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County commission moves forward with mental health Central Receiving Facility

Commissioner Ken Cornell makes a motion to move forward with the Central Receiving Facility

BY JENNIFER CABRERA

Bottom line: The County Commission voted to move forward with a brick-and-mortar mental health Central Receiving Facility, co-located with Meridian Behavioral Health Services. They have budgeted $500,000 from their general fund plus $1.5 million in ARPA funds, and they are asking the City of Gainesville to also increase their contribution from $250,000 to $500,000. They hope a Central Receiving Facility will improve the experience of residents who struggle with mental health issues and are often brought to the jail because of a lack of other immediate options in a crisis.

At their May 10 Regular Meeting, the Alachua County Commission discussed options for a Central Receiving System for Alachua County.

Deputy County Manager Carl Smart said that staff had considered a standalone system in its own building, a virtual triage system, and co-locating the County’s program with an existing Crisis Stabilization Unit. 

Stuart Wegener, Criminal Justice Liaison to the Department of Court Services, said the county commission’s motion in August of 2021 was: 1) Staff should direct and organize funding to move forward with the idea of a Central Receiving Facility (CRF); 2) Authorize the chair to send a letter of invitation to the City of Gainesville and to area hospitals to participate in the program operationally and financially; 3) Develop plans for an operational and oversight entity for the CRF; 4) Work together with Meridian to produce a 3-5 year plan that shows partners and funding sources with the goal that this could be sustainable without ongoing allocations from the County’s general fund. Wegener said that staff had turned to the Alachua County Public Safety Coordinating Council (PSCC) to help gather facts and develop ideas because the goal of the PSCC is to explore ways to reduce the burden on the jail, and a CRF helps address over-utilization of the jail and takes pressure off the existing system of crisis services through a coordinated system of care. Staff then developed a subcommittee of the PSCC that included PSCC members and community stakeholders. 

David Johnson, Program Manager of the County’s Justice and Mental Health Grant Collaboration Program, said that staff doesn’t recommend the virtual triage option, which would be “using [iPads] basically in the back of cop cars to connect persons in crisis directly to a mental health therapist.” He said that could be a complementary program to a CRF, but staff focused on the standalone and co-located options. He said that a CRF that is on-site at a Crisis Stabilization Unit (CSU) would reduce transportation costs because patients would just walk through a door if staff decided the CSU was the best option for them. However, the existing CSUs are not centrally located in the county or the City of Gainesville. He said that agreements would also be needed with other receiving facilities, such as partner hospitals, regarding patient transfers. 

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Johnson said a standalone facility would be very hard to do because it would have to be a quasi-hospital facility with “some very significant capital needs.” He said the operational costs would also be double the operational costs of a co-located facility. It would also be difficult to get the facility licensed before it’s built, increasing the risk. So, he said, they don’t think a standalone facility “is the feasible or responsible way, due to the cost, due to the time it would take, and due to the uncertainty of being able to make it operational.”

Both Alachua County and the City of Gainesville have committed $250,000 to the effort, and a legislative request is in the budget waiting to be signed by the governor. The facility may be able to get access to other state grants through Lutheran Services of Florida. 

Commissioner Mary Alford (who has since resigned) said she would “love to see this up and running as soon as possible,” but with prices rising and supply chain issues for construction materials, “I’m really concerned about the timeframe on any new construction… We have been talking about this for years… and now we’re at a place where it’s absolutely the worst time [in decades] to do construction.” 

“I spoke to a mother yesterday whose son was taken yet again back to jail, who has been in the jail 20-something times and has a diagnosed behavioral health issue that is hardly ever addressed because they continuously have to address the substance abuse issue that often goes along with other behavioral health concerns, and so, you know, this mother has been doing this for 22 years, something I can identify with, and the frustration in the community is high.” – Commissioner Mary Alford

Alford said she preferred a standalone facility, “nothing against Meridian. I just feel like—well, I know that patients that I have dealt with… almost everyone would prefer it be a standalone facility because of the trauma inflicted on the people coming through the system… If somebody says they went to Meridian, that’s a stigma that they don’t want… We need to do the fastest thing. I don’t care about the cheapest thing right now… I spoke to a mother yesterday whose son was taken yet again back to jail, who has been in the jail 20-something times and has a diagnosed behavioral health issue that is hardly ever addressed because they continuously have to address the substance abuse issue that often goes along with other behavioral health concerns, and so, you know, this mother has been doing this for 22 years, something I can identify with, and the frustration in the community is high.”

Alford said that if a virtual triage system could be effective “for certain audiences,” she would be in favor of doing that sooner than later. 

Commissioner Anna Prizzia pointed out that it could take years to get a standalone facility built and certified. 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 that if the board decided to move forward with a co-located facility, staff is asking that the County increase their $250,000 commitment to $500,000 and also ask the City of Gainesville to do the same. 

Commissioner Ken Cornell said that mental health needs had increased for all ages during COVID, so he thought the facility was an appropriate use of American Rescue Plan Act (ARPA) funds. He made a motion to implement a CRF as a brick-and-mortar campus, co-located with a crisis stabilization unit, specifically Meridian Behavioral Healthcare. Part two of the motion was to increase the County’s funding from $250,000 to $500,000 and ask the City of Gainesville to do the same. Part three was for staff to bring back a funding source, including determining whether ARPA funds can be used for this purpose. 

County Manager Michele Lieberman told the board they had previously set aside $250,000 to build the facility, along with $1.5 million in ARPA funds that were intended to help pay for operations for a couple of years. She said the County has not designated any funding source for operations once the ARPA money is gone, but the ARPA money could be shifted to capital to get the facility constructed.

A community advisory board is currently being negotiated, but right now it consists of representatives from Meridian, North Florida Regional Medical Center, UF Health Vista, a county commissioner, the State Attorney, the Public Defender, the Mayor of Gainesville, the Chief of Police, and the Sheriff. 

The motion passed unanimously. 

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