helped people I know personally.”
Hamilton said everyone is willing to work with county staff to come up with new innovative approaches for continuum of care and services using methods that include consolidation, sharing of staff and facilities, mergers, partnerships to lower costs or increase services. Using the internet to provide virtual services also is on the list as is standardization of communication and shared information.
Warren said her work thus far with the service providers had been an “eye-opening experience,” not only due to the volume of work they do but the quality of work, as well as their willingness to improve and enhance what they do.
She said everyone would be working together to look at the community’s needs and advocate on behalf of citizens. The plan staff is working on will explore the need for more services for women and children. They’ll look for gaps in service. They’ll look for ways to not only feed and find places for the homeless to sleep, but also ways to extend support so “they can regain control of their lives.”
One concern is the recent trend to Baker Act children, which Warren said was the result of the recent school violence. She said some communities had chosen to employ school guards and others had chosen legal actions to remove children exhibiting symptoms
Law enforcement and others use state law, the Baker Act, to place people in the hospital for mandatory observation when they are possibly a danger to themselves or others.
“Baker Acting Children – I never heard of such a thing,” said Commissioner Janet Long.
“Behavioral health trends change with conditions,” Warren said. “We have some new issues.”