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Transition Fund Passes House

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Over the summer, a group of legislators, county officials, advocates, providers, and others met to discuss issues related to the transition to the new regional system for funding and managing non-Medicaid mental health and disability services.  This group, called the Transition Committee, recommended the state spend $20 million to help counties make this transition and make sure no Iowan, adult or child, would lose services as the changes were made. 

The Department of Human Services recommended three funding options, ranging from $1.5 million to help three counties, $3.8 million to help eleven counties, and $11.6 million to help twenty-six counties.  Six counties that applied for funding were not included in these recommendations.  The Governor recommended $3.8 million, but lawmakers (both Republican and Democrat) didn't think that was enough to address the needs of counties. 

Last week, the House passed House File 160, which used $11.6 million in one-time federal dollars to help twenty-six counties struggling to get through the next six months without cuts to services.  The House debated the bill well into the night, with many lawmakers fighting to get the entire $20 million needed to help all counties in need. Those legislators were ultimately unsuccessful in getting those additional dollars, but were able to remove some language that could have forced counties to cut services immediately. 

The bill also fixes an issue for one region.  It allows regions to request a waiver to allow a county that is not contiguous (that is, doesn't share borders with other counties in the region) to join a region.  Right now a region that includes Story County wants to include Madison County because they have a long history of working together. The problem is Dallas County, which is in between them, has joined with another region.  This change would allow that region (and any others with such problems) to ask for a waiver from this requirement.  DHS still has the final say on the matter.

This week, a Senate subcommittee decided to move the bill forward.  Senators said they wanted to spend the entire $20 million but felt that helping 26 counties was better than helping none, since they would be unable to get agreement from the House and Governor for more money. 

The bill is still not without controversy.  The Iowa State Association of Counties has said they are worried that the source of the funding (one-time federal funds) cannot be used for Medicaid match or to replace other public funds.  Some of the counties owe money to the state for Medicaid services provided before July 1 of this year.  They will not be able to use these funds to pay those bills.  Counties used to receive money for services from the state, but didn't this year, so they worry that may be considered "replacing public funds."  So there is some concern counties will get this $11.6 million, but won't be able to use it.  Some legislators would like to see state tax dollars used for this fund, instead of federal funds.

The Senate Appropriations Committee plans to take the bill up early next week, and hopes the bill will be debated by the full Senate. If they don't make changes, it will be sent to the Governor, and if the Governor signs it into law, counties will get the checks two weeks later.  Click here to find out which counties receive money, and how much.