Mental Health Redesign Moves Forward

Legislators working on redesigning Iowa’s mental health delivery system moved closer to completion this week as the House readied to debate the main redesign bill. The House was expected to debate Senate File 2315, which would include the creation of mental health service regions to provide local management of the system, establishment of a core set of services that would be offered in all parts of the state, and improving the data collection in the system.

The House will consider a bipartisan amendment to the bill implementing a number of changes. Primary among the changes is language that would allow a county to continue operating independently if they are able to meet the requirements of a region. The amendment allows a county to get an exemption from the region requirement. Another change from the Senate’s language is a reduction in the number of advisory members on a local board. Instead of requiring three consumers and providers to sit on a board, the amendment reduces to one each.

The House amendment addresses funding for the system beyond FY 2013, with a redesign of the current mental health levy. The state sets a per capita rate that is provided for mental health funding. The amendment calls for a per capita funding level of $47.28. For counties whose levy is currently above the $47.28, they would have their levy reduced. The amendment provides just over $10 million in property tax relief in FY 2014. Counties whose levy is below that amount would have the difference provided by the state. No one’s actual property tax levy would go up, as the state would be responsible for difference.
The amendment also revises the language regarding sub-acute care facilities. The development of these facilities provides a mid-level of service that could significantly help provide an appropriate level of service to those with mental illness, while also establishing a lower-cost service that helps control costs.

The House also took final action on the bill addressing mental health issues in the Judicial Branch. Senate File 2312 is the product of the DHS/Judicial Branch work group tasked with addressing a number of issues related to the interaction of law enforcement, the Judicial Branch, and the mental health system. The group put together a series of recommendations ranging from on-going mental health and disability services training for law enforcement officers, the ability of residential care facilities to determine whether or not to accept people referred to them by the court, clearing up conflicts within the Code on which mental health professionals may be involved in the commitment process, allowing pre-assessment screenings to be used prior to a commitment.

Governor Branstad has already signed Senate File 2247, which removed the term “mental retardation” from the Code and replaces it with “intellectual disabilities.” As the legislative session nears its end, improving mental health services will be one of the major accomplishments of the 2012 session.