The Iowa Department of Human Services has sent its preliminary recommendations for revamping the delivery of mental health services to a legislative committee that is working on the issue. D.H.S. director, Chuck Palmer, says a key recommendation would change the structure from one based on the 99 counties to a regional system.
Palmer says the number of regions hasn’t been determined, but they would contain from 200-thousand to 700-thousand people with the counties being able to “self select” into regions. A lot of attention has been paid to changes in the Worforce Development organization and the closing of offices. Palmer says the change to a regional structure is not the same thing.
Palmer says it’s not a matter of closing offices, there are some functions that are now done at the local level that would be done at the regional level. He says the region is seen as an administrative entity and the service delivery would still be done through contracts with local providers. Palmer says another change involves determining eligibility for services.
He says the recommendations would do away with what is know as “county of legal settlement” where you have to live in a county for certain amount of time to be eligible for county payment. It would change to where you live and not the length of time you lived there. The recommendations were developed through work groups and public hearings after the governor directed the department to revamp the current mental health delivery system by 2013.
Palmer says the thing they are looking for is “consistency and quality across the state” so the care you get is not based on where you live. Palmer says the legislative committee has had one meeting already and plans two more meetings to develop a plan for legislation to change the system.
The state spends around $1.3-billion on mental health services each year, with ten percent of the cost paid for by property taxes, and the remaining funds coming from federal and state sources.
You can see the report on the redesign plan here: www.dhs.state.ia.us/docs/Iowa_Redesign_Interim_Report_Final.pdf>