The Crawford County Board of Supervisors on Tuesday discussed the future of juvenile mental health funding and a letter written by District 18 State Representative Steve Holt that was published in the May 9 Denison Review.
Holt was responding to the story, “Legislature hands juvenile mental health to counties” in the April 30 Denison Bulletin.
Supervisor Dave Muhlbauer disputed the idea that the Iowa Association of Counties (ISAC) fully supports legislation for creating juvenile mental health services within the already-existing mental health service regions that are funded by counties.
ISAC is for youth mental health because the organization recognizes the need for the services, he said.
“They wrote a letter saying, ‘Yes, we were in favor of it,’” Muhlbauer said. “They were very disappointed it did not come along with funding of $700 million it needed to have.”
Muhlbauer said Rolling Hills Community Services Region does not have a 122 percent carryover of funds, as Holt suggested.
“No. I think there might be one region in the state that does have it that high,” Supervisor Cecil Blum said.
Blum noted that nearly two years ago the state directed the mental health regions to spend down their balances to 20 or 25 percent by July 1, 2019.
“So we started spending down, which was reflected in our budget a year ago,” Blum said. “We didn’t take much of a levy for mental health.”
Blum noted that the new legislation allows regions to carry a 40 percent fund balance, which Holt had also noted.
“Well, most of the regions already spent below that,” Blum said. “We do not have a way, other than raising taxes, to rebuild that 40 percent.”
Blum said he believed that Holt was using an anomaly in one region that had excessive revenue – but that was not the case in the other regions.
“I think they are taking a victory lap on a poorly legislated policy,” Blum said.
He said that the legislation came without funding and the expectation is that counties will absorb it.
“What’s really frustrating about this – when the regions were started, we took over a state program that was in the dumps,” Blum said.
The state mental health program was poorly managed and run, he said.
“Through the hard work of the regions, and the people that work in the regions and govern the regions, we have made great strides in improving mental health,” Blum said.
The state has also done a bad job of managing juvenile mental health, he said.
“I think they are trying to credit themselves for fixing a problem that they actually created,” Blum said.
The new legislation is another unfunded mandate for counties, he said.
“We have about $12 per capita to raise in the levy,” Blum said. “We could go up about $200,000, but then that’s still an increase in taxes to our local people.”
Blum noted that the rules for juvenile health have not yet been written.
“It doesn’t take effect until July 1 of 2020,” he said. “That’s not to say some changes couldn’t happen next session before the implementation.”
“The state hasn’t really helped us turn around our own mental health regions,” Muhlbauer said.
Local control and improvements at the local level are what have improved mental health services, not anything the state has done, he said.
“I felt like he (Holt) spoke on our behalf a little bit by saying ISAC was for it and the supervisors kind of helped, therefore,” Muhlbauer said. “And yet he never came to us. He never came to the statewide supervisors meeting.”
“It’s just frustrating that he’s touting this is a huge win, when really, at a local level I don’t feel like it is,” Muhlbauer said.
Blum pointed out that Rolling Hills recently hired four new people – and two of them have juvenile mental health experience.
“I think we had an eye to the future in the people that we hired,” Blum said.
Blum said he believes Rolling Hills is a lean organization with four employees doing the work of six or seven in the past.
About $200,000 has recently been trimmed from the payroll - with some of that due to the consolidation of bill-paying when Woodbury County was added to the region, he said.
The supervisors discussed whether adult mental health services would be spread thin with the addition of new core services.
Blum said that is possible, but he did not see it as a worry.
“I’m sure at some point, after the rules are written so we know what we have to do, we may have to hire people specifically for juvenile mental health,” Blum said.
“There’s no doubt about it,” Chairman Kyle Schultz said. “And who is going to pay for that?”
“Well, the regions,” Blum said.
“At the beginning of the year Jerry Foxhoven (director of the Iowa Department of Human Services) stood in front of all the supervisors at our statewide meeting and said, ‘We realize the need for youth mental health services and it will be funded by the state, not put on the backs of your existing regions,’” Muhlbauer said.
The state did the reverse of what Foxhoven said would happen, he said.
“Now they are touting it as a win - at our cost,” Muhlbauer said.
“Oh, absolutely,” Blum said. “The fight that’s going on – maybe behind closed doors – they’re trying to figure out a way to shift some of the cost from property tax to another revenue stream. It probably won’t happen.”
Blum said there has been some discussion of a sales tax, an income tax surcharge or use of funds generated by the new legislation that allows sports betting in Iowa.
“But the problem is – even like the gambling money with sports betting – that money was spent before the bill was passed,” Blum said.