Iowa House approves changes to mental health reform bill

Under the statewide service delivery plan, access to services won't depend on where someone lives

April 3, 2014 | 5:13 pm

DES MOINES — Iowans should have access to mental health services regardless of where they live as a result of legislation lawmakers say will be approved before they adjourn.

The legislation, which was approved 66-32 by the Iowa House on Tuesday, puts into place a state funding mechanism for locally-delivered services. The current county-based mental health system would be replaced under the bill, which likely will be tweaked by the Senate, where it was approved earlier 32-18.

The House action “continues the direction of the Senate bill ... it improves the bill,” said Sen. Jack Hatch, D-Des Moines. There are “small changes” he said he would like to make, but Hatch said he hopes to avoid sending the bill to conference committee.

“There’s nothing that should prevent us from getting this done,” he said.

“The alternative is not good,” said floor manager Rep. Renee Schulte, R-Cedar Rapids. Although “this bill’s not perfect,” she warned colleagues the current county-based mental health system is an “unsustainable system with an unsustainable future.”

Under the statewide service delivery plan, access to mental health services will be more equitable and not depend on where someone lives, said Rep. Nick Wagner, R-Marion.

“We have the situation in Iowa today that because of where I live I may not get even get the medication I need,” Wagner said. “Another Iowan in another part of the state is getting a free cellphone. That is not right. That’s not a system any of us want in place.”

Still there was opposition, which Schulte attributed to the politics of place. Some representatives believe the counties they represent are not treated fairly by the bill. Rep. Mary Wolfe, D-Clinton, said taxpayers in her district would be paying taxes to “backfill” mental health budgets in “some of the biggest, most well-off counties” including Polk, Linn and Scott.

Rep. Lisa Heddens, D-Ames, said she couldn’t vote for the bill without being assured her home county wouldn’t lose as much as $2 million in funding and reduce services to as many 200 people.

“It pains me today that I’m going to be a ‘no’ on the bill,” Heddens said, “but until I have those figures to know what that impact will be ... I unfortunately have to be a ‘no’ today.”

The bill calls for counties to maintain their property tax levies, which generate about $125 million annually for mental-health services. Every county would levy the equivalent of $47.28 per person in property taxes for mental health services. Some counties levy less than that, so the bill calls for the state to spend $18 million to “buy out” those counties. Counties levying more than $47.28 could maintain their current levy or lower their property tax asking.

Wagner emphasized the unsustainability of the current funding. Counties, he said, “don’t use same accounting ... they don’t use the same data. Some counties are overstating revenue. Some counties are understating costs so they can balance their budgets.”

“It points to a need to reform this system,” Wagner said.

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