Residents in eastern Iowa, including Scott and Muscatine counties, could see a decrease in mental health services for the first time in a decade if the Iowa Legislature does not correct the system's funding situation, the leader of a five-county service region warned.
Lori Elam, CEO of Eastern Iowa Mental Health/Disability Services Region, offered the same bleak prediction Tuesday to the Scott County Board of Supervisors as she did a week ago to her governing board. "We'll probably be developing a plan of reductions," she said in her quarterly update to the supervisors. "The last time we did it was 2009."
Elam, who coordinates regional mental health services across Scott, Clinton, Muscatine, Cedar and Jackson counties, said the region will be forced to cut programs and/or expenditures if the legislature does not "fix the levy piece of this."
In the most recent session, Iowa legislators revised a 2017 law that had required regions spend down their mental health fund balance to 20 percent by July 1, 2020. The new House File 691 now allows regions to maintain a 40 percent fund balance and gives them three more years until 2023 to spend it down to that point.
"They didn't realize what the unintended consequences would be (of the earlier legislation)," she said in an interview Wednesday. "Regions were spending money for the sake of spending quickly and levying zero (in property taxes)." The result was regions then were forced to levy at the maximum the next year and "created a bouncing levy situation."
No changes were made this year to change the levy cap, which for Scott County holds the mental health tax levy at $30.78 per capita. It generates $9.2 million a year toward a $12 million budget.
"We can't continue living with this deficit budget," Elam said.
Programs are successful
Elam said new statistics show the reach and success of the region's mental health services.
As of the end of March, the region had a total of 2,183 face-to-face and tele-health evaluation and is on pace to reach 2,910 by fiscal year end. In addition 60% of those seen in a hospital have been reconnected to community services without hospitalization.
Amid the continuing budget woes, she told supervisors providers are launching new mandated services such as Assertive Community Treatment, or ACT, programs to assist those who don't respond well to traditional services, and Multi-Systemic Therapy for kids and families.
Other new programs include:
- A mobile crisis program, provided by Foundation Two. It will first be introduced in Scott County in June and then in Clinton, Muscatine and Jackson counties by July. Cedar County, she said, already has it because it does not have a hospital.
When a resident in crisis calls 911, they now can be served by a mobile crisis team. "Maybe all they need is to have someone just sit and talk to them or help them resolve the crisis, go to the ER, or connect them with Telehealth or a doctor."
- Beginning in July, Vera French will provide five crisis stabilization beds for individuals with mental illness. During their one- to five-day stay, they will receive other related services.
- The Carol Center, a new Peer Support & Drop-In Center for those with mental illness, opened earlier this month at 808 Harrison St., Davenport, in the former United Neighbors. In its first week of operations, Elam said the center assisted 100 people with a range of services including homeless outreach, peer support, psychiatric rehabilitation and medication management. It is named in honor of the late Carol Lujack, a long-time client of the center, who died in 2002.
In addition, she said the region now has to prepare for how it will serve children as required by legislation signed this spring.
"That system will mirror the adult system," Elam said, adding "There's no money tied to that."
Elam said she is excited to begin providing services to children and the steep learning curve ahead of a new system.
"I think we can do great things... but it's going to take money," she added.