By Tom St. Myer
Efforts to circumvent a looming mental health treatment crisis in Escambia and Santa Rosa counties are trending in the right direction after months of collaboration among stakeholders.
An about-face by HCA Florida West Hospital is spurring the positive movement. In August, Florida West announced intentions to stop being a receiving center after an influx of adolescent Baker Act and Marchman Act patients. None of its staff has a license to treat adolescents for behavioral health, according to Kendrick Doidge, vice president of business and public relations.
The Baker Act is a Florida law that enables families and loved ones to provide emergency mental health services and temporary detention for people impaired due to mental illness and unable to determine their treatment needs. The act allows the court, doctors or law enforcement officials to involuntarily commit the patient for at least 72 hours for a mental health evaluation. The Marchman Act deals with substance abuse and allows a person to be involuntarily committed for up to five days.
Florida West shutting down its services meant a potential doomsday scenario as it would have left Baptist Health Care as the lone receiving center in the two counties. The number of beds available for patients would have been inadequate.
Baker Act and Marchman Act patients are on the rise as society has become more attuned to behavioral health issues. Baptist sees an average of about 100 Baker Act patients a week, and Florida West sees about 70. Emergency services are already taxed with occasionally transporting patients to Fort Walton Beach or Panama City centers due to a shortage of beds here. The demand on emergency services to transport long distances would have increased significantly without Florida West in the mix.
“We’re trying to get upstream to avoid denial of admittance as much as possible,” Baptist CEO Mark Faulkner said.
Stakeholders in government, health care and emergency services intervened by promising to address the issue and convincing Florida West to agree to a 90-day reprieve. They held true to their word, formulating short-term and long-term plans. Florida West responded by extending the reprieve through March 2023 and recently deciding to remain a receiving center indefinitely, according to Doidge.
Their short-term plan includes expanding mobile response team services and limiting admittance to patients from outside the area. The financial investment for the long term will be significant and includes LifeView Group serving as an adult central receiving facility in either a new or renovated space on its Lakeview campus. Stakeholders hired the consulting firm Ernst & Young to assist in identifying space options, personnel needs and funding sources.
Long-term plans include Florida West remaining in its role as a receiving center and treating patients after their assessments at Lakeview. Baptist and Lakeview each sent representatives to the Apalachee Center in Leon County to tour its central receiving facility.
Law enforcement transports all Baker Act patients to the Apalachee Center for evaluation with a handoff time targeted at three minutes. After an evaluation, patients meeting the criteria for involuntary psychiatric admission are referred to one of four facilities in Leon County. A referral is based on patient choice, availability and identified third-party insurer. Hospitals have one hour to accept the referral before the patient is referred to the next up in the rotation. The target time from arrival to the central receiving facility to hospital admission is three hours.
LifeView Group CEO Allison Hill said she and her fellow stakeholders envision building a similar model with a notable exception. They recommend two central receiving facilities that will serve Escambia and Santa Rosa counties, with law enforcement transporting adults to Lakeview and adolescents to Baptist.
“We’re building a budget for what it would cost to open a central receiving facility, add inpatient beds to expand capacity and primarily admit uninsured patients in that facility,” Hill said. “That’s the long-term plan.”