'There is a lot of work left to do.'
About 80 people from seven counties attended a meeting to discuss the improvements as well as many of the drawbacks of the state’s mental health redesign.
Cutbacks in funding forcing the discontinuation of services were among the major concerns expressed when members of the Iowa Developmental Disabilities Council (IDCC) discussed the details of the coming changes. Another topic discussed was the parts of the legislation, which was approved last year, that haven’t been worked out yet, including how the changes will be funded.
“There is a lot of work left to do,” said Rik Shannon, public policy manager for the IDCC. “The Legislature that will do the work looks a lot different from the Legislature that began the work.”
Senate file 2315 changed the funding of Iowa’s mental health and disability services system, shifting greater responsibility to the state and away from the 99-county system. The state will be divided into regions governed by a board made up of county supervisors to provide mental health services. It also set up a new group of “core services” that must be available to all Iowans. Des Moines, Henry, Keokuk, Lee, Louisa, Van Buren and Washington counties are tentatively a region and sponsored the meeting. Shannon said it is the 19th such meeting he has given since the bill was approved. Jefferson County has asked for a waiver from joining a region.
So far, the only change that has been made is the state has taken over Medicaid payments for the counties. One of the drawbacks, Shannon said, is that some Medicaid payments are for services rendered six months earlier. He said that some medical providers have given services and are not being paid because the money is going to the state. He said the Legislature had approved a transition fund to take care of issues like this, but it was not funded in the last budget.
“They created the plan but they did not put money into the plan,” Shannon said.
Shannon said that because there are so many issues still to be addressed, this is a good time for people with concerns to contact representatives about making changes to the legislation.
In Washington County, a legislative briefing with state legislators will be held from 10 a.m. to noon Saturday in the Washington County Courthouse.
Shannon and assistant Amy Campbell explained that the new legislation had set a core group of services that must be provided to all Iowans. Campbell went on to say that whether services will be increased or will decline depends on where in Iowa a patient lives.
Campbell explained that the core services are requirements for the region to provide. After they are met, the region can elect to provide “core plus” services. Right now the core services don’t include people with developmental disabilities.
Shannon said that as it stands, access to mental health care depends on what disability exists, where the patient lives, what the income is and what kind of funding the state gives mental health.
“All of the changes are contingent on funding,” Campbell said.
She said the regions have to be in place by April 1. Counties wishing to file a waiver not to be a member of a region need to file the waiver by May 1. On July 12, counties not part of a region will be assigned to one, core service requirements will begin, and property tax will change. By July 1, 2014, everything is expected to be functioning.
A representative of Des Moines County said that cuts in funding have affected them so greatly they have had to limit patient visits from two to one per month. A representative from Lee County also said that spending cuts would make it possible for them only to maintain core services under the new system.