CEDAR RAPIDS — More funding, cutting the red tape and a better system for individuals under the age of 18 are needed to help improve Iowa’s mental health system, local officials told a gubernatorial hopeful Fred Hubbell Tuesday.
The Democratic Party candidate for governor continued his statewide tour to discuss the state of mental health care this week, with a stop in Cedar Rapids Tuesday morning at the Linn County Sheriff’s Office.
There, he heard from elected officials, representatives from the Linn County Sheriff’s Office, mental health care providers and lobbyists on the challenges they face providing mental health care to local residents.
“I think the big take-away is they’re all struggling to do their jobs,” said Hubbell, 66, a Des Moines businessman, in an interview with The Gazette following the roundtable.
Funding for these services is a major source of concern for those on the roundtable.
The state has shifted to a regional method of care delivery — Iowa has 14 separate regions — but a two-decades-old cap on property tax revenue has limited what services regions can afford to pay for.
This is further exacerbated, members of the roundtable said, when providers are not reimbursed properly for their services by the Medicaid managed-care organizations, the insurance companies that administer coverage.
“We can’t talk about sustainability of the entire system without adequate funding,” said Gary Grant, lobbyist for Mental Health/Disability Services of the East Central Region, which includes Linn County.
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Hubbell agreed the funding piece of the puzzle needed to be addressed. One of the first steps he said he would take if elected governor would be to move the Medicaid system back under state control. The program was privatized in 2016.
“It’s not working now where the managed-care organizations are basically running their business for profit,” Hubbell said. “We should bring it back under state management and run it as an expense of the state.”
Linn County Sheriff Brian Gardner expressed concern over the resources his office uses for individuals who need mental health care.
Officials with the jail estimated at least half the inmates are receiving mental health treatment.
In addition, Gardner said his deputies have handled 82 psychiatric committals so far in 2018, and are on track to have more than 140 by the end of this year.
A deputy is required to sit with individuals who are being committed to a mental health facility for treatment until a bed can be made available. This can last anywhere from three hours to several days, Gardner said,
“We are not prepared to do this, we are not trained for this, we are not equipped for this, and yet this has dropped firmly in our laps and we have to deal with this,” Gardner said.
Linn County Supervisor Ben Rogers said the county is attempting to alleviate this issue with the creation of an “access” center, as are officials in Johnson County.
And the Corridor is ahead of the statewide curve. Gov. Kim Reynolds signed a law earlier this year creating six such regional centers meant to fill a statewide need for short-term crisis care services.
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The law requires these centers have 16 or fewer beds for immediate, short-term assessments for those with serious mental illness or substance-abuse disorders and who do not need significant support.
However, no state funding has been allocated and no guidelines have been set in place for these centers.
“The unfunded mandates for health care don’t work,” Hubbell said. “All you’re doing is frustrating the system, you’re frustrating the patients and you’re not helping the providers. That’s got to be addressed.”
Linn County has earmarked $3.5 million in levy funds for its access center once it’s built. Further south, Johnson County supervisors approved the $1.35 million purchase of a little more than five acres of land in Iowa City for the facility, called the Behavioral Health Urgent Care Center.
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