County dealing with new mental health laws

BY CHUCK VANDENBERG

PCC EDITOR

FORT MADISON - A Lee County official overseeing regional mental health services said a new state law takes strides to help those needing assistance, but it's still shrouded with funding uncertainty.

Ryanne Wood serves as Lee County's Mental Health and Disability Services Central Point of Coordination Administrator, and CEO of Southeast Iowa Link, an 8-county regional mental health services group. She addressed the Lee County Board of Supervisors at Tuesday's regular meeting.

Wood said under the new law, the state is mandating the creation of six new core areas of service including sub-acute centers, six regional access centers, assertive community treatment (ACT) teams, intensive treatment programs, a state 24-hour crisis line, and a cross-occurring system across all five cores.

She said the sub-acute centers would look like a nursing facility, but serving people in mental health crises. The six access centers would be for people suffering mental health crises, but not needing hospitalization. Wood said the closest access center initially is being planned for Marion in Linn County.

"The sub-acute is very much like a nursing-facility type organization with a medical director, RNs, social work coordinators on staff, and that's a very high-end cost service to provide to folks," Wood said. "Access centers are very much an amalgamation of different services embedded within them. The rule-making process is just getting started and the Department of Human Services and the commission of Mental Health and Disability Services are creating subcommittees as they relate to all six of the new services identified in the legislation. So the rules aren't even made yet."

She also told the board that officials are anticipating further reductions in Department of Human Services funding, including reduced funds to the state's two remaining Mental Health Institutes.

The new law also specifies that state public schools provide suicide prevention training.

But Wood said the state has not offered a way to pay for the additional service requirements, other than using up fund balances that some counties are carrying in their MHDS allocated funds.

Lee County, who along with Des Moines, Keokuk, Van Buren, Henry, Louisa, Jefferson and Washington counties, make up the Southeast Iowa Link regional group, has about $1 million to spend down prior to July 1, 2021 as part of a law passed last year. She said the current legislation provides for no funds from state or federal sources to establish or maintain current programs, nor the new service requirements.

"Nothing was done with funding mechanisms for our system on-going," she said. As you all know, we're under pressure to spend down the fund balances and deal with levy asking issues."

She said SEIL has equalized their tax asking at a maximum of $46.20/per capita determined by annual census re-assessments, but some of the counties have very little fund balance left, while others like Lee County have a surplus.

In Wood's department there was no property tax levy as she worked to reduce the fund balance and just used those funds for operations. However, supervisors are cautious that the landscape could change and the entire cost of the MHDS services could fall on the county, which would inevitably require a boost in property tax asks in the future.

Supervisor Ron Fedler clarified that nothing in the new laws will result in the reopening of mental health facilities across the state that were closed under past legislation.

Wood said from her perspective all the new services identified will be reviewed on a statewide basis so applications of each service will be standardized across the state.