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Branstad: 'The buck stops with me'

Governor says he can make decisions on mental health, Medicaid without legislative input

Iowa Governor Terry Branstad addresses employees at Timberline Manufacturing in Marion in this 2013 photo. (Liz Martin/T
Iowa Governor Terry Branstad addresses employees at Timberline Manufacturing in Marion in this 2013 photo. (Liz Martin/The Gazette)

DES MOINES — Gov. Terry Branstad on Monday signaled he plans to proceed with the closings of mental health institutes in Clarinda and Mount Pleasant, where employee layoffs are beginning this week, and to consider bids from private health care providers to transform Iowa’s state-run Medicaid system into a managed care network.

“I am the chief executive. I was elected by the people of Iowa to reduce the size and cost of state government, and to make it more efficient and to modernize it and provide better services to the people of Iowa,” Branstad told his weekly news conference.

“We’ve been moving in that direction from the day that I took office. Those are tough decisions. Not everybody is going to like them.”

Branstad’s decision to stop admitting patients to the mental health institutes targeted for closing has drawn criticism from community leaders, legislators, mental health advocates and others who are pushing to keep the institutions open beyond June 30 and until alternative services are in place.

Branstad said Monday discussions have been underway for four decades concerning the state-run mental health institutes. and the need to close them, in favor of better, alternative services that have been the focus of a redesign of mental health services via a regional delivery system that began three years ago.

“I understand there’s always going to be resistance whenever you look at making a major change like this. But this is long overdue,” the governor said.

In previous cases, Branstad’s actions to close Iowa Workforce Development offices and the Iowa Juvenile Home in Toledo were successfully challenged by legislators and other interested parties, but they were unable to stop the process or undo the effect.

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Meanwhile, a measure died in last week’s self-imposed legislative funnel that would have established a new Senate commission to oversee the transformation of Iowa’s $4.2 billion Medicaid into a managed care system that would enlist private health care vendors to coordinate care and manage program spending.

Later on Monday, Sen. Rich Taylor, D-Mount Pleasant, took to the Senate floor to lament the loss of 35 state employees who would be losing their jobs at the mental health institutes in his hometown.

He also expressed concern that residents of the facility would be “out on the streets” and put in jail “where they don’t belong,” due to a hasty move in closing the state-run facilities.

Taylor urged his colleagues and Iowans to tell the governor to “just to hold off for a while.” Taylor said state policy makers needed to “step back” and make sure plans going forward will serve the state’s most-vulnerable population.

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