Coming together on mental health care

By The Gazette Editorial Board

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It seems like the news is filled with almost hourly evidence that our two parties can't work together to get anything significant accomplished, let alone tackling big issues.

But then we see something like the Iowa Legislature's bipartisan effort to remake the state's piecemeal, county-by-county mental health delivery system - and we realize gridlock can be broken.

Lawmakers are still working out myriad details, and budgetary questions remain to be answered.

But our divided Legislature is on the verge of approving a far-reaching strategy that would provide more equitable funding, foster regional cooperation, give local agencies more flexibility to meet local needs and provide much-needed oversight and accountability measures. And it will likely have broad support among Republicans and Democrats.

“Pretty miraculous,” in the words of Linn County Supervisor Ben Rogers, a Democrat, who sat next to state Rep. Renee Schulte, R-Cedar Rapids, a key architect of the effort, during a Friday interview with The Gazette Editorial Board.

We agree.

But this miracle is the product of years of deliberation over how best to fix a flawed, archaic system that delivered care of uneven quality to thousands of the state's most vulnerable citizens. For too long, mental health took a back seat to other state priorities.

“These are people who don't have a voice and can't speak for themselves,” Schulte said.

Legislation now poised for approval in the House and Senate would set the stage in 2014 for the regional delivery of mental health and developmental disability services among counties that choose to pool resources and share administrative functions. And those resources would be more equitably distributed, thanks to a new per capita-based, property tax funding system that spends $47.28 per person, increasing funding by

$18 million statewide.

But instead of raising property taxes, the state would cover that increase, so local property tax levies for mental health will remain steady. In addition, the state would take over counties' share of funding for Medicaid-eligible programs, potentially relieving counties of an estimated $44 million burden and freeing up local dollars for other needed services.

Counties are not mandated to join regions, but the prospect of shared resources, shared risks and greater efficiencies and potential cost savings are significant enticements.

Some counties already cooperate with neighbors to provide services, arrangements that should pave the way for regional delivery systems. All delivery systems will be required to meet outcomes-based accountability measures.

Of course, the redesign, like any major reform effort, is a work in progress and will be for years. But it's proof bipartisanship lives.

And it makes us wonder: What problem can we tackle next?

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