Limited Mental Health ALFs - OPPAGA Study needed now!

The 2010 legislative session is now underway. This year I am working to ask lawmakers to authorize the Office of Program Policy and Governmental Accountability (OPPAGA) to conduct a review of Assisted Living Facilities that hold a limited mental health license.

The need for lawmakers to gather information about these facilities is critical to the sucess of state efforts to realize cost savings in their efforts to reduce the state budget for health care. It is commonly known that institutional utilization in Florida runs around 93% whereas states like Orgeon have a much lower utilization rate around 78%.

The reliance on institutional care has dominated our state budget process for many years, now with a $3 billion short fall it is no longer sustainable to continue funding policies that create a heavy reliance on institutional systems of care to meet the needs of the low income and vulnerable.

It is well known fact that over 50% of the diversions from nursing homes under the "nursing home diversion program" are placement in licensed ALFs. The need for good quality ALF care that can be offerred at effective prices is critical to state efforts to change policy to capture savings.

Unfortunately in Florida the ability of state funded ALFs to continue serving the low income and the vulnerable is fading away and is being replaced by increased reliance on jails, forensic mental health treatment facilities, nursing homes and hospitals.

The problems associated with the funding programs for state funded ALFs center on the funding programs for providing access to care ( Optional State Supplementation) and the Medicaid Assistive Care Services. There are serious changes needed in how these programs function not to mention the need to examine how residents are accessing services under the new managed care programs ( pre paid mental health and medicaid reform).

The current reimbursement system for care contemplates a rate of $9.28/day for a whole list of Medicaid ACS services. We need to re-examine how these services are funded and perhaps look at a creating a three tiered payment system so that the system will focus bed space at those with the greatest need.

According to DCF there has been a loss of 2400 state funded ALF beds in Florida since 2001. This loss in capacity means that people must go elsewhere for care. With a growing elder population and rising levels of need for the disable as they age the need for stable housing and stable service is more critical now than ever.

The last OPPAGA study was in Feb 1997, because there are so many factors affecting the viability of these important facilities the need for a closer look by OPPAGA is critical to help identify how lawmakers can make changes that result in a more effective system of care and also enable these facilities to play a role in helping the Florida create the savings that are needed in the budget.

I will keep you updated on this blog.

Douglas D. Adkins
Executive Director
Dayspring Village, Inc.
Hilliard, Florida