A case of misplaced priorities
Sarasota Herald-Tribune: Opinion
Updated May 19, 2018 at 7:56 PM
Proposed Department of Corrections cuts would decimate substance abuse programs in the midst of the opioid epidemic
Sometimes the shortsightedness of our state government leaves me speechless — and that’s not a condition I’m very familiar with.
I learned of a recent mind-bogglingly irrational decision last Friday when P.J. Brooks of First Step of Sarasota told shocked attendees at the regular monthly meeting of the Behavioral Healthcare Consortium that his agency — the primary provider of substance abuse services in Sarasota County — and dozens of other around the state were facing imminent cuts of 40 percent or more in funding they receive from the Florida Department of Corrections.
Actually, I was hearing about this belatedly — perhaps because it was originally announced in a May 1 press release under the innocuous header “FDC Announces Steps to Award a Heath Service Vendor for Inmate Health Care.” You had to read on to learn that funding to community agencies, which for the past 15 years have been funded to deliver substance abuse and mental health treatment, as well as re-entry programs that prepare inmates for life out of prison, was being cut to make up for a $28 million shortfall after the state legislature reduced FDOC’s operating budget by nearly $25 million.
FDOC Secretary Julie Jones recommended reallocating money from those community partnership contracts to cover the anticipated cost for health care services to about 87,000 inmates in state-run prisons, which the state is constitutionally required to provide. A $2 billion, five-year contract for those health care services with Centurion of Florida, the sole bidder, was approved by Jones and is now in the final stages of approval.
“In order to secure a health services contractor, fund the increased pharmaceutical budget and adjust for reductions, we’ve unfortunately had to make some very difficult decisions,” Jones said in the press release. “It is our hope that these decisions, while necessary given the circumstances, are temporary and a positive working partnership with our community partners can continue in the future.”
Though lawmakers had been aware of recent legal challenges around treatment of inmates with disabilities, mental illness and hepatitis that would necessitate an increase in funding, nevertheless they passed — and Gov. Rick Scott approved — a budget they knew would leave the department in the hole. Jones’ solution was to dip from a pot legislators did approve funding for to fill another that they short-changed.
Where do we begin with how wrong all this is? Well, for starters, we could mention that we are in the middle of an opioid epidemic the likes of which we’ve never seen and to which the governor previously pledged a top-priority response. Yet the proposed cuts will result in as many as 15,000 individuals statewide being eliminated from substance use disorder treatment.
“We hear about the desire to put resources behind the opioid epidemic, that this is a scourge and we need to address it, but those of us who are treatment providers are still waiting for meaningful change,” said Brooks, vice president of outpatient and youth services at First Step, which stands to lose 36 of its 62 residential treatment beds if the cuts take effect. “Our budget has not increased to support the opioid epidemic and we’re the primary substance abuse provider in the county.”
The cuts will also decimate or eliminate prisoner re-entry and education programs which, along with substance use services, have proven to be the most effective and cost efficient way to prevent recidivism. Between 55 and 70 percent of inmates in Florida have a substance use disorder that requires treatment and studies have shown cost savings of between $2 and $5 for every dollar spent on treatment programs.
The state can hardly claim poverty as an excuse. Florida had a record $87 billion in total revenues last year, and the deficit these cuts are intended to remedy represents less than 2 percent of the FDOC’s overall $2.4 billion budget.
Not only will these eliminations dash the possibility of recovery for thousands, they will likely disrupt the lives of the very people trying to restore the addicted and incarcerated to health and productivity. It is estimated they will result in 600 full-time jobs lost at these community agencies; smaller organizations might be forced to shut down entirely, and others could be absorbed by larger facilities, leaving some regions without any local services.
All of the affected agencies received requests in March from the FDOC asking for voluntary cuts, as they had several times in the past. But with reimbursements in First Step’s residential program set at $52 a day (that’s for room, board and treatment), Brooks said the margin on breaking even is already “so razor thin” there was nothing to cut.
“It becomes a question of, ‘Do you cut off an arm or a leg?’” he said.
On May 1, the targeted agencies received emails from FDOC containing amended contracts that included the cuts and were given a 48-hour deadline for acceptance. The deadline was subsequently extended by a week, but the extra time hardly mattered.
“All the organizations begrudgingly signed because … well, what else could we do?” Brooks said. “We didn’t really have any choice. Everyone is still teasing through what all of this means.”
Outcries against the reallocation of funds have come from disparate sources, including Sen. Jeff Brandes (R-St. Petersburg), who heads the Senate Criminal and Civil Justice Appropriations Committee; Mark Fontaine, director of both the Florida Behavioral Health Association and the Florida Alcohol and Drug Abuse Association; and Attorney General Pam Bondi, who called the cuts “ridiculous.”
Yet, on May 11, Jones submitted her recommendations to the House and Senate, which have until Friday to respond. That’s less than a week away. The Senate has indicated it is not inclined to approve, but the House, according to several sources, will likely offer no objection. Approval by either body — not both — is sufficient to put the cuts into effect.
The elimination and reduction of these services flies in the face of the governor’s stated priorities, the specified amounts set by the Legislature for substance abuse treatment, and best practices to prevent recidivism and save money — not to mention common sense. Even if you’ve never had a friend or family member incarcerated or addicted, even if you aren’t invested in saving lives and reducing prison populations, even if your only concern is how your tax dollars are being spent, this kind of myopic thinking and hypocrisy should matter to you.
You can reach House Speaker Richard Corcoran at 813-792-5177 and the governor at 850-488-7146.