By Steve Woodhouse
Oskaloosa — Representatives from the county governments of Jasper, Mahaska, Marion and Poweshiek met Thursday afternoon in Oskaloosa to discuss the group's regional mental health district.
Last year, the Iowa Legislature passed Senate File 2513, which forced individual counties to join with at least two other contiguous counties to form mental health districts. This is part of mental health reform in Iowa, intended to pool resources in the hopes of providing better service to those in need. If counties failed to join or form a district, the State will dictate a region for that county.
The four counties mentioned voluntarily joined each other last year. In the months since, communication has existed between each county's Central Point Coordinator (CPC) and the Iowa Department of Human Services.
Elected officials in attendance were briefed regarding what has been discussed thus far, and what their next moves should be. The CPC's had prepared proposed structures for a governing board for the district, which is expected to include one member of each county's Board of Supervisors to represent his or her county.
Jasper County has already appointed its representative, Supervisor Joe Brock. The other three counties have not designated their representatives, though these boards intend to have the appointments on their next meeting agendas.
Though each county will have an appointed representative, the new region will require a 28E agreement that must be ratified by all four counties. Input into this agreement, and its approval in each county, will be done so by entire Boards of Supervisors.
Studies are being done to measure what requirements for employment will be necessary for the board to function. Julie Jetter, Community Systems Consultant, MHDS Division of the DHS, was asked what role CPC's will play with the new region. She said she believed the role of the CPC in each county will evolve, and will ultimately depend upon the structure of the district's management. According to Jetter, when everything is prepared for the district, there will be plenty of work to do.
The four counties are expected to pool their resources for the new mental health district. This includes money raised through county property tax levies. Though nothing is finalized, the CPC's indicated that funding levels established for each county will be based on an equal per capita amount. This money would be collected and pooled to fund mental health services in all four counties. Details of this will be worked out in the final 28E agreement.
Jetter was asked if paying staff for the new regional mental health district model would take money away from providing mental health service to residents in need. Her response was that she "didn't think so" and that administering the new process could be done so with the current level of funding specified for this.
The fiscal aspect of the mental health district is still in limbo. No one, not even DHS, knows what kind of impact changes to Medicaid will have on mental health or County funding for such programs.
Scrutiny has increased for regional boards, such as the one that will govern this mental health district, has intensified in the years since the discovery that the paid, unelected director of the Central Iowa Employment Training Consortium (CIETC) misused hundreds of thousands of taxpayer dollars. The proposed structures provided to those in attendance today resembled the composition of the now-defunct CIETC board. When asked about it, Jetter said the legislation that created this new mental health system clearly defines the level of accountability necessary for mental health districts. She said transparency is a key part of the future of this system and all meetings with the board will be open to the public. CIETC's board meetings were also open.
Marion County Supervisor Mark Raymie agreed that transparency is vital to the success of this endeavor. He spoke on behalf of the Marion County Board, and believes the sentiment of the other boards of supervisors, when he said that protecting taxpayer money, including prudent stewardship, is their top priority.
Services provided by current county mental health systems also vary. For instance, Poweshiek County reportedly offers services beyond those available to residents in the other counties. Addressing this issue, and determining what services will be provided by the mental health district, will be done during the 28E process.
This region also meets state requirements for having a mental health center with qualified providers, a hospital with an inpatient psychiatric unit or state mental health institute nearby. Letters from these providers in each county will also be necessary for the formation of the district.
Supervisors said they found today's meeting productive, and they have an idea of what they should do next, in each of their counties, before another joint meeting is held.
"It's great to have a working relationship with our neighboring counties," Brock said. Jasper County residents may see a property tax reduction as a result of the district's formation.
Mahaska County Supervisor Mark Doland said he believed the CPC's had goals in mind for the meeting which helped the gathering's productivity. He believes more information will be needed and his board will keep up with changing mandates.
"I believe the meeting accomplished what it was supposed to accomplish," Doland said.
The state's deadline for each region to become functioning is June 30, 2014. This district could choose to be operating, as a region, prior to then if it so desires.