Legislative Column From Sen. Pat Ward: Working to Move Iowa Forward

After months of meetings on the redesign of the Mental Health and Developmental Disability Act, we finally have a bill.

What problems would you like to see corrected in Iowa's system of mental health-care delivery?

Thursday morning the bill was distributed to legislators and the public at the Capitol. The bill pulls together the recommendations from seven workgroups and more than 100 people consisting of state legislators, county supervisors, providers, consumers, and family members.

We spent months identifying what we believed would be the best system, regardless of cost. The governor and the Department of Human Services are determining the costs of the proposed changes to the mental health services.

A highlight of the bill is the move from a county-managed system to a regional one. Currently, each county can set up different set of services creating huge inequities across the state. The bill proposes to create between 10 and 15 regions with a population of between 200,000 and 700,000 people.

Counties would be initially allowed to partner with other contiguous counties to form regions. This would allow counties that currently are partnering to continue. The bill gives discretion to the Department of Human Services director to approve regions that may not fit the strict definition. This is particularly helpful in low populated regions of the state where it would take a huge number of counties to reach the minimum population threshold.

The key management structure would have the state set the standards, the regions would administer the services and the services would be provided locally.

Workgroup members stressed that there must be little change at the local level to avoid making it more difficult for consumers to get help. It has been proven that the more difficult it is to get services the more likely it is that they will quit trying to get help. Many believe the regional management structure will help achieve economies of scale, reducing duplication of administration and inefficiencies to better use scarce resources.

The other major component of the bill is the funding structure.

Although the appropriation will be in separate legislation, the governor released his proposal for the redesign. It calls for the state to pick up almost the entire non-federal share of Medicaid costs. The counties would then retain the dollars they currently receive from the mental health property tax levy to be used for non-Medicaid expenditures.

Non-Medicaid services are generally used for housing, vocational training, transportation, as well as for persons with a mental illness. The bill also encourages moving individuals from institutional settings to congregate settings in their home communities. This is consistent with the Supreme Court’s Olmsted ruling.

The mental health redesign proposal continues to be a top priority in the legislature. As your senator, I can assure you I will continue to work on this important issue and promote what’s best for Iowa and my constituents.

Our first community forum will be hosted by the Windsor Heights Chamber of Commerce on Saturday, Jan. 28, from 9 – 10:30 a.m. at the 3-E Company at 953 73^rd St., Windsor Heights.  Everyone is welcome!  I am your voice at the State Capitol and look forward to your input.  You can also reach me by calling the Capitol at (515) 281-3371 or emailing me at pat.ward@legis.iowa.gov  Your thoughts and concerns remain very important to me – it is truly an honor to serve you in the Iowa Senate.