Linn County joins growing statewide discussion on access centers

CEDAR RAPIDS — Linn County Supervisors have earmarked $3.5 million in levy funds for a crisis intervention facility — also known as an access center — to house mental health and substance abuse intervention services and ease burdens on local law enforcement and hospitals.

But while Linn joins neighboring Johnson County in local attempts to create their own respective community access centers, two bills in the Iowa Statehouse also aim to fill Iowa’s gap in mental health services. Those bills would mandate the creation and funding of a half-dozen regional access centers across the state.

The relationship between those county and regional centers, and any impacts they’d have on each other, remains murky at best.

In Linn County’s case, Supervisor Ben Rogers, who proposed the center, said the county is required to pay down their Mental Health and Disability Services fund balance to 20 percent by 2020. That, coupled with a need for mental health and substance abuse services, made for a “perfect storm” to get the project in motion.

“An access center would help to right-size some of the underfunding that we have had in our community as it relates to mental health and substance abuse services,” Rogers said during a Wednesday meeting.

“This gives us a rare and unique opportunity to use our levy rate to fund this service ... . This will not be an increase to taxpayers.”

The Linn County Board of Supervisors on Wednesday voted unanimously include the $3.5 million levy into the county’s fiscal year 2019 budget. The proposed budget would represent a $4.5 million cost savings compared to last year’s $8 million levy, Rogers added.


Rogers said the $3.5 million will fund the build-out of an existing space to house mental health and substance-abuse services provided by local organizations. The levy also covers the first year of operations and some administrative costs.

See here: What’s an access center?

Once the center is up and running, partners will operate a fee-for-service structure, with Medicaid covering many services for those eligible.

While a location has not been selected, county documents indicate the center could be in or around the Cedar Rapids MedQuarter Regional Medical District.

Supervisor Brent Oleson said one of his biggest concerns is ensuring the facility doesn’t become a massive drain on future county budgets.

“Usually you only want to use one-time money for one-time expenses. So if this is a one-time expense, and the county is not going to be bearing the cost of sustaining something, we need to see that,” he said.

Rogers said a project manager would take point developing project plans and finances.

“We will absolutely do the work to prove it’s feasible, prove it’s sustainable and also leverage other partners, hospitals, municipalities, organizations in this,” he said.


To the south, Johnson County officials have spent the past three years fleshing out plans for a center to provide services comparable to those proposed here in Linn County, such as sobering and crisis stabilization units as well as a low-barrier homeless shelter and telemedicine, among other features.


While earlier plans entailed the construction of a new facility, Supervisor Mike Carberry said renovating an existing space will be the most cost efficient. Earlier project estimates have come in between $5 million and $10 million.

The center is projected to cost the county about $400,000 a year to operate.

The Johnson County Board of Supervisors have already earmarked $1 million for an access center. The board informally has discussed allocating up to another $1 million to the effort in the Fiscal Year 2019 budget.

City councils in Iowa City, Coralville and North Liberty have expressed interest in participating in the effort, Carberry added.

“Everybody is wrapping up their budgets now, we’re hoping to get a place purchased in this fiscal year and start renovations this calendar year,” Carberry said, adding that services could be implemented in phases at the center.


As Linn and Johnson counties move toward local access centers, two bills in the Iowa Legislature — House File 2327 and Senate File 2252 — could force the creation of six regional centers across the state to be funded by Iowa’s 14 Mental Health and Disability Services Regions.

Those centers would have 16 or fewer beds that provide immediate, short-term assessments for people with serious mental illness or substance-abuse disorders and who do not need significant amounts of support, according to the bills.

The proposed bills follow a December Iowa Department of Human Services report that recommends the creation of six regional access centers by the end of 2019. The state’s 14 Mental Health and Disability Services regions should provide startup funds for the establishment of the centers, the report states.

“We really view this report as a road map, and I think the legislation they’re putting forward is to help us implement this,” said Matt Highland, Iowa Department of Human Services spokesman.


Highland said Iowa’s regions will determine where those centers are located, but the hope is they will be spread across the state.

“Certainly that is the goal, to make sure people have access within a reasonable distance,” Highland said.

But some local officials are skeptical of the state’s regional model.

If the distance to the nearest regional access center is too great, law enforcement officials could find it easier to keep taking people to hospitals or the local jail, Rogers said.

“They have to feel that it’s convenient, that it’s easier for them to drop someone off at an access center or else they’ll continue to take them to jail,” he said.

Carberry said, for Johnson County, the state plan is too little, too late.

“In my opinion, you’re proposal is not ready for prime time. This is an actual need that should have happened a long time ago and we’re moving forward on it because the state hasn’t,” he said.

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