This past New Year's Eve, I had the pleasure of welcoming in 2016 at a Billy Joel concert. A rare treat in the midst of another challenging year of therapeutic problem-solving to divert people arrested on low-level and quality of life types of offenses out of jail in the State of Florida. As Broward's Misdemeanor Mental Health Court moves into its 19th year, more than 19,000 people have come through the court. I always believed that community resources would expand once law makers on state and local levels, understood the intersection of the inability to access care, and the criminalization of people with mental illnesses and co-occurring substance disorders.
Recently, a journalist asked me what it's like in Florida, in terms of mental health care. My response, "I am speechless." Particularly, in light of the fact that the Florida Legislature had just opened its session with the announcement that Medicaid Expansion is off the table. For mental health advocates, this is discouraging in light of the fact that Florida ranks at the bottom of mental health funding in the nation. The Florida Department of Children and Families failed to apply for a National Excellence in Mental Health Act Planning Grant. A national demonstration project, which made $22.9 million available to 24 states, willing to develop a new model of certified community behavioral health clinics.
This past week I watched as the newly elected Governor of Louisiana, John Bel Edwards, signed an executive order expanding Medicaid coverage under the Affordable Care Act. At his press conference, Mr. Edwards stated, "We are consistently ranked one of the poorest and unhealthiest states, and this cycle will not be broken as long as anyone in Louisiana has to choose between their health and their financial security."
That statement applies equally to Florida. One million Floridians are living in poverty, with 600,000 in South Florida who are in need of Medicaid coverage. For Floridians with mental illnesses and substance use disorders, the inability to access community based mental health care and treatment translates into homelessness, victimization, and a revolving door which often includes incarceration.
It has been 17 years since the U.S. Supreme Court issued its landmark ruling of Olmstead v. L.C. This decision strengthened the Americans with Disabilities Act, Title II., by declaring that, "Unjustified isolation, we hold, is properly regarded as discrimination based on disability." According to the Department of Justice, states and local governments have a legal obligation to affirmatively remedy discriminatory practices through reasonable modifications to community based programs and services.
All Americans deserve excellence in mental health care and equal justice under law. It is time for law makers to adopt an Olmstead state of mind -- not simply because it is their legal duty to remedy discrimination and institutional bias, but because it is the right thing to do. In order that people with disabilities can have the opportunity to live, work and engage in the community, and experience the joys -- of just "livin day to day."