Mental health concerns unite county staffs
Nov 14, 2012 (The Hawk Eye - McClatchy-Tribune Information Services via COMTEX) --
Representatives from seven southeast Iowa counties met Tuesday at the Henry County Courthouse to share ideas and flesh out the prospect of joining forces to provide mental health services.
Having agreed to explore forming a region, county supervisors and central point of coordination administrators from Des Moines, Lee, Louisa, Washington, Henry, Keokuk and Van Buren counties established ground rules to govern the regional process.
Among the initial rules is the precept that each county, regardless of size, will get one vote when making decisions for the region. Apart from committing to providing uniform services in a timely manner, the CPC administrators also agreed regional funding for mental health services should only be made available once all other funding avenues have been explored and exhausted.
"We will truly be the funder of last resort," said Keokuk County CPC administrator Jesse Hornback. "And we really mean it this time."
The CPC administrators also agreed whatever debt they have coming into the region will not be a shared responsibility. Des Moines County, for example, has $957,000 in state debt to pay back.
"We're going into unfamiliar territory," said Sarah Kaufman, Henry County's CPC administrator. "We've never done business like this."
The mental health redesign law passed this year will reorganize county CPC administrators into regions by 2014 and already has reassigned payment of the non-federal share of Medicaid to the state. In doing so, the law has severed funding to the state's 99 counties.
Kaufman questioned an underlying premise of the redesign, that it will bring a standard level of mental health services to each county. The law calls for each county to provide a package of core services at a given level. But some counties, such as Des Moines County, already provide more than the core services at a higher level, something Kaufman and the other CPC administrators may find troubling as they standardize.
"People aren't equitable," she said. "People don't have the exact same needs. So making everything equal, I think is going to be tough to capture."
Ryanne Wood, the CPC administrator for Lee County, agreed: "If they want everyone to have equal access to services, why not have a University of Iowa in every county "
Lee County is deadlocked over how to serve mentally ill people serving time in jail.
Des Moines County is beginning to experience Lee County's dilemma when it comes to handling mentally ill inmates who would be better served at a psychiatric treatment facility.
Hornback predicts such consequences will get worse as state legislators continues to grapple with a law he sees as being beyond their grasp. He said the unseating of Rep. Renee Schulte, R-Des Moines, in the state legislature as of the Nov. 6 election may lead to chaos in regard to the redesign, since Schulte played a pivotal role in the law's architecture.
"I think you're going to have a body up there with no head running around," Hornback said.
"If there truly is a body up there with no head, wouldn't you be able to influence them " said Michael Berg, Keokuk County supervisor. "They're searching right now. They don't know what they're doing."
Kaufman wasn't so sure the Legislature has been too concerned with the feedback the CPC administrators have provided thus far, but has high hopes they will start to pay attention as the deadline for regionalization gets closer.
"I'm hoping that the legislature is starting to see how their legislation is truly going to impact the system," Kaufman said.
The CPCs administrators at the meeting are looking to form a region by July 1.
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