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Legislators in Iowa passed a measure expanding behavioral and mental health services for children, but advocates say the law lacks permanent funding.
Iowa will begin developing a statewide system for children’s mental health under legislation signed into law this week.
The bill, signed by Gov. Kim Reynolds on the first day of Mental Health Awareness Month, creates a regional system that coordinates mental and behavioral health care for children. It would take the same format as the state’s adult mental health system, which relies on county property taxes along with state and federal funding to pay for services.
The legislation also creates a state board to oversee the project and a 24-hour crisis hotline to help parents locate help for their children. It also allocates $1.2 million for home and community-based children’s mental health services, designed to eliminate extensive waiting lists for care. Children are eligible for care if they have a diagnosis of a “serious emotional disturbance” (substance abuse and developmental disorders don’t count), and if their family’s income totals less than 500 percent of the federal policy level.
“This landmark legislation will ensure that young Iowans, who suffer from mental illness, will be treated with dignity and respect on the journey to well-being for generations to come,” Reynolds said at the signing ceremony.
The bill was based on a strategic plan compiled by a state board last year and had broad bipartisan support in the state legislature, clearing the House 83-14 and the Senate 46-2. Advocates praised the main components of the legislation, but cautioned that it lacks longterm funding in its current form.
“I was particularly disappointed in this session that they did not address the longterm issues to make it sustainable,” Peggy Huppert, state director of the National Alliance on Mental Illness Iowa, told the Des Moines Register.
According to the bill’s financial estimate, the new system will cost $3.7 million in its first fiscal year, with Medicaid covering just $423,110. In the second fiscal year the program is expected to cost $6.4 million, with Medicaid contributing $1.3 million. The rest—and bulk—of the funding will be left to the county-based mental-health regions. That provision was a sticking point for some legislators, who voted against the bill due to its lack of more concrete funding agreements.
“It’s just a facade. It’s based on money that’s not provided,” state Sen. Rob Hogg told the Quad-City Times. “There’s less of this bill left than there is of the cathedral in Paris, and I’m really, really disappointed.”
Proponents of the plan said the funding structure was purposefully vague, designed to give each region room to hammer out its own plan.
"When you're looking at putting on services for the regions, we want to give them some flexibility," state Sen. Jeff Edler told radio station KMA. "Things aren't always stable. We've got to have flexibility, especially if you're looking at Medicaid dollars and possible fluctuations with the ACA. That's why this language is in there.“
Reynolds said she would prioritize finding a financing solution in the next legislative session. As enacted, the bill requires each region to submit to the state an implementation plan by April 1 of next year.
Kate Elizabeth Queram is a Staff Correspondent for Route Fifty and is based in Washington, D.C.