Iowa House, Senate make breakthrough on mental health reform funding

DES MOINES - Iowa lawmakers have made a breakthrough on funding the redesign of Iowa's patchwork mental health delivery system.

News of the agreement led to some speculation the legislation, which may be taken up today in the House, could set the tone for a timely conclusion of the legislative session that is scheduled to end April 17.

“It does set a tone,” said floor manager Sen. Jack Hatch, D-Des Moines, about the bipartisan nature of the agreement on one of the Legislature's session priorities. “I think it shows that we can accomplish some pretty nice things - and in a civil way.”

She may not share his optimism, but Hatch's counterpart, Rep. Renee Schulte, R-Cedar Rapids, said she would like to think compromise might be catching.

“If this could be the first bill of a lot of compromises, that would be a good thing,” she said, but stopped short of predicting it will make it easier to find agreement on a host of budget issues likely to be negotiated in House-Senate conference committee.

“This was a good faith effort to move forward in a bipartisan way” to avoid sending the bill to a conference committee, Schulte said.

The heart of the agreement is to maintain the county levies that generate about $125 million annually for mental-health services. Every county would levy $47.28 per person in property taxes for mental health services. Some counties levy less than that, so lawmakers working on the bill agreed to put in $18 million of state funds to bring those levies up to $47.28. Counties levying more could maintain their current levy or lower their property tax asking.

“This is more than we expected,” Hatch said, adding that Democrats believed counties should maintain a role in funding mental health services. Republicans, he said, came to the realization on their own that the county property tax funds would help maintain the stability and security of the mental health delivery system that will be administered regionally and delivered locally.

Under the agreement, the state will buyout the non-federal Medicaid services, Schulte said. Now, the state pays about 60 percent of that cost.

The proposed redesign calls for creating 10 to 17 regions serving targeted populations between 200,000 to 700,000 people. The regions would be made up of contiguous counties that use a single “checking account” where federal, state and county funds would be deposited and spent. The goal is to bring consistency and equity to a service-delivery system that's now carved up 99 different ways.