The Clinton Herald, Clinton, Iowa

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January 24, 2013

Officials work to stretch mental health dollars

CLINTON — Mental health in Clinton County faces an uncertain fate as the Mental Health Redesign takes its toll on the budget.

Revenue dropped from $9.1 million last year to $2,642,429 for Fiscal Year 2014, as presented during a budget presentation to the Clinton County Board of Supervisors this week.

“We are plugging along and trying to plan as best as we can with what we have,” Clinton County Mental Health Coordinator Becky Eskildsen said.

State legislators passed the bill on mental health and disability redesign last spring in an effort to even out services to the state. All counties will move toward a statewide average in property taxes collected for mental-health services at $47.28.

Some counties, like Clinton, will take large cuts, while others will see little change. With taxpayers going from paying $58.71 to the new rate, county officials are left stretching the budget as far as it will go. The county loses more than $10 per taxpayer leading to a $561,224 budget cut for the county’s mental health services.

Regionalization is also a big part of the plan. Mental health services will change from being managed by county supervisors to regional boards consisting of supervisors from multiple counties. Clinton has teamed up with Cedar, Jackson, Muscatine and Scott counties to form a regional mental health board. This leaves a very uncertain budget for Eskildsen to deal with.

“I don’t know what we will see in the next fiscal year,” Eskildsen said. “We are just dealing with the changes and waiting to see what happens.”

There are no increases to providers in the 2014 budget. The only services that will be funded at 100 percent county tax dollars are Sheltered Workshop Services, Residential Care Facilities, costs related to a mental health commitment and mental health services including prescription medications.

Eskildsen is recommending the county discontinue a waiting list for services in 2014. Individuals will need to access all Medicaid funded services prior to accessing county dollars as set forth in the County Management Plan.

“We will try everything we can to make them eligible for Medicaid funding,” Eskildsen said.

No dollars in the budget have been assigned to cover claims owed to the state on behalf of previous Medicaid funded services, which currently total $1.2 million. The department plans to continue to slowly pay down this amount beginning with the oldest claims.

The office budget is $238,630, which includes an increase for the Central Point of Coordination director of 2 percent and increases as set forth under the Collective Bargaining Agreement for one full-time County Social Worker and one full-time administrative assistant. General operating expenses are $12,740 to include longevity, mileage,education, postage and computer upgrades if needed.

Total projected revenue of $2,642,429 includes property taxes, State Payment Program and mental health cost recovery.

The Board of Supervisors will continue to piece together the budget with a work session on Friday at 1 p.m. As far as mental health, only time will tell.

“Hopefully this budget will make sense, we will have to wait until the end of the legislative session,” Eskildsen said.

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