Commissioner Moran calls for in-depth discussion during board’s December retreat in regard to county funding of all health services
In March 2021, as they worked on their budget for the 2022 fiscal year — which began Oct. 1, 2021 — three of the Sarasota County commissioners concurred on a request to the county’s administrative staff: that the proceeds of an extra one-tenth of a mill be dedicated to mental health and substance abuse services.
The proposal came from Commissioner Michael Moran, who also had championed the creation of a Mental Health Care Special District that the board members would govern. Commissioners Nancy Detert and Alan Maio voiced support for his idea during the March 24 discussion. Maio called the extra millage “a modest increase” in the overall millage rate for the 2022 fiscal year.
Then, on July 14, 2021, the commissioners formally voted on that additional millage in approving the not-to-exceed millage rate for FY 2022, with Commissioners Ron Cutsinger and Christian Ziegler in opposition. The not-to-exceed figure is adopted every year in July so the Sarasota County Property Appraiser’s Office can send out the Truth in Millage Notices to all property owners in August.
The millage rate can be lowered during formal budget hearings, county staff has explained, but it cannot be raised.
Ziegler told his colleagues that he had vowed, during his campaign for the District 2 commission seat, that he would not raise taxes. Cutsinger offered hope that the county might be able to use federal funding in response to the COVID-19 pandemic to provide extra funding in the new fiscal year for mental health and substance abuse services.
Ultimately, the commissioners approved a millage rate that did not include the extra 0.10 mills. Chair Maio reminded them that a task force, whose establishment they had requested, would be providing a report in 2022 on recommendations for services through the Mental Health Care Special District. By the time the commissioners received that report, he continued, so much of the fiscal year would have have elapsed that it did not appear necessary to make the millage change.
Instead, Maio pointed out, staff should be able to find other revenue that could be used for the purposes that the new funding would have covered.
That task force ended up presenting its report in late January of this year. Nonetheless, as Maio has noted, County Administrator Jonathan Lewis did work with staff to find the necessary funding from other sources to provide the mental health care services as the commission had directed.
This week, as they prepare for the Oct. 1 start of the 2023 fiscal year, the commissioners voted unanimously to approve a resolution that formally called for county Health and Human Services Department staff to ensure that the revenue generated by 0.10 mills be set aside for mental health and substance abuse programs, under the aegis of the Mental Health Care Special District.
Moran made the motion, which Detert seconded.
However, prior to that Sept. 13 action, Moran called for an in-depth discussion of future funding of all the health services that the county supports. That will take place during the board’s annual retreat in December.
A major focus of those talks, Moran indicated, will be the fact that, in 2008, the commissioners seated at that time adopted a plan to dedicate the revenue generated by 0.1661 mills to cover not only what staff calls the “CORE” health services programs each year — those that the board members have agreed are their top priorities — but also to pay for county contracts with private providers for other initiatives, as recommended by the county’s Human Services Advisory Council (HSAC).
Chuck Henry, director of the county’s Health and Human Services Department, as well as the director of the Florida Department of Health in Sarasota County, reminded the commissioners of that millage history during a Sept. 13 presentation.
Pleas for more funding for necessary services
That morning, during the Open to the Public comment period, three speakers pointed to growing needs for health services in the community, which they noted was partly a result of the increase in population in recent years and partly a factor of the COVID-19 pandemic.
Former Commissioner Jon Thaxton, a senior vice president of the Gulf Coast Community Foundation — which has been involved in a number of initiatives to improve the mental health of county residents — encouraged the commissioners to ask staff to make an annual determination about health care funding on the basis of community needs.
Subject matter experts have determined that county spending on mental health services should be around $6 million a year, Thaxton said; instead, it is about $2.6 million.
Over the past decade, Thaxton pointed out, the county had welcomed about 77,000 new residents; yet, “the funding source has been near flat over the last decade while the needs have increased.”
With approval of the resolution regarding the proceeds from the one-tenth of a mill, he continued, the money left over for other programs will decrease.
Then Melissa Larkin-Skinner, regional CEO for Centerstone in Florida — a nonprofit provider, with a Sarasota County location, “specializing in mental health and substance use disorder,” as its website says — appeared at the podium.
She noted that she is chair of the board of the Florida Behavioral Health Association and a member of the Florida Commission on Mental Health and Substance Abuse. Those positions, she added, enable her to learn “a lot of information about mental health, the needs and the lack of resources across the state [and the country].”
Larkin-Skinner asked the commissioners to plan for the future. The people who need the services do not care where the funding comes from, Skinner pointed out. “They just need to know that they feel better.”
Finally, Chris Johnson, CEO of the Suncoast Partnership to End Homelessness, also talked of the need for adequate funding for health services overall. If the county was able to use just the revenue generated by 0.0661 mills for programs other than those related to behavioral health and substance abuse, he said, those remaining programs “would still be underfunded” by about half a million dollars.
‘The harder question’
During his remarks before approval of the new resolution, Commissioner Moran stressed that the commissioners constantly deal with questions regarding the appropriate expenditures of taxpayer money. He pointed out that the commission annually has been adding to the revenue from the 0.1661 mills for health care services. The extra money has come out of the county’s General Fund, which is the most flexible source of money for needs that arise. That fund is made up largely of property tax revenue.
The resolution that the board members approved on Sept. 13 explains that the commissioners supplemented the revenue generated by the 0.1661 mills each year from the FY 2008 through FY 2022 with “varying General Fund transfer amounts to maintain the level of service and implement new programming” as agreed upon by the board.
“The harder question and the more difficult discussions,” Moran continued, should be focused on whether the board members are making the best use of the money they allocate to health and human services.
Then Moran said that the 0.1661 figure is “just not sufficient” for all of the needs. The discussion during the retreat, he continued, should focus on whether such a cap should remain county policy, given the trend of subsidies from the General Fund.
Perhaps Henry of Health and Human Services should just make an annual budget request for the appropriations linked to all of the services, Moran pointed out.
Moran did acknowledge that, having engaged in discussions with members of the county’s Human Services Advisory Council and stakeholders, he is aware of the concerns about steps that commissioners may take in coming years in regard to paying for health services to county residents. Calling for the retreat discussion — and potential action as a result of it — “is putting very healthy pressure” on providers to ensure that their programs deserve county funding, Moran said.
Moran finally did indicate support for eliminating the “formula-based decisions” and using General Fund allocations instead, though he noted that would be part of the retreat discussion.
In seconding Moran’s motion to approve the resolution that morning, Commissioner Detert agreed that the formal dedication of funds to mental health and substance abuse services shows that the board members have not wavered from their assertions over the past couple of years that more attention should be focused on such programs to help county residents.
Commissioner Cutsinger added that the board members also need to discuss longer-term funding issues, not just how to handle the annual allocations.