County officials will cut $1 million from the county budget next year to help pay for the mental health redesign.

Mental health providers and county officials discussed the ramifications of the new plan to regionalize the county’s mental health program with staff from the Iowa Department of Human Services at a Board of Supervisors meeting on Monday.

“There are enough revenues to pay for local services and administration, but not enough to pay the state for Medicaid,” Community Systems Consultant from the Iowa Department of Human Services Julie Jetter said. “There is a negative fund balance.”

The current tax levy rate is based on a system implemented in 1996. With this system in place, the county will have to cut $1 million out of future expenditures.

Officials also were encouraged to apply for transitional funding to support the mental health program for this year, but will still need to make the big cut for the next fiscal year.

“You just have to hang on until the legislature goes into session,” DHS Community Systems Consultant Robyn Wilson said.

To combat the monetary hardship this puts on the county, emphasis will be put on getting those who are eligible for Medicaid into the program, so county funds will not be used to pay for them.

The Clinton County Case Management Department has already made cuts, but will have to make more with the redesign.

With the levy decreasing, the $1 million shortfall will hit next July.

The levy covers $2.5 million, but the cost for non-medicaid patients in the county is $3.5 million, according to Jetter. While regionalization is just being introduced now, it is something that has been in the works for 17 years in an effort to make everything more uniform across the state,  Wilson said.

“We’re just pushing that bus a little farther down the road,” Wilson said.

Several health providers were concerned about the difficulty with helping individuals qualify for Medicaid. Jetter and Wilson mentioned that SOAR, a government program, could help speed up the process. SOAR is a national project funded by the Substance Abuse and Mental Health Services Administration that is designed to increase access to Supplemental/Social Security Disability Insurance for eligible adults who are homeless or at risk of homelessness and have a mental illness and/or a co-occurring substance use disorder. This also provides Medicaid and/or Medicare health insurance to individuals who are eligible.

“With SOAR, they can get into disability a lot faster,” Jetter said. “The process that can take up to two years is shortened to as little as 90 days with this program.”

Supervisor Jill Davisson was thoroughly disappointed in the proposed budget cut.

“With all these things, we lose sight of what we are trying to do,” Davisson said. “We are supposed to take care of those who can’t take care of themselves. They shouldn’t have a dollar sign next to them. That million is probably a hundred or more people we can’t help. We can’t cure everyone, but maybe we can make their daily life better.”

There are both negatives as well as positives to the changes, according to Jetter.

“We will see some changes in Medicaid and other programs, but it could lead to more community-based alternatives,” Jetter said.

The case management department plans to meet with each of the providers to discuss what changes and cuts need to be made. Providers could see serious changes as far as services and employment.

Chairman Brian Schmidt gave his sympathies to the mental health care providers at the meeting.

“You have a difficult job and this will only make things harder,” Schmidt said. “I commend you all for everything you do for our community.”

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