• Wed. Jun 7th, 2023

Millions for mental well being care at threat if surplus is not spent


May 26, 2023

HIAWATHA — County supervisors on the board that governs regional mental well being and disability solutions advocated Thursday for spending down significantly of its practically $9.two million surplus prior to the finish of the price range year subsequent month by boosting assistance for initiatives inside its nine-county location to prevent the state withholding future funds.

As the finish of fiscal 2023 looms on June 30, the East Central Mental Wellness Area governing board directed regional employees to draft a strategy for how to invest portion of the surplus — at least about $four.two million that goes beyond the state-mandated fund balance — to superior spend mental well being care providers, who are seeing higher levels of demand for underfunded solutions.

The Iowa Division of Wellness and Human Solutions allocates state home tax dollars to regions, but if regions carry also significantly of a surplus the agency withholds additional dollars. That primarily suggests providers inside the area drop out on funding that would otherwise go toward enhancing solutions and addressing unmet nearby demands.

State lawmakers need the regions to hold fund balances of 20 %, but that will drop to five % subsequent fiscal year.

Regional Chief Executive Officer Mae Hingtgen asked the board for path at the board’s meeting Thursday at the Kirkwood Regional Center on how to invest the fund balance, or no matter whether to let it stay as is. The area covers solutions in nine counties: Benton, Bremer, Buchanan, Delaware, Dubuque, Iowa, Johnson, Jones and Linn.

“These dollars are appropriated for the taxpayers of the area to have spent on people today in the area who have these demands,” stated Johnson County Supervisor Rod Sullivan, who represents the county on the board. “I hear from people today definitely in my personal county there’s a lot of unmet will need, so I feel we really should do what we can to get the cash out the door.”

Dubuque County Supervisor Ann McDonough stated it produced her heart ache that the board had so significantly obtainable to invest when there are millions of dollars necessary on the ground that could be spent in partnership with providers.

In current months, supervisors pressed for extra funding for the Linn and Johnson County mental well being access centers, anticipating the area would finish up holding a multimillion-dollar surplus. The board passed a fiscal 2024 price range in March that allocated $two.9 million to the facilities — up from the initially proposed $two.five million.

County officials have stated regional funding and low Medicaid reimbursement prices do not cover the price of solutions, and for Linn County the resource gap is a barrier to the access center’s expansion to be open about the clock.

It is these sorts of solutions — and other people such as youth or homeless shelters — that supervisors are hunting to superior fund with the obtainable surplus.

McDonough stated the area is getting also conservative in the awards it tends to make, and there’s not a adhere to-up method to reconsider escalating allocations. She and Linn County Supervisor Ben Rogers took situation with CEO Hingtgen’s lack of suggestions for spending down the surplus, which McDonough stated felt like a scramble to now allocate with only about 5 weeks to go.

Rogers stated this area could make a decision to be a model and opt to supplement the gap providers face from low Medicaid reimbursement prices.

“We have so significantly in fund balance that is not getting spent down, and now by legislative decree, we have to surrender it,” Rogers stated. “And we have surrendered it for final year. Now it is May possibly 25, and we’re going to come back at the finish of June, asking for proposals (from providers).”

Saddled with a surplus every single year that is in excess of the state-mandated fund balance, the supervisors urged superior monetary organizing to guarantee the board is not faced with the similar situation in future years of obtaining one particular month to figure out how to invest millions.

“There has to be a option to this that is sustainable. We can not run into this brick wall year right after year,” McDonough stated. “ … We have so significantly cash left at the finish of the year when we know our communities, it is dry earth nevertheless, that there is not adequate solutions.”

McDonough recommended forming a subcommittee of the board focused on finances.

Deborah Seymour-Guard, finance coordinator for the area, stated there are a quantity of challenges involved with price range estimates. She stated at times providers are not billing for solutions in a timely style, so it is not possible to accurately track how significantly is spent. In addition, regional employees stated at times solutions may possibly not come to fruition till a later date than anticipated, throwing off providers’ estimates.

She recommended possibly boosting funding allocated to the Linn and Johnson County mental well being access centers, which she estimated could invest down at least $two million. Access hubs in Dubuque and Benton counties, which are not state-designated facilities and present a smaller sized scope of solutions, could potentially get a enhance as properly.

Supervisors indicated assistance for reviewing prior proposals that had been not completely funded, specifically escalating allocations to the access centers and hubs.

If the area opted not to additional invest down its surplus, McDonough stated that would fuel lawmakers’ arguments in the future to lessen the quantity of funding for regions — hindering the board’s capacity to assistance suggestions such as jail diversion and access centers.

Lobbyist Gary Grant stated one particular of the region’s legislative priorities for the 2023 legislative session — to enhance the expected fund balance from five to ten % — didn’t acquire traction amongst lawmakers since some of the 14 regions have also significantly of a surplus.

“Now, I do feel the legislature understands the utility of getting ten % rather than five %,” Grant stated. “However, as lengthy as there are regions out there that way exceed that, I feel it is going to fall on deaf ears.”

Comments: (319) 398-8494 marissa.payne@thegazette.com

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