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MH/DS Redesign Update

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There is a lot going on with mental health and disability services (MH/DS) redesign - and not alot.  On the surface, it looks like there isn't much going on. But dig deeper and you will see that lots of meetings are happening, just not publicly. The Department of Human Services has met with key legislators to talk about the "savings" counties will see because so many Iowans are now signing up for health insurance, particularly the new Iowa Health and Wellness Plan.  Counties are meeting with the same legislators to explain why they think that the Department's guess on the amount of savings counties will see is wrong.  Those same legislators are meeting with their budget chairs, the Governor, and their leaders to talk strategy.

But no one really knows what to do.  It's a game of "he said - she said" - and it's anyone's guess as to who will be believed.  So to cut through all the back and forth going on at the Capitol, here are a few things you should know:

  • DHS says counties will save about $30 million, of which they will have to pay back 80% beginning next year.  That "savings" goes into a pot that the Legislature gets to decide how it will be spent.

  • While MH/DS Redesign passed two years ago, counties do not begin operating as regions until July 1, 2014.  So many regions are not yet fully operational.

  • Counties say they need at least one year of operating as a region to be able to tell Legislators how much it will cost to provide all core services, services to non-mandated populations (DD and BI), and provide core plus services. Until those numbers are available, they ask that the Legislature not take funds away.  They also are asking that any "savings" be reinvested in the system to make progress on full redesign.

  • The MH/DS "Clean-Up" bill (House File 2417) may be more controversial than first expected.  According to several legislators and the Iowa State Association of Counties, the changes made in that bill could seriously affect regional operations and the region's bottom line.  More on this in upcoming issues, but watch for updates on the website.

  • The Crisis Stabilization Bill (House File 2378) passed the Iowa House unanimously this week. It clears the way for new mental health crisis stabilization programs to be developed, giving the Department of Human Services the direction to write rules that would allow regions to move forward in responding to this need to provide a non-hospital level of care to help Iowans experiencing a mental health crisis stabilize safely.  Crisis Stabilization is a core plus service.

  • Funding for MH/DS Redesign was in the Governor's budget ($29.7 million).  It is unknown if the funding is in the joint budget targets issues this week, as that level of detail was not available.

If you are concerned about funding for MH/DS regions, do not worry about details. Talk to your legislator about the services you get from your region, the services you wish you'd get (that might be available if redesign is fully funded), and improvements you want to see in the system.  One thing is apparent - not all legislators understand the value of regional services. They see money going into a system, but don't see how that money is spent, and the value of it.  So let them know!

You can contact your legislator quickly by email here.  Or you can call your legislators during the week at: (515) 281-3221 (Representatives) or (515) 281-3371 (Senators).