Q&A: Dr. Christine Cauffield on sustainable behavioral health funding in Florida

Christine Cauffield, PsyD, is the President and CEO of LSF Health Systems, a managing entity that provides behavioral health services in Northeast and North Central Florida with a focus on uninsured individuals. Cauffield actively works with policymakers to ensure Florida’s most vulnerable residents have access to the behavioral health care and resources they need. 

In this Q&A, Cauffield details LSF Health Systems’ plans to invest pending funding from the legislature into services that will improve health outcomes among their patients. 

 

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State of Reform: What recent policy changes have had the most impact on your work in the behavioral health sector, and what initiatives are you most focused on right now?

Christine Cauffield, PsyD: “This past legislative session has been unprecedented in regards to the new funding coming into the behavioral health care system. The legislature came together and they recommended $126 million new, recurring dollars into the system of care to address Floridians’ mental health and substance use disorders. Of course, we’re waiting for the Governor to sign, but we’re very hopeful and optimistic that the Governor will sign this and these monies will be flowing into the system of care. 

We have really been focused on addressing individuals’ depression and substance use during this pandemic. It’s still continuing with mental health challenges for Floridians. In fact, there’s been a 62% increase in overdose deaths. Suicide rates are rising. Child abuse cases are more severe than in the past. Domestic violence incidents have increased dramatically. So we’re really seeing some very negative consequences as a result of the frustration, the isolation of the pandemic. 

We’re focused at LSF health systems on diversion techniques, diversionary programs, to keep people out of jails, to keep them from entering a Baker Act situation. We have greatly expanded, for example, our co-responder teams, or the co-responder model, where we have a licensed clinician paired with a trained law enforcement officer that responds to behavioral health care calls. As a result, we have a 92% diversion rate of success from people entering jails or being Baker Acted or going to emergency rooms because of that paired expertise. 

We also are looking at expanding our in-home, on-site services, because we understand that for many families, transportation is a barrier. Childcare issues can come in the way of them making their appointments or treatment. So, we are expanding the teaming models that we have, which include Community Action Teams. These models help wrap arms around individuals that are struggling. They provide in-home, on-site services, to break down any barriers that might pose a problem for individuals getting treatment. We are also very involved in the rollout of 988, the new suicide prevention hotline. We are working with our 211 agencies that we fund because those are the agencies that will be housing the 988 features. That’s certainly been a big focus.”

 

SOR: The issues around mental health and substance abuse are not necessarily new, but the pandemic has definitely highlighted them. How will LSF Health System’s response differ this year, especially with the new funding?

CC: “The fact that the new funding is recurring in nature is, again, such a blessing for our system of care. In the past, usually the funding that comes into our state for behavioral health care needs is non-recurring. So every year, we have to work with the legislature to make sure that the programs that are providing good outcomes and utilizing evidence-based practices continue. Recurring dollars allows so much more flexibility and gives us the guarantee that any new programs or expansion of programs will continue with this new funding. 

We have submitted a plan to the Department of Children and Families. They are examining all of the managing entity plans now. Within the next couple of weeks, they’re going to let all of us know if our plans have been approved. What we did with our plans, anticipating this new funding, was review our needs assessment data that we complete every year to see where the gaps and services lie in our 23 counties that we serve. We look at these new funding opportunities and request new programs or expansion of existing programs that are providing excellent outcomes with this new funding stream. We’re anxiously awaiting the Department’s final approval, and then we’ll be able to move forward with the requests that we’ve made to ensure that Floridians continue to get the help that they need.”

 

SOR: You recently held your Behavioral Health Innovation Summit in April. What are some of the findings that came about in those conversations with stakeholders?

CC: “We have an annual Behavioral Health Innovation Summit, and it is so successful because we bring together a variety of stakeholders: thought leaders in our state, legislators, philanthropic organizations. We bring together our providers, we bring together insurance companies to discuss the latest innovative programming that is available in our state. The goal is for everyone to hear about these innovative programs and replicate them statewide. At LSF Health Systems, we have so many innovative programs that are indeed being replicated throughout the state as a result of this innovation summit. It also allows our philanthropic members, our foundation members, our insurance companies to hear about these innovative programs, and then they can choose to begin funding them as well. So it offers an opportunity to blend and braid existing funding to further expand these programs.”

 

SOR: What value do you see in investing in cross-silo relationships—looking beyond just the providers and plans, but really bringing in community partners and others?

CC: “It’s absolutely critical. You know the old saying, ‘It takes a village.’ It truly does. Mental health and substance use disorders are community issues. I don’t think anybody has been untouched or unscathed by these issues, especially during the pandemic. We have to have community solutions. We have to have community stakeholders come together and help address these issues. 

When Floridians are healthy, their communities benefit. There’s more employment opportunities, there’s more individuals that become stabilized and able to enter the workforce and contribute to the tax base. It’s a win-win for everyone to have good behavioral health. It’s just imperative that all stakeholders come together, all community members come together to address these issues, and to come up with funding solutions to be able to expand best practice programs that are really working to help individuals that live with mental health and substance use disorders.”

 

This interview was edited for clarity and length.