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Governor Vetoes Key Parts of MH/DS Redesign

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The legislative session isn’t really over until the Governor either signs or vetoes the bills sent to him.  In Iowa, the Governor has 30 days from the time session ends to make these decisions.  The Governor finished his work with a couple of days to spare, approving a budget that increases spending by 3% but making several vetoes that may significantly impact services to Iowans with disabilities.  

While the Governor held a bill signing ceremony to celebrate the historic compromise that will give more than 150,000 Iowans access to free or low cost health insurance, he quietly used his veto authority on the same bill to cut out funds intended to protect services to Iowans with disabilities as the redesign enters its second transitional year. 

The Governor vetoed:

  • $8.7 million that would have taken thousands of Iowans off Medicaid waiver waiting lists.  Right now, some counties provide services to people while they wait for a Medicaid slot to become available, so these additional dollars could have helped free up some county/regional funds.

  • $13 million that would have gone into a Risk Pool to help the 45 counties that will be forced to collect fewer dollars locally for MH/DS services, and who have no other source of state dollars to balance that out.  Some of these counties may have to cut services or stop paying providers in order to live on this reduced budget.

  • Language that would have made sure regions kept their current funding levels for the State Payment Program even if the federal funds are reduced, helping them smoothly make the switch from legal settlement to residency.  Border counties and “magnet counties” where people go to get services may feel these cuts more than others – and they may be forced to make cuts in order to live within their local funding levels.

  • $250,000 that would have moved the mental health advocates (who help people going through the involuntary commitment process) to the state and created uniform standards to ensure consistency and accountability.  Counties will continue to pay for these advocates, who vary widely in experience, education, and workload.  

To compound the issue, the Governor signed language that requires counties to pay back any savings they get in their MH/DS systems because people are now eligible for the newly created Iowa Health and Wellness Plan.   

So while the Governor signed $29.8 million in funding for non-Medicaid regionally delivered services to people with disabilities, he cut over $22 million in funds that would have stabilized services to Iowans with disabilities, and some of that $29.8 million will need to be repaid to the state next year.  

In addition, three counties (Polk, Clinton, Scott) that have about $2 million in unspent risk pool funds must return those funds to the state, and counties that have outstanding Medicaid bills are required to use their remaining local dollars to repay those funds by June 30, 2014.   Any one of these vetoes could have resulted in some setbacks in the redesign of the mental health and disability services system, but the combination of these cuts could threaten the stability of the entire MH/DS system.

You can read the Govenror's veto message on the waiver waiting list here, and on the risk pool here.

Concerned? Wondering what you can do?  Unfortunately, these changes are now law and your legislators can’t fix things until the session starts up again in January.  But they can start working on a solution now.  Talk to your legislators.  They are back home now, in their districts, back at their “regular” jobs.  Call them and ask them what they can do to fix this situation (and ask what you can do).  Click here to find out who represents you at the Iowa Capitol, and how you can reach them this summer.