Linn, Scott Counties Big Winners in Iowa Mental Health Transition Fund Plan

By James Lynch, Reporter

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By Ellen Kurt

DES MOINES, Iowa – Linn and Scott counties would pull down nearly 40 percent of the $11.6 million lawmakers have agreed to make available to 26 counties having trouble meeting their Medicaid obligations as Iowa moves to a regional mental-health service delivery system.

Linn would receive $2.2 million and Scott County would get $2.4 million in transition funds this fiscal year to meet mental health obligations. Lawmakers agreed to the $11.6 million pot to help counties earlier this week.

Lawmaker, counties and the Department of Human Services have agreed to the transition funds, according to Rep. Dave Heaton, R-Mount Pleasant, and Sen. Jack Hatch, D-Des Moines, co-leaders of the House-Senate human services budget subcommittee. They expect the allocation will be approved – possibly next week.

However, Gov. Terry Branstad said Feb. 6 that he’s not sure the plan passes muster. There are questions about the funding source that have to be answered before he will sign off.

“We have to check to make sure that the funding source is legal,” he said. It’s not clear to him that federal funds can be used for the transition.

“We don’t want to get in a situation where we do something inappropriate and then we have to pay it back,” Branstad said. “We want to work with the Legislature to resolve this, but I don’t think it’s worked out yet.”

Hatch doesn’t have the same level of concern. The only restriction on the federal funds – a bonus for having such a high enrollment rate in the state’s children’s health insurance program – is that “you can’t use federal money to match federal money.”
“But there’s always a way to do it,” Hatch said.

In this case, rather than having counties reimburse the state this year for county expenses the state covered, the state can give the counties two years to make good.

“If we don’t require them to pay it back this year and give them two years to pay it back and they don’t use (bonus) money, they we can use it to do the transition fund,” he said.

Branstad advocated giving counties just $3.8 million, far short of the $20 million the Legislature’s Mental Health and Disability Services Redesign Fiscal Viability Study Committee had recommended in January to cover Medicaid and mental health costs through June 30.
County officials told lawmakers last month that at least a third of Iowa’s 99 counties need millions of transition dollars through June 30 to make the switch to a regional delivery system for equalized mental-health services or they would be forced to reduce their help for recipients or create waiting lists to receive services.

Lawmakers have made incremental progress in the past two years to move from a county-based mental-health system to one where services are administered regionally and delivered locally.
The concept has the support of both parties, but there are differences over funding issues.

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