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MH/DS Redesign Round 2

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When legislators redesigned the Mental Health and Disability Services (MH/DS) system last year, they knew they left alot undone.  They set up a Transition Fund to help counties maintain services while the system is redesigned, but they didn't fund it.  They created a new equalization formula to get money to the counties that don't raise enough money locally, but they didn't fund it.  They required counties to regionalize, but they won't know what the regions will look like for two more months.

Over the last two weeks, several bills were introduced to start checking off that "to-do" list:

  • HF 98 fixes a problem that 45 counties were faced with after the Legislature adopted the new "Per Capita Equalization Formula" last session.  Beginning July 1, 2014, counties are allowed to spend $47.28 per person living in their county on non-Medicaid mental health and disability services.  Counties raising less than this amount from their local property taxes will receive state dollars to make up the difference.  Counties raising more than $47.28/person must lower their property taxes and won't get any state money.  Not all of the 45 counties in this position will need extra money, but some will.  This bill allows those counties to continue to collect more than $47.28/person if they need it (but they still won't receive state dollars).  Two Clinton County legislators sponsored this bill, Rep. Mary Wolfe (a Democrat) and Rep. Steve Olson (a Republican).  The bill is now in the House Ways & Means Committee.
  • HF 97 would require the newly formed MH/DS regions to pay for services delivered to children, as long as their diagnosis is covered under the regional management plan and a qualified professional associated with the child's school makes that diagnosis.  Because the state is currently required to pay for services to children, and the regions are required to pay for services to adults, this would be a new requirement that would require additional dollars over and above what the Legislature has discussed to date.   There are a few counties that provide outpatient, school-based services to children, but continuation of this is unknown under redesign as children are not a part of the "targeted population."   Rep. Pat Murphy, a Democrat from Dubuque, sponsored this bill.  It is currently in the House Human Resources Committee, assigned to a subcommittee of Rep. Linda Miller (Chair), Rep. Lisa Heddens, and Rep. Kevin Koester.
  • HF 117 distributes the full $20 million in transition funds as recommended by two MH/DS Redesign interim work groups (Transition Committee and Fiscal Viability Committee) and the MH/DS Commission. This funds all 32 counties that applied for transition funds, as well as others that are experiencing short-term funding problems.  The bill also requires counties to establish a payment plan to pay their Medicaid bills over a defined period of time (no deadline set).  This bill is an alternative to HF 160 below, and is sponsored by 30 House Democrats (lead sponsor is Rep. Lisa Heddens of Ames).  It is currently in the House Human Resources Committee, assigned to a subcommittee of Rep. Greg Forristall (Chair), Rep. Dave Heaton, and Rep. Mark Smith.
  • HF 160 distributes $11.6 million in transition funs to 26 counties, and requires all counties (whether receiving money from the transition fund or not) to pay their Medicaid bills by the end of next year.  Read more about this bill, which will be debated by the full House next week, in the next article.

  • HF 161 makes the new regional MH/DS system responsible for paying for non-Medicaid services to both adults and children.  There is no additional funding in this bill to help regions pay for these additional services.  Rep. Mark Smith of Marshalltown sponsored the bill, which s currently in the House Human Resources Committee and assigned to a subcommittee of Rep. Linda Miller (Chair)Rep. Lisa Heddens, and Rep. Kevin Koester.


If you see something that you like in these bills (or something you don't like) - contact your legislators.  If you want to do more, contact the members of the subcommittee and committee.  Click here to use our Grassroots Action Center to email your legislator.