WEST DES MOINES — Members of a state board charged with developing the framework for a new children’s mental health system expressed a sense of urgency Thursday to get a comprehensive plan in place and a desire to see it adequately funded to meet the needs of vulnerable young people.
“The time is right,” said Jerry Foxhoven, director of the state Department of Human Services, who co-chairs the Children’s System State Board that Gov. Kim Reynolds created by executive order to develop a strategic plan to be submitted to her and the General Assembly by Nov. 15. “It’s the right time to design it.”
Board members said they took hope from bipartisan work by lawmakers last spring to revamp Iowa’s adult mental-health system, but they were concerned over past efforts to deal with childhood mental-health issues in a comprehensive way that failed to bear fruit. They said they did not want to be part of another dead-end study.
“I don’t think this is a study committee,” said Rick Shults, a DHS division administrator who has worked on children’s mental-health issues. “This needs to be an action committee. We need action, and the time is now.”
In establishing the board, Reynolds acknowledged that the current delivery system is inadequate to address the mental-health needs of Iowa’s children, but board members Thursday were concerned a timeline to begin a new governance and service structure within 18 months that would be fully implemented in five years was not aggressive enough.
“I think that’s too long,” said John Parmeter, a board member from Des Moines whose daughter struggled with mental illness until she ended her life in 2016. “I think there are going to be lives lost and lives that are irreparably damaged. If we wait, we’re not going to be able to recoup some of those things that have happened to those kids, so there is going to be a lot of damage that is happening.
“I don’t want to prejudge the process,” Parmeter added, “but I guess the first question that comes to mind is ‘Do we really have to remake the governance wheel?’ We’ve got the adult system, and a lot of regions are starting to implement children’s treatment programs with them. There might be a way to adapt what we already have and have it up and running much sooner.”
Board co-chair Ryan Wise, director of the state Department of Education, said the goal is to accelerate but not duplicate past study efforts in developing a high-quality approach that is “action-oriented” in bringing structure and accountability to a network with statewide standards, regional or area governance, and local service delivery.
Earlier this year, Reynolds signed into law two significant pieces of legislation designed to bolster Iowa’s commitment to treating children and adults facing mental health challenges. House File 2456 dealt with comprehensive mental-health upgrades, and Senate File 2113 set up required training for Iowa’s educators to recognize and address the signs of a young person facing a mental-health crisis.
Along with that, the new state children’s board has been tasked with establishing a statewide mental-health system committed to improving children’s well-being. The board has been directed to find concrete solutions to the challenges that exist relating to children’s mental health in Iowa, to study and consider existing information and data from previous working groups’ materials and reports, and to collect and use new information and data to develop and implement a strategic plan for a children’s mental-health system.
Rep. Mary Mascher, D-Iowa City, one of four legislators at Thursday’s board meeting, expressed concern that the current adult mental-health system is not being adequately funded and worried the planned children’s network would face similar budget pressures given that GOP-enacted state tax cuts were projected to lower fiscal 2020 revenue projections by nearly $263 million.
“We need to make sure the dollars are there going forward, otherwise you’re doing a lot of feel-good things without really actually being able to implement it well,” Mascher said. “ ... What needs to come out of here is an action plan with a financial budget that actually can be implemented and is realistic.”
However, Sen. Jeff Edler, R-State Center, another legislator attending the meeting, said services in the adult system are being covered by matching federal Medicaid money or excess reserves of $145 million that regions can spend for core services to supplement state appropriations. He said the children’s system could build on existing funding streams but it’s too early in the process to know what additional funding needs might be.
“We need to have the mechanism or the template there for the system. Without knowing what that is, you really don’t know what the requirements are,” Edler said. “I think we need to make that structure first to understand what the funding requirements are.”
The board is slated to hold several more meetings before making final recommendations to the Legislature this fall.
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