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Sarasota County to resurrect mental health funding talks

The Herald-Tribune - 1/19/2021

Jan. 19—SARASOTA COUNTY — Sarasota County commissioners may be taking a bold step in 2021 to address disparities in local mental health funding, potentially resurrecting the idea of a public referendum that could create a mental health taxing district to fund treatment.

The proposed district, if approved by commissioners and subsequently passed by voters, would be used to levy taxes to provide funding for mental health services.

While pro-business groups have opposed the idea, the county has seen strong support from civic leaders and the general public.

"It's a money issue, it's a quality-of-life issue, it's just an obvious desire in the community and nationally," said Commissioner Mike Moran, who first raised the idea in 2019.

During the commissioners' strategic planning retreat in December, a group of civic leaders and local health experts called on commissioners to revive the discussion to establish a mental health taxing district to meet the growing demand for behavioral and emotional health and other related services.

The board's decision in April 2020 to delay the effort, which would have put the taxing district on last November's ballot, was driven by the financial and health impacts of the COVID-19 pandemic.

While elected officials are generally receptive to the idea of dedicating money to help fund mental health programs in the county, there appears to be some reservation about tying that money to county residents' property taxes.

It's still too early to tell how much of an increase there would be.

County Administrator Jonathan Lewis told commissioners last week that he planned to have a report prepared and ready to present to the board in March. Lewis said he would seek policy direction the following month.

Commissioner Ron Cutsinger said that while he liked the idea of dedicating funding to mental health services, he would like to discuss "what that actually means."

"We need to talk about it, but mental health, as an issue, needs to be a top priority," Cutsinger said.

For Commissioner Nancy Detert, that priority should be focused on mental health services for juveniles.

"There's a scarcity there," Detert said.

Only half of the children in Sarasota County with a mental health condition received any treatment during the previous 12 months, according to a 2018 University of South Florida study commissioned by the Charles & Margery Baranik and Gulf Coast Community Foundations.

"I will tell you that at any given day, if I need someone in court, there is someone I can contact in this community that can provide the treatment," said Judge Erika Quartermaine, who previously presided over Sarasota County's Mental Health and Comprehensive Treatment courts. "It might be a little bit of a wait, but I don't believe that we lack providers."

The problem, Quartermaine said, is a dedicated funding source for these programs. Many mental health programs in the county work on grants that have short expiration dates or are only partially funded.

The comprehensive treatment court that Quartermaine used to run — which has been lauded for its successful efforts to curb homelessness — is funded with 50% of a state grant that will end in a little over two years.

"This is not uncommon in the mental health world," Quartermaine said. "It's very difficult to procure employees. Even when a program has established its value, it's subject to very onerous reporting requirements by these grants. There is the added difficulty of maintaining these employees when you can only guarantee employment for three years or less."

The mental health programs in Sarasota County have shown their value, she said. It's time to dedicate funding for them.

Commissioners last spring feared that, if passed by voters through a referendum, the district could increase county residents' property taxes at a time when so many were losing jobs, businesses and regular income.

The county had yet to publish the results of a survey of stakeholders and residents — a survey that showed overwhelming community support, the Herald-Tribune reported last year.

While many of the 1,663 people who took the survey likely had a particular interest in the issue — more than 67% reported knowing someone in need of mental health services — an impressive 78% expressed willingness to support some degree of tax increase (from $50 to more than $200) to fund such a vehicle.

Former County Commissioner Jon Thaxton, now the senior vice president for community investment at the Gulf Coast Community Foundation, has been encouraging commissioners for months to revive the discussion.

Thaxton said there should be an "intentional and deliberate decision to support an individual mental health taxing district."

Christine Robinson, a former county commissioner and executive director of the pro-business group, the Argus Foundation, said that while she encourages the county to add the words "mental health" to its priorities this year, it should not create a separate taxing district.

She believed that the process, protection and parameters should be completed first before the county decides if it should use the general fund or create a taxing district.

"If you intend to raise taxes, it is understandable why a taxing district will be considered," Robinson said. "You should let the public know that up front. If you intend to just use the mental health money you are spending now to the taxing district, it is a mistake that will have terrible consequences for mental health."

The county has two mechanisms for addressing mental health, Robinson said. It could prioritize in the existing general fund to move more money into mental health services. Officials could also increase the property tax rate.

"Conversely, think of the ramifications of a tax value dip and the devastating effect it could have on mental health," Robinson said. "Operating within the district, you could be forced to cut mental health and raise the millage during a recession. As someone who has sat in your seat during a recession, that is a horrible choice for a commissioner to make," Robinson said.

If the county is intent on a special taxing district, she urged caution, as voters in 2022 will be asked to consider the surtax referendum, which would be up for renewal. That's the 15 year program that is used by the county, each municipality and the school board for capital dollars.

"Please watch your timing and do not jeopardize the surtax which could single-handedly shift our community into a locally induced recession if it does not pass," Robinson said.

Dr. Washington Hill, a physician at Sarasota Memorial Hospital, called mental health a "critical and timely issue facing Sarasota County."

"Regretfully, mental health is a stigmatized topic," Hill said. "It can be difficult for many to discuss, especially in a public forum such as this. Yet mental health is pervasive in our families — it is common in my own — our workplace and in our schools."

Because it's difficult to discuss, mental health needs often get overlooked.

The annual economic cost for the under treated in the county alone is over $86 million, Hill said.

"Untreated mental health illnesses are the root cause of many of our county's most challenging and consistent needs," Hill said.

Those include criminal justice and homelessness — all exacerbated by the unprecedented coronavirus pandemic.

Former Sarasota County Sheriff Tom Knight, who is now the CEO of First Step of Sarasota, said that the county has made significant strides in reducing the jail population in recent years, recidivism rates for people with substance abuse caused by mental health is still significantly high.

"You can imagine the burden that has put on Sarasota Police, North Port Police and your Sheriff's Office and the courts with those arrests," Knight said.

Just shy of 50% of the people in the jail in early December were on medication to treat mental illnesses. While funding for that medication is built into the sheriff's budget, there is a need to enhance those services.

"Maybe to the point of keeping people out of the justice system," Knight said.


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