Stakeholders gain glimpse into mental health's future

By STEPH TAHTINEN

Mt. Pleasant News

By July 1, 2014, the state?s plan for mental health redesign will be fully implemented, and on Tuesday afternoon, Henry County Central Point of Coordination Administrator Sara Kaufman met with approximately 30 mental health stakeholders, including service providers, to provide a ?surface picture? of the changes that will happen over the next two years.

One of the biggest changes is that on July 1, 2012, the state takes responsibility for the non-federal share of Medicaid, about 40 percent of Medicaid costs, which was previously funded by the counties.

?This is a big change. It?s going to be a good change for a few counties, it?s going to be a neutral change for a lot of counties and it?s not going to help for another handful of counties,? said Kaufman.

Henry County falls into the first category, as the state buyout of Medicaid will amount to $1.4 million in savings for the county.

?That is a good thing for us. It?s going to keep us in a great cash flow situation,? said Kaufman.

The big push for the state buyout of Medicaid is that the state is receiving an extra two percent Medicaid match to transition clients from institutionalized care to community settings.

?If they would have continued to cost share that, they would have had to figure out a formula to give the counties a part of that two percent,? said Kaufman. ?It made more sense for the state to take over that whole funding responsibility, and then the two percent doesn?t have to be split out.?

The county will still be responsible for funding any non-Medicaid services, such as outpatient mental health center services, those who do not have a funding source when they go to the mental health institute, non-Medicaid eligible developmental delays and chronic mental illness and committals.

?We?ll still be busy. We?ll still have a lot of high dollar services that we?ll have to continue to allocate resources for,? said Kaufman.

Another change ? effective July 1, 2013 ? is a change in how the county levies taxes for mental health funding.

Previously property taxes were levied based on a valuation of property; in Henry County, a $1.21 per $1,000 valuation of property totaled about $846,000 in property taxes for mental health funding. However, now the funding will be levied on per-capita basis, multiplying the county?s population of 20,250 by $47.28, equaling $957,420.

This is an increase of over $100,000 in taxes that Henry County should be receiving. Rather than increasing property taxes for the county, the state will make up the difference.

?The legislature did not want to have the system cause the property tax payers to pay more property taxes, so what will happen is that Henry county will continue to levy that $846,000, and then the state then will give us money to make up the difference, to get us up to that $900,000 mark,? explained Kaufman.

On July 1, 2014 yet another change will go into effect when the regions become fully functional.

?Regions were actually mandated in code last year. What this (year?s) legislation was doing was putting some criteria into what a region is,? said Kaufman.

A region must have three or more contiguous counties and access to services like in-patient hospital services, said Kaufman. Counties can ask for a waiver to be their own, independent region if they have the ability to provide the required services, but Kaufman said from what she hears it does not sound like any will.

The counties will be responsible for setting up their own regions, and over the next two years the 99 boards of supervisors in the state will be making decisions on which counties they want in their region.

?Boards of supervisors are going to create those regions based on their supervisor-to-supervisor relationships,? said Kaufman. She noted that politics between the counties also plays a role.

The counties will be having state regional meetings in June, and Kaufman has advised the Henry County supervisors to begin conversations with other counties now, and they are looking at neighboring counties of a similar size to Henry County.

?I can tell you right now they?re looking at maybe a five county region they want to have a conversation with,? she said. ?They?re thinking that they may look at Van Buren, Jefferson, Washington then seeing about Lee, Des Moines and Louisa.?