Panel recommends paying $20 million to Iowa counties for mental-health transition

State changing to regional-based system

DES MOINES – A legislative panel on Friday recommended that up to $20 million in state transition money to be approved early in the upcoming session to cover Medicaid and mental health costs through June 30 even before they tackle expanding needs in the fiscal 2014 state spending plan.

County officials told members of the Mental Health and Disability Services Redesign Fiscal Viability Study Committee that at least a third of the counties need millions of transition dollars in the next six months to make the switch to a regional delivery system for equalized mental-health services or they will be forced to reduce their help for recipients or create waiting lists to receive services.

Officials from the state Department of Human Services laid out three scenarios to help counties cover for non-Medicaid mental health services that ranged from $1.5 million to $11.6 million in state aid. That was based on a DHS analysis of 32 county requests for transition funds that found those counties owed about $22.1 million in undisputed state bills as of Oct. 31. The remaining counties owed about $26 million, but they did not request state transition funds to balance their ledgers.

The study committee, however, decided to recommend that the split-control Legislature and Gov. Terry Branstad approve up to $20 million as “gap” funding to get through the transition of moving from a county-based to a redesigned regional service delivery system that maintains the goal of not ending core services or creating waiting lists.

“We’re very pleased with the recommendations,” said Bill Peterson, executive director of the Iowa State Association of Counties. If approved, however, he said the supplemental state money would get counties through the current fiscal year but they likely would need additional state help in fiscal 2014 and beyond in moving from a system that was a blend of federal, state and county dollars to a system will primarily will be county funded once clusters of counties merge into new service-delivery regions.

Committee co-leader Sen. Joe Bolkcom, D-Iowa City, said there remain a lot of unknowns in the transition process but it is clear that Iowans support a strong mental health system, especially in the aftermath of high-profile shooting incidents around the country involving assailants with histories of mental problems.

“We’re making some big changes to the system and I think we have a responsibility as the leaders of the change to make sure that the resources are there to make sure that the people get the services they need,” he said.

Committee member Sen. David Johnson, R-Ocheyedan, said he expected the panel’s recommendation to be accepted by the Democrat-controlled Iowa Senate, but added “it might be a hard sell in the (GOP-led Iowa) House and it still has to pass muster with the governor, so it still has a ways to go.”

Linn County Supervisor Linda Langston, whose county would receive $2.2 million under the DHS’ $11.6 million scenario, said she was encouraged by Friday’s committee action but noted many challenges remain in a regional change-over that likely will take several years to complete.

“I think there’s still a little bit of devil in the details, but I think they took a lot of good steps today,” she said after the Statehouse meeting.

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