Legislators, supervisors focus on mental health reform
Sen. David Johnson (R-Ocheyedan) appeared before the Clay County Board of Supervisors Wednesday to share some limited information on the planned changes to the state's mental health care system, and to receive input from the county officials on the issue which will impact the way care is provided across the state.
Johnson, who is serving on a committee dealing with workforce-related issues associated with the changes, as well as a larger study committee, admitted specifics are hard to come by at this time.
"It's still a work in progress, but I can guarantee that it's going to happen," Johnson said.
The plan involves pooling funds regionally with counties clustered to offer services under the guidance of a governing board.
Johnson shared his initial disappointment at a reduced amount of transitional funding the state had suggested. The Senator noted an initial "gentleman's agreement" had the figure in the area of $20 million, but the dollars have been reduced dramatically and will fund only three counties.
"It's going to be about $1.5 million with a million going to Scott County alone. Only three counties will receive the transitional funding," Johnson said.
Clay was among 32 counties in the state which had sought assistance with transitional dollars.
It was suggested the Iowa Department of Human Services is making a lot of the calls with the program.
"We have bodies out there making decisions that are not elected officials," Supervisor Linda Swanson said. "We have DHS making decisions. Do you have any control over the entities?"
Ken Chalstrom, a supervisor, noted a conversation he had with former state senator Jack Kibbie. "Sen. Kibbie said, 'We make the laws, somebody else makes the rules and it very seldom turns out like we would like it.'"
Chalstrom continued, "Is it right to use Clay County tax money to help another county out?"
Clay and Dickinson counties are the largest in a seven-county shared region under the proposed health care redesign.
"The intent of the law is good. We have to determine if we're going to work with the intent of the law or the letter of the law," Clay County Supervisors Chairman Del Brockshus said.
He continued, "The entire law is based on generalizations. Certain areas of the state don't have access to core services, so we're changing core services for the entire state.
Kim Wilson, charged with overseeing the mental health care concerns of the county, noted Clay County has only been forced to place someone on a waiting list on two occasions since she's been in her position.
"The first time we have a Clay County resident on a waiting list for services, wherever we have to scrape money up, legally or illegally - I'm not afraid to go to court on this ... - to provide core services, that's what I'll do," Brockshus said.
"The bureaucracy is horrendous on this thing," Chalstrom said. "Lots of areas are very gray."
"Each region could have its own set of rules," Supervisor Joe Skow said. "I just see a myriad of issues with this whole thing. This could go on for a very long time."
"If the idea of this whole design is to fix things and make it better, aren't we moving backwards?" Chalstrom asked. "We're going to have less funding and be able to offer less services."
Brockshus challenged the basis of authority for the governing board.
"Are counties in the region going to obey the governing board? Can the governing board legally control what a county can do? Are the member counties required by law to follow the governing board?" he asked.
Other supervisors questioned the ability of the governing board to enforce anything if a rogue county opts out of the agreement.
County Attorney Mike Houchins suggested enforcement would be determined legally as breach of contract.
Supervisor Burlin Matthews wondered if the recent rash of gun-related crimes on the national landscape could have an impact.
"This has nothing to do with that. ... If that comes up, I'm going to put a stop to it. As unfortunate as all these incidents have been, that isn't the issue here," Johnson said.
The Senator was joined by Representative-elect Megan Hess (R-Spencer) who took notes and asked the supervisors to please contact them with questions or concerns as the process continues.
Johnson and Hess were both scheduled to meet with the Palo Alto County Board of Supervisors Thursday.