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Mental health system for kids clears Iowa House

Overwhelmingly sent to Senate despite funding concerns

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DES MOINES — Despite criticism it wasn’t robust enough, didn’t identify funding and fell short of meeting the need, legislation creating a children’s mental health system in the state won overwhelming support Thursday from the Iowa House.

“We are starting a foundation for children’s mental health for every child across the state to be able to access equal services,” Rep. Joel Fry, R-Osceola, told colleagues before they voted 83-14 to approve House File 690. The bill establishes a system just for children, lays out what core services must be provide, and creates a state board to oversee it.

A companion bill, Senate File 479, awaits final action in the Senate.

Fry acknowledged the House bill was just a start and did not address every concern. But he said lawmakers could “stand proud of the work we’ve done.”

Still, Rep. Beth Wessel-Kroeschell, D-Ames, was “disappointed in the lack of substance” because children with mental health issues and their families need more from the state.

An amendment by Rep. Mary Mascher, D-Iowa City, would have addressed many of those concerns — providing transportation for children to and from service providers, in-school services and home visits.

Schools are more likely to be staffed by police officers than mental health professionals, Wessel-Kroeschell noted. Too often, if there are problems, the students enter the juvenile justice system rather than a children’s mental health system, she said.

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Lawmakers have been working toward establishing a children’s mental health system for 30 years, Mascher said.

“I don’t want us to look back and say ‘Where did we fail?’” she said. But her amendment was rejected.

HF 690 would create a system to serve children up to age 18 who have serious emotional disturbances. It would not cover brain injury, intellectual disability or substance and developmental disorders unless they also occur along with a diagnosable mental, behavioral or emotional disorder.

The plan would cover services to children from families with incomes up to 500 percent of the federal poverty level. If family income is between 150 and 500 percent of the poverty level, there would be a copay, a sliding fee scale or other cost-sharing requirements as later approved by the state Department of Human Services.

Many of the questions about the bill dealt with funding. While Mascher saw the bill as a step in the right direction, “until we know where those dollars are coming from, we all should feel a little insecure.” She voted against HF 690.

It wasn’t the best bill lawmakers could have written, Rep. Lisa Heddens, D-Ames, said, but she supported it for families and children with mental health needs.

“I certainly would have liked one that was more comprehensive,” she said. One in five people have mental illness; half of the illnesses occur by the age of 17, but 79 percent of children go without mental health services, Heddens said.

“I think families want to take the risk because they are so desperately seeking something for their kids,” she said. “They need support and their kids need support.”

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HF 690 only scratches the surface of what needs to be done, said Rep. Timi Brown-Powers, D-Waterloo, the lead Democrat on the bill.

“We have a lot of work to do,” Brown-Powers said. “We have taken a small step forward (but) don’t go home to your forums and say we have passed this robust legislation because we aren’t today. We have a lot of work today, so everybody better keep their work boots on and get busy.”

Gov. Kim Reynolds agreed passage was a step in the right direction toward an integrated children’s mental health system.

“We’ve been talking about this for decades, but now is the time to act,” said Reynolds, who in January made children’s mental health a priority in her Condition of the State speech to the Legislature.

Regardless of the size of the step, Fry reminded House members that HF 690 is not the only thing lawmakers have done for children’s mental health. They’ve expanded the statewide crisis hotline, provided additional funding for increasing the number of mental health professionals in rural Iowa and eliminated the waiting list for children’s mental health home- and community-based services waivers.

In the end, 52 Republicans and 31 Democrats voted for HF 690, and 14 Democrats voted against.

l Comments: (319) 398-8375; james.lynch@thegazette.com

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