Medicaid Should Do More for Floridians With Serious Mental Illness
5/1/2026
This article first appeared as a column in the 2026 May issue of South Florida Hospital News
By Mary Mayhew, FHA President and CEO
For the millions of Floridians with serious mental illness or substance use disorder, access to regular and timely psychiatric treatment, medication management, and medical care is essential. Equally important is access to education and training, housing, employment, peer relationships, and other long-term community-based supports. These wraparound pieces are just as instrumental as psychiatric care for achieving and maintaining stability, connectedness, and recovery.
As the largest payor of mental health services in the state, Florida Medicaid’s coverage and payment policies have significant influence on both the adequacy of the mental health/substance use clinician workforce and the availability and accessibility of community-based supports.
Mental Health Awareness Month is an opportune time to highlight what more Medicaid can do to ensure its contracted managed care plans’ payment amounts and network adequacy policies support the robust and timely availability of psychiatrists, psychologists, and other behavioral health clinicians and to continue investing in and expanding funding for proven community-based behavioral health programs, such as the Clubhouse model and Florida Assertive Community Treatment (FACT) Teams.
Nearly 990,000 adult Floridians have a serious and persistent mental illness, such as schizophrenia, bipolar disorder, or long-term recurring major depression. Another 2.5 million have a substance use disorder. 325,000 Florida teens experience a major depressive episode each year, and more than 200,000 have serious thoughts about suicide. These conditions disrupt lives, affecting individuals, families, and communities. Across the U.S. economy, serious mental illness causes $193.2 billion in lost earnings each year, and untreated substance use disorder costs $400 billion annually in direct health care costs; law enforcement and incarceration costs; and employment costs from missed work, disability, and reduced performance.
In 2025, Florida Medicaid began covering Certified Community Behavioral Health Clinic (CCBHC) services – a giant leap forward in the state’s investment in community-based behavioral health care models and expanding the reach and impact of this proven model. CCBHCs take the siloed parts and pieces of the behavioral health system and create a holistic system that addresses all the needs of the person served, regardless of their entry point into care. The CCBHC model prioritizes integrated, person-centered care and has demonstrated significant reductions in hospitalizations, incarceration, and homelessness.
Enhancing access to care and fostering stronger community ties, the model ensures that individuals with serious mental illness receive all essential services for a healthy life, including 24/7 crisis services, screening, assessment, diagnosis and risk assessment, treatment planning, outpatient behavioral health care, case management, primary care screening and monitoring, psychiatric rehabilitation services, peer recovery support, care coordination, and services for veterans.
The state has the opportunity to build on that investment by increasing reimbursement for another proven wrapround program, the Clubhouse model. Clubhouses operate globally and provide a restorative environment for and with adults living with the effects of a mental illness and co-occurring disorders. Clubhouse members can access training, education, employment, and other community-based supports. They also forge meaningful friendships and receive peer support, both of which foster a deep sense of belonging, which is at the heart of the Clubhouse model. Despite the model’s proven effectiveness, however, Medicaid reimbursement remains stagnant at $5.00 per quarter hour.
The state could also leverage federal Medicaid funds to increase the availability and reach of Florida’s Assertive Community Treatment (FACT), Community Action Teams (CAT), Mobile Response Teams (MAT) and Family Intensive Treatment (FIT) teams, which provide critical support for individuals and families facing mental illness and substance use. These teams provide programs and services in community settings, such as schools and homes, rather than in psychiatric or medical institutions with the goals of crisis reduction, rehabilitation, and long-term recovery. These programs are largely funded with state general revenue, creating budget pressure that could be mitigated if the state covered the services as Medicaid benefits.
During Mental Health Awareness Month, we should celebrate the tremendous progress made in reducing stigma about mental health conditions and needs and the greater openness in talking about emotional well-being and resiliency. We should also redouble our commitment to serving those with the most intractable and complex mental conditions so they can fully participate in their families and communities. With Medicaid’s investment, we can.