Eastern Iowa has a strong network of social service providers, but nonprofit and government leaders say a key piece is missing. Emerging plans in Linn County would go a long way toward filling that gap.
The county government is leading an effort to open one of the state’s first mental health access centers in Cedar Rapids. It’s part of a national movement to offer low-barrier services to people experiencing mental health or substance abuse crises.
Access centers are an alternative to incarceration and hospitalization for individuals who might pose a threat to themselves, other people or property. Jail cells and hospital beds are not only expensive, they often are not the best environment for de-escalating a crisis situation. Unfortunately, police officers and other service providers don’t have many options.
The proposed access center in Linn County would offer a wide range of support programs — suicide assessment, crisis stabilization, psychiatric evaluations, medication management, peer support services, a sobering unit and medical detoxification.
Some services would be new to Linn County, while others are currently offered, but not in a central location. Importantly, the center would be available 24 hours a day, 7 days a week, and law enforcement officers would be trained to identify situations where the access center would be most beneficial.
By their nature, access centers are cross-jurisdictional endeavors. Planners must secure buy-in from local governing entities and nonprofit organizations.
To that end, Linn County officials have assembled a core group of service providers, including the Area Substance Abuse Council, Abbe Mental Health Center, Penn Center and Foundation 2. They also are engaging nearby counties that would use the center, as well as the East Central Region Mental Health and Disability Services board.
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The center is expected to open in late 2019 or early 2020. While the plan holds great promise, the public still does not have a clear view of what the center’s operating budget will look like.
The county has approved $3.5 million in surplus mental health funds as one-time support to renovate the Linn County Public Health building, which is being replaced by a new facility in another location.
Organizers expect service fees from private insurance, Medicaid and Medicare will cover a substantial portion of expenses, but additional taxpayer support may be necessary.
The county’s $3.5 million in upstart funding is a significant investment. Before that’s spent, it is imperative for planners to offer a detailed estimate of the access center’s expected finances.
Earlier this year, construction began on a similar access center in Johnson County. Once it is operational, the Board of Supervisors will cover up to $400,000 annually for unreimbursed services. They’re also asking city governments in the county to make annual commitments.
Linn County should chart a similar path by committing to a specific annual figure before the center comes on line.
Advocates hope and expect the access center will lead to cost savings to local government. Studies in other communities have shown frequent users of local services can generate hundreds of thousands of dollars in unreimbursed expenses for health care providers, law enforcement and the judicial system. The access center will provide a more effective and efficient way to treat those individuals.
Nevertheless, there is a financial risk involved with such a large undertaking. Taxpayers deserve a clear idea of what level of commitment they can expect.
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Other funding for the Linn County center could come from the state government. Last year, the Legislature passed a mental health package that included six access centers across Iowa. However, the state has not yet provided specific details about funding or given direction about what will be required of state-sanctioned access centers.
Linn County planners say they will be prepared to meet the state’s criteria, but they aren’t willing to wait for bureaucrats to give the go-ahead.
“We’ll be set up to meet their definitions, but knowing how legislation works, we’re not going to wait and wait until they decide what an access center is,” Linn County Supervisor Ben Rogers, who is leading the planning effort, told The Gazette earlier this year.
Another possible source of financial support is the mental health region. However, since Johnson County and Dubuque County, which is also planning an access center, are part of the same nine-county region as Linn, regional dollars will be in high demand.
It is vital for Linn County officials to continue fostering relationships with peers and partners beyond the county borders. They should flex their diplomatic muscles to ensure the county gets its fair share of state and regional money.
And it is equally important for access center planners to continue seeking input from constituents within Linn County. Even as the project is far along in its planning stages, we suspect the majority of local residents have never heard of it. This service model will be a new idea to most locals, and neighbors understandably will have questions about safety, efficacy and cost.
Despite a few lingering concerns, we are overwhelmingly supportive of the plan to provide easier access to critical mental health services in Linn County. It’s a good plan that only stands to be improved by broader community discussions.
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