Not too long ago, state government leaders received widespread accolades for a bipartisan overhaul of the adult mental health system, and state leaders are well aware that Iowans want and need a comprehensive system for children. Now comes the hard part.
Reforms of mental health services approved last year included critical access centers for people in crisis, a statewide crisis hotline, removal of residency caps and improved community-based care to spur more comprehensive treatment options for those with persistent illnesses. Some counties within the state’s 14 mental health regions, like Linn, are positioned to move forward on at least some of these goals. Others, however, continue to have difficulty providing basic services that state law already required.
Adding to the complications at the Statehouse is a more recent push for the development of a much needed children’s mental health framework — something the state never has had.
Gov. Kim Reynolds appointed a task force to research the issue last year, and that group has provided its recommendations. Not surprisingly, creating a system based on those or other suggestions will require additional taxpayer investment.
The current adult system is funded largely through local property taxes, capped by the Legislature. Some regions also are hindered by caps placed on the amount of funding that can be carried forward to the next year. County leaders, some of whom face mandates that exceed levy capacities, converged in Des Moines once again to plead for a solution.
A video featuring various county and regional officials, as well as parents to a young man who took his own life in 2017, ending a long-term battle with mental illness, recently was released by county leaders.
“It quickly became evident that he needed longer term help if he were to recover from his illness, and there simply wasn’t any,” says Mary Neubauer of Clive, mother of Sergei.
Marion County Sheriff Jason Sandholdt, also in the video, urged lawmakers last week to find long-term funding for mental health services. When parents phone him in the middle of the night to report a suicidal teen, Sandholdt says telling them to go to the emergency room where they “might have to sit there for a couple of days” awaiting an open bed is “not good service.”
Majority Republicans in the Legislature have balked at a system that would allow county governments to increase property tax levies. In fact, a proposal under consideration in the Iowa House would allow voters to petition for a referendum on property tax increases above 2 percent.
Removal of property taxes as the primary funding for mental health services, however, would require taxpayer investment from another funding stream, such as sales tax revenue.
One possibility being debated at the Capitol is for lawmakers to raise the sales tax by a penny, which would enact the three-eighths of a cent tax for natural resources and recreation approved by voters a decade ago. The remaining five-eighths then could be used for other state priorities, such as mental health services.
Others wonder whether backfill funding, used to offset cuts in commercial and multifamily residential property tax enacted by the Legislature in 2013, could be earmarked for mental health services or otherwise eliminated and the money used to create a new state funding stream. Doing that, however, could prompt already cash-strapped county and municipal leaders to further increase property taxes to recoup at least a portion of the difference.
While researching needs and creating mental health frameworks isn’t necessarily an easy task, such recommendations are far more palatable to the public than generating the funding to provide them. Bills enacting such a framework, likewise, are easier political lifts than those that provide the investment needed to make them a reality — especially for lawmakers who appear to be stuck in a never-ending campaign cycle.
But, as county officials reminded us all this week, we can and must do better. The state’s current path on mental illness, which relies largely on expensive and overpopulated jail cells and emergency rooms, is unsustainable.
If we truly believe in a basic set of minimum services as our laws require, or that all Iowa children deserve comprehensive health care as the governor’s task force recommended, then we must be prepared to deliver consistent and sustainable funding.
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