Letters to the Editor

No funding included for children's behavioral health system

To the Iowa Department of Human Services:

Monumental legislative changes have occurred in the past two sessions relevant to Mental Health and Disability Services Regions. With the passage of House File 2456 and HF 690, the Core Services of regions have been expanded to meet the needs of adults with complex needs and for children with Serious Emotional Disturbance. The policy passage was well intended to meet the needs of those identified disability groups that have previously struggled to access the level and intensity of service their diagnosis require and deserve.

The SEIL region acknowledges the need to address person-centered care services and rapid access to non-eligibility based crisis services. It is, however, disappointing that subsequent appropriation/financial legislation was not passed to sufficiently ensure that these expanded intensive mental health services and the children’s behavioral health system services (with respect to the Region’s administrative and financial responsibility) was not addressed.

House File 691 was passed to allow for 40 percent carry forward. This is appreciated, yet clearly pertains to cash flow issues associated with crossing fiscal years, not tax levy/revenue matters to sufficiently fund the newly required core set of services. By definition, when policy bills are passed without appropriation or financing being addressed, this registers in the category of an unfunded mandate as per Iowa Code Chapter 25B.

The SEIL region respectfully acknowledges that the new expanded adult core services go into effect July 1, 2021, and the Children’s Behavioral Health system diagnostic category/service expansion will go into effect on July 1, 2020. Therefore, there is opportunity to remediate the anticipated scenario of unfunded mandates should the legislature be so inclined.

Though, the SEIL region is presently financially soluble and our region has not transitioned into maximum levy capacity, (in due part to the previous legislative directive to retain less than 20 percent carry forward) there is anticipation that our region will be financially flat lined with no capacity for service expansion or growth in existing provider network services by Fiscal Year 2022. This is, of course, in the event that there is not any legislative modifications or appropriations to the MHDS system to remedy financial concerns.

Recognizing your limitations in effecting the financial structure of MHDS regions, you are the Director of the Department of Human Services which is the state department recognized as the authority to MHDS Regions. SEIL dutifully requests your recognition of the above stated matters and assistance to influence change that will facilitate sufficient service network development and financial sustainability for regions along with all other vested partners in this important work.

We have before us opportunity to collaborate and reform systems across all state and local government categories with more knowledge and resources then were ever available previously. We implore you to be a visionary with us that effects change across the entirety of tax paid services with acknowledgement of desirable outcomes to recipients of governmentally funded endeavors and the taxpayers of Iowa.

In closing, we thank you for the opportunity to share our concerns and desire to be good stewards to all Iowa citizens. The SEIL Region would be happy to provide any additional information and/or discuss the matter further if you see fit and useful.

By Southeast Iowa Link Governing Board (of which Jefferson County Supervisor Dee Sandquist is a member)