Johnson County officials skeptical of mental health regionalization plans


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Johnson County officials were apprehensive on Thursday about the state’s plans to regionalize Iowa mental-health services into multi-county hubs that will provide core care.

The Johnson County Board of Supervisors voted 3-1 on Thursday in favor of the Resolution of Intent to Regionalize Mental-Health and Disability Services.

This resolution stated the intent for Johnson County to team up with eight other counties — Benton, Bremer, Buchanan, Delaware, Dubuque, Iowa, Jones, and Linn — to serve as a hub for mental-health and disability services.

“I’m happy that Johnson County is moving ahead,” said Sen. Joe Bolkcom, D-Iowa City. “It has partnered up with some other great counties to work with.”

But Johnson County Supervisor Janelle Rettig is not so sure.

Rettig, the only supervisor to vote against the resolution, said she doubts whether regionalization will benefit Johnson County, which has excellent mental-health services.

“I am very concerned that being in a region with eight counties will not be beneficial to the residents of Johnson County,” Rettig said.

Rettig said Johnson County currently taxes the highest possible amount, $3.1 million, to meet its mental-health and disability services needs, and she does not want to lose control over that system.

“I don’t want to give up authority over Johnson County property-tax dollars to a region so that the region can decide how that $3.1 million is spent,” she said.

Though Johnson County Supervisor Rod Sullivan, appointed delegate throughout the regionalization planning process, voted for the resolution, he said he has similar concerns.

“I just don’t see how the changes we are implementing improve services for anyone,” he said. “My fear is that they will establish a ceiling and not a floor.”

Further, Rettig said, the new mental-health system would only require regions to provide “core services”; Johnson County provides services beyond the state’s requirements.

“I don’t want to see them go away,” she said about non-core services.

Kristen Artley, the director of Johnson County Mental Health and Disability Services, said these non-core services include caring for people with developmental disabilities.

“Unfortunately, only persons with mental-health or intellectual disabilities are required to be served,” Artley said about the state’s required core services. “Currently, Johnson County also funds services for persons with a diagnosis of developmental disabilities. Unless the state appropriates sufficient additional funding, some or all services for these folks may have to cease. We are attempting to educate our legislators about this in the hope that this issue will be corrected.”

The intent of regionalization goes much deeper than Johnson County — it is an effort to redesign the state of Iowa’s entire mental-health format and to ensure that people in all areas of the state receive proper care.

“The goal of regionalization for Iowa is to make sure that people have access to quality service everywhere,” Bolkcom said.

Sen. Tim Kapucian, R-Keystone, which is in Benton County, said he hopes regionalization will “streamline some services,” making them available at lower prices.

Professor James Potash, the head of psychiatry at the University of Iowa Hospitals and Clinics, said it would be easier to accommodate people across the state with 12 regional “hubs” rather than with the current 99 county-based mental-health systems.

“We are hoping that within each region, there will be a comprehensive set of services for patients so that each person suffering with a mental illness has access to the help they need,” Potash said.

Bolkcom said regionalization would help rural areas that lack mental-health resources by “building on an existing network of disability providers” and making them available to people in rural Iowa.

The next steps, Bolkcom said, would be to smooth out funding details and provide adequate resources to regions.

“Where this is all going to shake out in the end, I’m not sure,” Kapucian said. “I’m just hopeful that it’s a positive change, but I have some concerns.”

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