Iowa Senate expected to take up mental health care bill

The second of two legislative plans that change the way the state runs mental health care is expected to pass out of a House committee today.

The first plan made it out of a Senate committee Wednesday and is set to be heard on the floor of the Democratically-controlled Senate.

Meanwhile, Gov. Terry Branstad gave his support to the effort Monday when he said he wanted to see the state take a greater role in the administration of the state's mental health services.

The governor and lawmakers who have been involved in the process say the legislation is the beginning of a reform process that could take at least two, and as many as five, years to complete.

Neither the House nor the Senate plan have specific dollar figures attached to them yet, a fact that one member of the state's Human Resources Council, which met Wednesday morning to question if the state was going to be able to get something done this year.

“I think when you have the Democratic Senate, the Republican House and the governor all come out for something, it would be hard to believe that something won't happen,” Department of Human Services director Chuck Palmer said in response. “They're all agreed on the problems, now they're just working on what the best solutions are.”

There are only a few major differences between the House and the Senate proposals at the moment, mostly because the details for each plan haven't been worked out.

Sen. Jack Hatch, D-Des Moines, who has led the Senate reform effort, described the situation as “we're on different chapters of the same book.”

Rep. Renee Schulte, R-Cedar Rapids, point person on the House legislation agreed with Hatch's analogy. “The House is flexible,” she said. “We're coming at the problem in a couple of different ways.”

One difference is the Senate plan calls for the state to be divided into eight regions - where they would be would be up to the counties - in which counties would combine together to share costs and resources. Schulte said the House considered regions, but discounted the idea after some discussion. Still, she said, that could be negotiated.

The other main difference comes to paying for the first year of the plan. The House plan calls for substituting state money for the county mental health property tax levy over a period of time. This, Schulte said, would give property owners tax relief and while keeping funding for mental health.

“We think that's a mistake,” Hatch said. “We think counties, that's one of the safety net provisions of the county it's one of the responsibilities of the county, we want to lessen the load for the counties … On the other side we can't afford a mental health system without county participation.”

The Senate proposal keeps the county property tax levy but also has the state keep Medicaid payments that it currently distributes to the counties to help pay for the eventual state-run program.

Linda Hinton, government relations manager for the Iowa State Association of Counties, said neither the House nor the Senate versions are ideal, but noted they are works in progress.

“The things that we have proposed don't seem to be what they're doing,” Hinton said.

The counties association had suggested that the state take over some parts of the system such as the commitment process and taking over the state institutional costs.

“We have done it the way the state has told us to do it with the resources they have given us,” Hinton said. “I think counties in general feel a lot of responsibility and ownership for their citizens and have managed these (mental health) services for many, many years, decades, so there is a lot for counties to come to grips with on how that will be done differently.