CLINTON — Case Management Director Patti Robinson met with the Clinton County Board of Supervisors on Tuesday to discuss the future of  case management in the county. 

The case management department in Clinton County provides services for those who are chronically mentally ill and developmentally disabled.

Robinson explained that when the program first started, the federal, state and county governments were each responsible for a third of the cost. Later on, the county was pulled out and it was up to the federal and state governments. Now, the state wants all Medicaid services to be moved into managed care. This has caused Robinson to wonder about the future of the case management department. 

 “Right now the concern that’s going out is that these Managed Care Organizations (MCOs), several of them have sent letters out to the providers, including case management, asking them to sign a letter of intent that you would sign on with them as a potential provider,” Robinson said. “And it’s a little uncomforting, I’ve got a couple of them here, to think that they want us to sign on now when they haven’t even been awarded the contracts yet.”   

One possible solution would be for the county to be contracted individually through the Iowa State Association of Counties. She explained that the MCOs will not subcontract individually with counties so an organization, such as ISAC, would have to serve as the umbrella over case management. 

“They’ve (MCOs) already said that’s too much. We’re not going to do that. It’s going to have to be almost an umbrella of entity who would then subcontract with someone to do the case management,” Robinson said. “We may not exist and then we would have to go somewhere else and provide the services under another entity or what we’re talking about next week is would ISAC become the umbrella and then we would subcontract under ISAC as a county.” 

Supervisor Shawn Hamerlinck told Robinson that he liked the idea of ISAC being an umbrella for case management. However, he questioned whether ISAC was designed to be in that capacity. Robinson told him it would be a subdivision of ISAC that would be in charge of overseeing the case management department. He also asked whether ISAC could perform this duty and Robinson said it could if it gets more people involved. 

“I think that’s the blunt talk we’re going to have to have on Monday is what are your weaknesses and what do you need to be able to do this,” Robinson said. “I think she’s going to be willing enough to say this is my weakness. This is what we need to bring in so that we can make this work because again it’s their jobs too. Because if we go away, they’re done too.” 

Herald Staff Writer John Rohlf can be reached at


This Week's Circulars