Cutbacks may force Meredian centerto close - Gainesville (FL) Sun

By Diane Chun

Meredian Behavioral Healthcare may be forced to close the doors of its 10-bed short-term residential treatment center for patients with psychiatric and substance-abuse problems within the next 30 days, due to cutbacks in state funding.

That would leave many of the 550,000 residents of an 11-county area in North Central Florida who depend on publicly-funded health care, such as Medicaid, without in-patient psychiatric services.

Meredian's short-term treatment center, or SRT, was established four years ago, and each year it has been funded as a special member project by the Legislature.

Meredian is a private, nonprofit agency that operates a crisis-stabilization unit in Gainesville licensed for 40 beds, and outpatient counseling clinics in nine counties. It is not affiliated with Shands at Vista, an 81-bed psychiatric hospital in Gainesville that largely serves a population with private health insurance.

The current state funding crisis has taken away money for anything that was non-recurring, including the SRT, explains Maggie Labarta, president and CEO of Meredian. The $1.45 million in cuts from the state includes the entire $900,000 operating budget of the SRT.

Labarta said the irony of the cutback is that insurance companies will not cover short-term residential treatment.

"Yet our cost is about $291 a day, compared to average cost of psychiatric beds statewide of about $1,200. We have a deal here, but no one could see it that way," she said.

"We will now be one of the few districts in the state that does not offer the SRT level of care as part of the public funding arena," she said.

The average length of stay in Meredian's crisis-stabilization unit is four to seven days, she said, but not everybody can get restabilized in that length of time. If they must be placed in the state hospital in Macclenny, the wait time can be two months.

"Right now, we can put those folks in the SRT and have them wait in a setting that is more appropriate," she said. "In many cases, we have been able to stabilize them right here. It provides a more local option with an appropriate level of care at a rate lower than a community hospital bed or state hospital bed would cost."

Alexis Henderson, 22, is one of those for whom the SRT has been a lifeline.

She was just a freshman in high school when she made the first of several suicide attempts and wound up in the hospital.

The Gainesville resident has since been diagnosed with bipolar disorder. She has been in the crisis-stabilization unit several times after she stopped eating and stopped taking care of herself.

"I get delusional," she said.

She would have had to go to the state hospital, but was able to stay in the SRT for three months while she regained her emotional balance.

"There's nothing like it in Gainesville," Henderson said.

The young woman has been out of treatment since July, and is working three days a week with the Gainesville Opportunity Center, which offers transitional employment to those who have struggled with mental illness.

"That's kept me out of the hospital," she said.

Labarta said that North Florida has been traditionally overlooked and underfunded when it comes to mental health and substance-abuse treatment.

The state budget crisis has only made things worse. Meredian also faces a $2.6 million loss in Medicaid funding, based on the new cap rate. Add that to the $900,000 loss in operating funds for the SRT and the loss of 20 full-time positions, and the cuts amount to 12 percent of Meredian's revenues for the current fiscal year, Labarta said.

Her immediate concern, though, is the potential loss of the transition care offered by the SRT unit, which she describes as a "safety valve for those who can't be treated without longer term care."

Labarta said, "To lose 20 percent of your beds is a travesty, and it could be a tragedy in the making.

I see a huge erosion of commitment (by the state) which is tantamount to abandonment."