A stronger safety net, for less

How can we better serve Linn County residents with mental health issues and developmental disabilities, and how can we do it for less?

That was the $1 million question Linn County supervisors asked Mental Health and Developmental Disabilities director Mechelle Dhondt last fall.

Dhondt set out to find the answer, enlisting the help of everyone she could think of - boots-on-the-ground folks who knew the people the system hopes to serve.

She asked them: What are you doing? How is it working? What might make it better? Then, she listened.

The conversations that followed were “unbelievable,” Dhondt told me last week.

A lot of the issues raised were familiar in broad contours, but the dialogue brought out details, and possible solutions, that no one had really considered.

Take Iowa's shortage of psychiatrists - something we've known about for years. It can take weeks for a person with mental illness to get in to see someone, even if only to have a prescription filled. Turns out a huge part of the problem is patients missing appointments in the first place.

During community meetings in recent months, one provider said they might book 20 appointments for a day but only have six patients show.

“All that time was just wasted time,” Mechelle told a packed house at the Grant Wood AEA office on Friday.

About 100 people were there to review the draft redesign concept that's come from the fact finding - an elegant proposal to stitch together the MHDD safety net while improving efficiencies.

“The nice thing, you'll notice, is there's really nothing there that costs much money except printing,” Dhondt said while reviewing a proposal for transition services. That's true for most of the ideas outlined on a handful of densely written PowerPoint slides.

Developing a joint assessment and referral process, diverting non-emergency cases to free up hospital beds, enlisting the support of peers to help keep clients stable - over the next few months, small committees will further refine these ideas and create action plans to implement them.

It will likely take some money to fill a few gaps, but overwhelmingly, the plan stands to measurably improve services while significantly slashing costs. That will be critical as details of the new regional MHDD delivery system start to jell.

“Resources are going to become more and more limited,” Dhondt warned the group Friday. Another issue that's no big surprise, in broad contours.

But taking a closer look, that might not be such a problem, after all.

Comments: (319) 339-3154; jennifer.hemmingsen@sourcemedia.net