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Behavioral health association says state MAT program expanded network, improved retention; senators press for clearer race and ethnicity data
Summary
Florida Behavioral Health Association described a decade‑long medication‑assisted treatment (MAT) program run under contract with the Office of the State Courts Administrator, reporting higher engagement and longer average stays but prompting senators to question demographic reporting and representation.
Melanie Brownwofer, president and CEO of the Florida Behavioral Health Association (FBHA), told the Appropriations Committee on Criminal and Civil Justice that a legislatively funded medication‑assisted treatment (MAT) program serving court‑involved and at‑risk adults has expanded to 63 of 67 counties, served thousands and shown improved engagement and retention.
Brownwofer said the program — funded through proviso language in the trial court budget and administered under contract by FBHA’s services arm (FATA) — began in fiscal 2014–15 with $5.5 million for extended‑release naltrexone (Vivitrol) and was expanded in 2018–19 to include additional medications such as buprenorphine and methadone. In the current fiscal year the Legislature funded approximately $5,500,000 for extended‑release naltrexone and $6,000,000 for broader medication‑assisted treatment, Brownwofer said.
Under the contract, FBHA is required to recruit a qualified provider network, ensure statewide coverage, monitor program participation and reconciliation of payments, and file quarterly outcome reports. Brownwofer said FBHA has complied with the contract’s deliverables and that the Office of State Courts Administrator (OSCA) monitors invoices, conducts site visits and may exercise contractual remedies if necessary.
Presenters said program outcomes for the most recent five‑year window include: more than 10,000 clinical screenings, approximately 19,900 medical assessments, and about 9,200 individuals who received at least one dose of medication. Brownwofer said roughly 6,600 participants have been “successfully discharged,” which the program defines as meeting an individualized treatment plan. She said engagement rates improved from about 51% ten years ago to roughly 85% in 2023–24 and average length of stay rose from approximately three months to six months.
Brownwofer described participant demographics and diagnoses as follows: 59% opioid use disorder, 29% alcohol use disorder and roughly 13% co‑occurring disorders; average participant age about 43 and 59% male. Several senators pressed for clearer racial and ethnic reporting. Senator Russin asked why the slide showed a heavy overrepresentation of white participants (82% white, 7% African American on the slide presented); Melanie said Hispanic/Latino reporting in her slide used ethnicity categories and that the committee had requested clarifying detail. Senator Osgood and others asked whether the program receives hospital referrals and whether demographic skew may reflect self‑selection or differences in referrals; Brownwofer said hospital referrals are not a major source and that self‑referral and court referral patterns affect the observed demographics.
Senators also asked about program access in jails and the benefits of beginning long‑acting injectable treatment prior to release. Brownwofer said on‑jail dosing and warm handoffs to community providers help retention and reduce post‑release overdose risk.
Committee members requested additional demographic breakdowns to reconcile race and ethnicity fields. No committee votes were taken on the MAT program during the hearing.
